UE peripheral nerve entrapments Flashcards
WHat do nerves need (3 things)
Space, large amounts of blood flow and movement. If impaired results in symptoms
With nerve compression what occurs at a cellular level
Neuroinflammation, increased tunnel pressure, blood backed up into vein and fascicle, ischemia, scarring and axonal compression and degeneration
Mechanical pressure on a nerve results in what symptoms
N/T and weakness. NOT PAIN.
PAin is a result of ischemia and hyperalgesia from neurogenic inflammation
Recovering from nerve pressure based on what variables
Severity of compression, number of sites compressed, health of the nervous system
Median nerve levels
Ulnar nerve levels
Radial nerve levels
C5-T1
C7-T1
C5-C8
Median nerve injuries can occur as a result of
Cervical radiculopathy
CTS
Whiplash
Shoulder dislocation
Humeral fx
Bicep rupture
Carpal tunnel syndrome demographics
Older
Women- 3x more likely than men
3% of general adult population
Changes in blood flow with median nerve
Only need a change in 30mmHg to restrict blood flow to nerve and cause ischemia and pressure to back up. With full wrist flexion and extensin pressure increase is roughly 30mmHg
Ulnar nerve pathological considerations
cervical radic
FOOSH
SHoulder dislocation
Humerus fx
Cubital tunnel
Ulnar nerve ULTT (B) changes in pressure
With bending of the elbow- 4times the pressure on the nerve
Ulnar nerve after chemo/radiation
Can result in scarring around ulnar nerve and may be prominent in axilla
Radial nerve pathological considerations
Cervical radic
Stroke as a result of hemiplegic shoulder
Humerus fx
Saturday night palsy
Radial tunnel syndrome
Double crush syndrome
Sensitized nervous system results in sick neurons and can result in risk of neural entrapment elsewhere down the chain
Can also happen in reverse
NCT controversies
-50% result in false negatives
-Less accurate on small nerve fibers
-Nerves can be mechanosensitive without axonal damage
- Not good with immediate compressions
