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Peripheral Nerve inj
per NBCOT Study Guide, 6th ed. pgs 145-147
| Question | Answer |
|---|---|
| Carpal Tunnel Syndrome (CTS) | Median nerve compression - most common compression injury -- numbness/tingling thumb, index, middle, and radial half of the ring fingers -- PT will complain of dropping things -- parasthesias usually occur at night |
| Pronator Teres Syndrome (proximal volar forearm) | Median nerve compression between 2 heads of pronator teres -- symptoms same as CTS + aching in proximal forearm |
| Carpal Tunnel Syndrome treatment | Conservative: wrist splint in neutral, median nerve gliding and tendon gliding exercises, activity modification, ergonomics Surgical: CTR |
| Pronator Teres Syndrome treatment | Conservative: elbow splint at 90 w/ forearm in neutral, activity modification, Surgical: decompression of nerve |
| Guyon's canal | Ulnar nerve compression at wrist -- numbness/tingling ulnar nerve distraction, motor weakness, postive tinel's at wrist |
| Guyon's canal treatment | Conservative: splint wrist in neutral, act. mod. Surgical: decompression |
| Cubital tunnel syndrome | Ulner nerve compression at the elbow -- 2nd most common compression injury -- numbness/tingling along ulnar aspect of forearm and hand, pain @ elbow with extreme position of flexion, weakness of power grip |
| Cubital tunnel syndrome treatment | Conservative: Elbow splint to prevent extreme flexion, act. mod. Surgical: decompression or transposition |
| Radial Nerve Palsy | Radial nerve compression (Saturday Night Palsy) -- can occur with fx's to humeral shaft -- weakness/paralysis of extensors to wrist, MCP's & thumb |
| Radial nerve laceration classic sign | Wrist drop -- loss of extensors at wrist, MCP's & thumb |
| Radial Nerve Palsy / laceration treatment | Conservative: dynamic extension splint, act. mod. Surgical: decompression |
| Median nerve laceration | Sensory loss to central palm - thumb to radial 1/2 ring finger |
| Median nerve laceration classic sign - low lesion | Ape hand -- low lesion -- loss of lumbricals I & II (MCP flexion of digits I & II), Opponens pollicis, Abductor pollicis brevis --(flexion of thumb MCP) -- flattening of thenar eminence |
| Median nerve laceration classic sign - high lesion | Benediction sign - inability to flex index and middle finger, voluntary flexion of ring and small finger |
| Ulnar nerve laceration | Ulnar aspect of palmar and dorsal surface -- loss of power grip, decreased pinch strength |
| Ulnar nerve laceration classic sign | Claw hand -- loss of lumbricals III, IV (causes MCP flexion of ring and small fingers), loss of ADM, ODM, FDM (causes ABd, opposition and flexion of small finger) |
| Compare/Contrast Benediction Sign with Claw Hand | Both look similar: BS: affects index & middle fingers, unable to flex CH: affects ring & small fingers, can flex index & middle fingers |
| Radial nerve laceration - low | forearm level - loss of wrist ext due to impaired/absent ECU, loss of MCP extension, & thumb extension |
| Radial nerve laceration - high | Above the elbow -- all of low level + loss of ECRB, ECRL & brachioradialis |
Created by:
msmaus
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