Flashcards in RADICULOPATHY AND PLEXOPATHY Deck (14)
What are the clinical features of any radiculopathy?
Pain - severe, sharp, shooting and/or burning pain radiating into the dermatome or myotome supplied by the root. Aggravated by movement, straining or coughing.
Lower motor neurone lesion signs
Sensory impairment in affected dermatome
What is the most common radiculopathy in the cervical spine?
What are the muscles affected by a C7 radiculopathy?
Wrist and finger extensors
What are the reflexes affected by a C7 radiculopathy?
What is the most common radiculopathy affecting the lumbar spine?
L5 and S1 due to lateral prolapse of L4/5 and L5/S1
What are the symptoms of L5 or S1 radiculopathy?
Low back pain
Pain radiating down the buttock and lower limb
What are the movements affected by a L5 radiculopathy?
Extension of the big toe
What are the movements affected by a S1 radiculopathy?
Plantar flexion at the ankle
What are the classic clinical features of cauda equina compression due to a central lumbar disc protrusion?
Low back pain
Radiation down the legs
Lower motor neurone weakness of the legs and feet
How do you treat cauda equina compression?
Imaging and decompression
What are the clinical features of neuralgic amyotrophy?
Severe shoulder muscle pain followed 2-7 days later by rapid wasting and weakness in the proximal muscles of the arms
Can be bilateral
Loss of tendon reflexes
Minor sensory impairment
What are the features of thoracic outlet syndrome (cervical rib)?
Caused by a fibrous band or cervical rib stretching the lower part of the brachial plexus (C8, T1).
Pain along the ulnar border of the forearm and sensory loss initially in the distribution of T1, with wasting of the thenar muscles predominantly.
Can develop vascular syndrome with compression of subclavian artery or vein - unilateral Raynaud's, loss of radial pulse on abduction and external rotation of shoulder (Adson's sign)
What is the treatment of cervical rib (thoracic outlet syndrome)?