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MSK 4 > Peripheral Nerve Injuries Of UE (2) > Flashcards

Peripheral Nerve Injuries Of UE (2) Flashcards

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1
Q

What is mononeuropathy?

A

Damage to selected peripheral nerves like the median nerve (traumatic or non traumatic)

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2
Q

What is polyneuropathy?

A

Metabolic (diabetes or alcoholic)

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3
Q

What is Grade 1 neuropraxia?

A

Focal segmental demyelination (full recovery)

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4
Q

What is grade 2 axonotmesis?

A

Axon damaged with intact Endoneurium (full recovery)

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5
Q

What is grade 3 axonotmesis?

A

Axon and Endoneurium damaged with intact Perineurium (partial recovery)

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6
Q

What is grade 4 axonotmesis?

A

Axon, Endoneurium, and Perineurium damaged with intact Epineurium (no recovery, requires surgery)

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7
Q

What is grade 5 neurotmesis?

A

Complete nerve transection (no recovery, requires surgery)

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8
Q

What is a grade 6 injury?

A

Mixed nerve injury

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9
Q

How can PNI be diagnosed?

A

Using electromyography combined with nerve conduction study

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10
Q

What are some involuntary activation that occurs with PNIs?

A

Fibrillation potential and fasciculations

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11
Q

What pain occurs with PNIs?

A

Burning

Primarily distal

Projected or referred

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12
Q

Where can the median nerve be damaged?

A

Carpal tunnel (most common)

Pronator teres

Anterior interosseus

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13
Q

What are the motor loss involved with pronator teres syndrome?

A

Flexor pollicis longus

Flexor digitorum profundus (1 and 2)

Pronator quadratus

Opponens pollicis

Flexor pollicis brevis

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14
Q

What is the sensory loss involved in the pronator teres syndrome?

A

Thenar eminence and digits 1-3 (possibly 4 too)

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15
Q

What are the special tests of pronator teres syndrome?

A

+ pronator teres syndrome test

+ tinels in forearm

  • phalens
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16
Q

What is the sensory loss in anterior interosseus syndrome?

A

No sensory loss but have aching

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17
Q

What is the motor loss in anterior interosseus syndrome?

A

Flexor pollicis longus

Flexor digitorum profundus (1 and 2)

Pronator quadratus

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18
Q

What are the sensory loss of carpal tunnel syndrome?

A

Median nerve distribution except for the thenar eminence

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19
Q

What is the motor loss of carpal tunnel syndrome?

A

Atrophy of thenar muscles

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20
Q

When do patients with carpal tunnel syndrome complain of paresthesia?

A

At night or with increased use of

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21
Q

What are the special tests for carpal tunnel syndrome?

A

Pain radiating distal to proximal

Report dropping objects

+ tinels at wrist

+ phalens and reverse phalens

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22
Q

What are the provocative tests of carpal tunnel syndrome?

A

Phalens

Tinels

CCT

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23
Q

What is the clinical prediction rule of carpal tunnel syndrome?

A

Hand shaking improves symptoms

Wrist-ratio index > .67

Symptom severity score > 1.9

Diminished sensation in median sensory field 1

Age > 45

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24
Q

Where can the ulnar nerve be damaged?

A

Cubital tunnel (elbow)

Guyons canal (wrist)

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25
What is the second most common peripheral nerve injury?
Cubital tunnel syndrome
26
What are the sensory losses of cubital tunnel syndrome?
Sensory deficits at the 5th digit and ulnar 1/2 of 4th digit
27
What are the motor losses of cubital tunnel syndrome?
Atrophy of ulnar intrinsics
28
What are special tests for cubital tunnel syndrome?
+ elbow flexion test + tinels at cubital tunnel
29
What are sensory losses of Guyans canal syndrome?
Limited to palm
30
If there is Guyons canal at zone 1 what do you lose?
Motor and sensory
31
If there is Guyons canal at zone 2 what do you lose?
Motor only
32
If there is Guyons canal at zone 3 what do you lose?
Sensory only
33
What are special tests for Guyons canal syndrome?
+ phalens and reverse phalens + tinels at Guyons canal + froments sign + wartenbergs sign
34
Where are the locations where the radial nerve is damaged?
Upper arm lesion Posterior interosseus Radial tunnel Wartenbergs syndrome
35
What is an upper arm lesion caused by?
Fractures or prolonged compression (crutch or Saturday night palsy)
36
Where is sensory loss in an upper arm lesion if the lesion is at the spiral groove?
Dorsum of hand and 1st two digits (most common)
37
Where is motor loss in an upper arm lesion if the lesion is at the spiral groove?
Weakness distal to tricep (wrist drop)
38
Where is sensory loss in an upper arm lesion if the lesion is proximal to the spiral groove?
Posterior arm, posterior 1/3 forearm, Dorsum of hand, and web space
39
Where is motor loss in an upper arm lesion if the lesion is proximal to the spiral groove?
Triceps
40
What causes posterior interosseus syndrome?
Fracture or RA
41
Where does posterior interosseus syndrome occur?
Arcade of froshe
42
What are the sensory losses in posterior interosseus syndrome?
None
43
What are the motor losses in posterior interosseus syndrome?
Supinator Wrist extensors
44
How does the wrist present in posterior interosseus syndrome?
Radial deviation with wrist extension
45
What is present in radial tunnel syndrome?
Lateral elbow pain below epicondyle (no sensory or motor losses)
46
Where does wartenbergs syndrome most commonly occur?
Where the nerve exits the Musculotendinous junction of the brachioradialis and ECR
47
What is the sensory loss of wartenbergs syndrome?
Dorsal radial wrist and hand (worse with pronation, wrist/finger flexion, and ulnar deviation)
48
What is motor loss to wartenbergs syndrome?
None
49
What nerve is damaged if there is an ape hand presentation?
Median
50
What nerve is damaged if there is a bishops (Benedict) hand?
Ulnar
51
What nerve is damaged if there is a claw or intrinsic minus hand?
Combined median and ulnar
52
What nerve is damaged if there is a wrist drop?
Radial
53
Where does thoracic outlet syndrome occur?
Between scalenes (no venous) 1st rib and clavicle Pec minor
54
What is interventions for thoracic outlet syndrome?
Posture education Stretching/strengthening to improve posture
55
How does an axillary nerve injury occur?
Dislocation
56
What are the sensory losses to axillary nerve injury?
Lateral deltoid (axillary patch)
57
What are the motor losses to axillary nerve injury?
Teres minor and deltoid
58
What causes a suprascapular nerve injury?
Direct blow or cyst
59
What is a suprascapular nerve injury often mistaken for?
RC tear
60
What are the sensory losses of a suprascapular nerve injury?
None
61
What are the motor losses of a suprascapular nerve injury?
RC weakness (atrophy of Supra and Infraspinatus)
62
What is a sign that someone has a suprascapular nerve injury?
Deep burning worse with horizontal adduction
63
How can you get a long thoracic nerve injury?
Idiopathic or fall on your side
64
What is presentation of someone with a long thoracic nerve injury?
Winging and aching
65
What are the nerve injuries that are considered birth injuries?
Brachial plexus birth palsy Klumpke
66
What is affected in brachial plexus birth palsy?
C5-C6 roots
67
What is affected in a kempke?
C7, C8, and T1
68
What is the shoulder presentation in erbs palsy (C5-6)?
Extended, IR, and slightly abducted
69
What may denervated muscles require?
Support like splinting or AAROM
70
What has been shown to not be beneficial in nerve injury rehab?
Electrical stimulation
71
What should be controlled early in nerve injuries?
Inflammation
72
What should be prevented in nerve injuries?
Overstretching denervated muscles or injured nerve Prevent joint contractures
73
What type of strengthening exercises should be used for nerve injuries?
Low load (avoid muscle fatigue or failure)

MSK 4 (24 decks)

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