Neurology > Lesson2 > Flashcards

Lesson2 Flashcards

(53 cards)

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1
Q

Cervical Plexus Superficial Branches

A
  1. Lesser Occipital
  2. Great Auricular
  3. Transverse Cervical
  4. Supraclavicular
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2
Q

Cervical Plexus Deep branches

A
  1. Ansa Cervicalis Sup
  2. Ansa Cervicalis Inf
  3. Phrenic
  4. Segmental Branches
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3
Q

Lesser Occipital O/D

A

O: C2
D: Posteroinferior head, post to ear

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4
Q

Great Auricular O/D

A

O: C2-C3
D:Ant/inf to ear, over parotid gland

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5
Q

Transverse Cervical O/D

A

O: C2-C3
D: Anterior neck

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6
Q

Supraclavicular O/D

A

O: C3-C4
D: Superior Chest/shoulder

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7
Q

Ansa Cervicalis Sup O/D

A

O: C1
D: Infrahyoids

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8
Q

Ansa Cervicalis Inf root O/D

A

O: C2-C3
D: Infrahyoids

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9
Q

Phrenic O/D

A

O: C3-C5
D: Diaphragm

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10
Q

Segmental Branches O/D

A

O: C1-C5
D: Prevertebral, lev scap, mid scalenes

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11
Q

What do Compression Syndromes of Peripheral Nerves result in?

A
  • Conduction block in the peripheral nerve, but no structural damage to the axon or tissue distal to the lesion
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12
Q

Compression syndromes of peripheral nerve symptoms

A

Numbness, tingling, pain, weakness

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13
Q

Compression syndromes of peripheral nerves symptoms due to

A
  • Impaired oxygenation (ishemia) of nerve
  • Impaired local neural conduction
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14
Q

Erb-Duchenne Palsy

A
  • Injury to superior roots of Brachial Plexus (C5-C6)
  • Traction injury
  • Forceful pulling of head away from shoulder
  • No senation over lateral arm (Loss of C5-C6 dermatomes
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15
Q

Erb-Duchenne Palsy
Waiter’s Tip Position

A
  • Arm Adducted
  • Medial rotation
  • Elbow extended
  • Forearm pronated
  • Wrist and fingers flexed
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16
Q

Klumpke’s Paralysis

A
  • Traction injury to lower brachial plexus
  • Poor positioning at birth or pulled with forceps
  • Median and ulnar lesions
  • Claw hand
  • Sensory loss for C8-T1 dermatomes
  • Can get Horner’s Syndrome
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17
Q

Horner’s Syndrome

(On affected side)

4 points

A
  • Miosis - constriction of pupil
  • Ptosis - Drooping of eyelid
  • Anhydrosis - Loss of sweating to face and neck
  • Enophthalmos - Recession of eyeball into orbit
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18
Q

TOS

A
  • Compression of brachial plexus from structures in thoracic outlet
  • Thoracic outlet runs from Interscalene triangle to inferior border of axilla
  • Subclavian artery and vein may also be compressed
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19
Q

TOS Path

A
  • Brachial plexus travels with subclavian artery between anterior and medial scalene
  • Subclavian vein joins in after scalenes and then whole bundle goes under clavicle and the pec minor inserstion and down arm
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20
Q

TOS Symptoms

A
  • Pain, numbness, weakness, tingling in arm/upper thoracic area, or scapula
  • Trophic changes in tissue with blood vessel compression
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21
Q

TOS Locations

4 points

A
  1. Cervical Rib (additional rib at C7)
  2. Anterior Scalene Syndrome
  3. Costoclavicular Syndrome
  4. Pectoralis Minor Syndrome
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22
Q

Cervical Rib syndrome

Study These Flashcards
A
  • Additional Rib at C7
23
Q

Anterior Scalene Syndrome

Study These Flashcards
A
  • Compression b/w anterior and middle scalene
24
Q

Interscalene Triangle

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A
  • Anterior Scalene
  • Middle Scalene
  • Rib 1
  • Brachial Plexus and subclavian artery pass through. (Subclavian vein is anterior)
25
Costoclavicular Syndrome
* Compression b/w clavicle and rib 1
26
Pectoralis Minor Syndrome
* Compression b/w coracoid process and pec minor
27
Radial nerve branches before?
Supinator
28
Radial nerve Posterior Motor Branch "Posterior Interosseous nerve"
* Enters supinator and travels down lateral radius to wrist
29
Radial Nerve Superficial Branch
* Travels down the posterior forearm to hand
30
Radial Nerve Lesion Causes
* Fractures - at spiral/radial groove * Dislocations - Head of radius, humeroradial, radial ulnar jt * Post-surgical complications * Compression
31
Radial Nerve Lesion Symptoms
* Altered sensation at posterior arm and hand (digits 1, 2, 3, lateral 4) * Wrist drop * If injury proximal to elbow - motor and sensory affected * If injury distal to elbow - only sensory OR motor affected
32
Crutch Palsy
* Radial nerve compression at axilla
33
Saturday Night Palsy
* Radial Nerve Lesion at spiral groove * Direct pressure against firm object * Deep sleep on arm (passed out on hard surface)
34
Posterior Interosseous Syndrome
* Comes off in front of lateral epicondyle * Motor nerve * Wrist drop * Compression underneath supinator
35
Cheiralgia Parasthetica
* Compression of superficial branch of radial nerve under brachioradialis tendon * Sensory * Pain at dorsum wrist, thumb, webspace * Cause: trauma, tight cast, swelling
36
36
Median Nerve Lesion Causes
* Fractures at elbow, wrist, carpals * Dislocations at elbow, wrist, carpals * Compressions * Trauma
37
Ape Hand
* Median Nerve lesion * Thumb in same plane as rest of hand due to no opposition * Wasting of thenar eminence
38
Oath Hand
* Median Nerve Lesion * Only digits 4 and 5 can flex when trying to make a fist
39
Median nerve lesion symptoms
* Can't grasp objects * Can't pronate forearm, Flex PIP, DIPS of digits 2,3 (no air quotes) * Weak wrist flexion, weak thumb movements * Altered sensation digits 1,2,3, half of 4 (palmar)
40
Median Nerve Lesion Locations
* Ligament of Struthers * Pronator Teres * Carpal Tunnel
41
Ligament of Struthers
* From abnormal spur on shaft of humerus to medial epicondyle * Median nerve compressed as it passes under * Only in 1% of population
42
Pronator Teres Syndrome
* Median Nerve Lesion * Compressed at proximal attachment of Pronator Teres * Aching in anterior forearm * Numbness in thumb/index finger * Weakness in thenar eminence
43
Anterior Interosseous Syndrome
* Branch of Median Nerve * Pinched/entrapped between 2 heads of pronator teres * Pain and motor loss of Flex pollicis longus, lateral 1/2 FDP, and pronator quadratus * Paralysis of flexors in index finger and thumb
44
Carpal Tunnel Syndrome
* Most common entrapment condition in arm
45
Carpal Tunnel Formed by
* Carpal bones * Flexor retinaculum (attaches to scaphoid tubercle and trapezium)
46
Structures that pass through Carpal Tunnel
* Median Nerve * Flexor Digitorum Superficialis * Flexor Digitorum Profundus * Flexor Pollicis Longus
47
Two ways compression can occur at carpal tunnel
1. Size of tunnel decreases * Bony callus, space occupying lesion, RA bony changes 2. Size of contents passing through increases * Repetitive actions, edema, fibrosis * Retinaculum thickening from scar tissue (repeated trauma) * Systemic conditions causing edema/fluid retention
48
Ulnar Nerve path at the wrist/hand
* Travels over flexor retinaculum b/w pisiform and hook of the hamate (guyon's canal)
49
Ulnar Nerve Lesion Causes
* Fractures (medial epicondyle, midforearm, wrist) * Dislocations (elbow) * Compression * Repetitive actions * Direct trauma
50
Ulnar Nerve Lesion Symptoms
1. Ulnar Claw Hand * baby finger hyperextended and abducted at MCP and flexed at IP * Ring finger hyperextended at MCP and flexed at IP * Atrophy of interosseous membrane 2. mm wasting of hypothenar 3. Altered sensation of little finger + medial half ring finger 4. Fromont's sign positive
51
Froment's Sign
* Hold paper b/w thumb and index finger * Adductor pollicis (innervated by ulnar nerve) needed for this * Patient flexes thumb instead, using flexor pollicis longus
52
Tardy Ulnar Palsy
* Complication of fracture at elbow * Occurs years after fracture * Callus formation or valgus deformity of elbow * Produces gradual stretching of the nerve in the ulnar groove at medial epicondyle
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