OS Compression Neuropathies

Question 1

Neuro Testing-Motor:

Shoulder Abduction

Answer 1

C5

Question 2

Neuro Testing-Motor:
Elbow:
1. Flexion
2. Extension
3. Supination
4. Pronation

Answer 2

1. C5,6
2. C7
3. C6
4. C7,8

Question 3

Neuro Testing-Motor:
Wrist:
1. Extension
2. Flexion

Answer 3

1. C6

2. C7

Question 4

Neuro Testing-Motor:
Fingers:
1. Extension
2. Flexion
3. Ab/Adduction

Answer 4

1. C7
2. C8
3. T1

Question 5

Neuro Testing-Sensation:
Peripheral:
1. Radial
2. Ulnar
3. Median

Answer 5

1. C6,7,8
2. C8, T1
3. C5,6,7,8

Question 6

Neuro Testing-Sensation:
Peripheral:
1. Musculocutaneous
2. Axillary

Answer 6

1. C5-7

2. C5,6

Question 7

Neuro Testing-Sensation:
Central:
Dermatomes?

Answer 7

C4-T1

Question 8

Neuro Testing-Reflexes:

1. C5
2. C6
3. C7

Answer 8

1. Biceps
2. Brachioradial
3. Triceps

Question 9

CNS Neuropathy test/

Answer 9

Spurlings Sign-Compression

Question 10

Spurlings test % sensitivity and specificity?

Answer 10

1. 30% sensitivity

2. 93% specificity

Question 11

Neck distraction positive test?

Answer 11

Relief of symptoms

Question 12

Another test to look for central neuropathy?

Answer 12

Valsalva maneuver

Question 13

The thoracic outlet is broken into 2 segments. What are they?

Answer 13

1. Vasculogenic

2. Neurogenic

Question 14

What structures are involved in the thoracic outlet? (3)

Answer 14

1. Brachial Plexus

2. Subclavian vein and Artery

Question 15

Think of Thoracic outlet as 3 zones-?

Answer 15

1. Scalene Triangle
2. Costoclavicular space
3. Retropectoraliz Minor (Pectoralis minor)

Question 16

What are possible compressions for thoracic outlet? (3)

Answer 16

1. First Rib and Scalenes
2. Pec Minor
3. Clavicle
   - The scalene triangle

Question 17

Brachial plexus inferior or superior of coracoid?

Answer 17

Inferior

Question 18

Brachial Plexus inf or sup of pec minor tendon?

Answer 18

Inferior

Question 19

Roos Test: EAST?

Answer 19

Elevated arm stress test

Question 20

What does Roos test for?

Answer 20

Compression of sublclavian A.

Question 21

Roos test: Pt position? Pt do?

Answer 21

Sit
Abduct shoulder -90

Ext rotate w/elbow flexed - 90

-Open close fist for 3 min. (reproduce symptoms = positive test

Question 22

Roos test % sensitive/specific

Answer 22

84% sensitive

30% specific

Question 23

Adson Maneuver tests for?

Answer 23

Compression of subclavian A. Between first cervical rib and scalenes

Question 24

Adson Maneuver: What to do?

Answer 24

1. Palpate radial pusle of affected arm
2. Extend/ext. rt shoulder while palpating
3. Extend/Rt head TPWARD affected side (1st rib etiology
4. Pt takes deep breath
5. Repeat w/AWAY Rt (Tight Scalene)

Question 25

What confirms a positive Adsons?

Answer 25

Loss or change in pulse

Question 26

Adson: Sensitivity and Specificity

Answer 26

1. Sensitivity: 18-90% | 2. Specificity: 76%

Question 27

Wrights Heyperabduction tests for?

Answer 27

Neurovascular entrapment by pec minor

Question 28

Wrights: How do you do it?

Answer 28

1. Dr. Behind pt and monitors effected side pulse | 2. Pt Abduct arm above head. W/extension`

Question 29

Positive Wrights =?

Answer 29

Change in pulse or reproduction of symptoms

Question 30

Wrights: Sensitivity/specifity?

Answer 30

Sensitivity: 90% Specificity: 29%

Question 31

Halstead: Testing for?

Answer 31

Decreased space btw rib 1 and clavicle -Costoclavicular/military test

Question 32

Halstead: How to?

Answer 32

1. Contact ipsilateral wrist at radial pulse | 2. Extend shoulder and apply caudal pressure on shoulder

Question 33

Halstead: Positive test?

Answer 33

Decrease in radial pulse

Question 34

First rib ME: General?

Answer 34

Follow exhalation Resist inhalation

Question 35

First rib Pump handle ME position?

Answer 35

Flex neck

Question 36

1st rib bucket ME position

Answer 36

Flex neck and SB towards

Question 37

Scalene MFR (Direct): position

Answer 37

SB away from effected side

Question 38

Scalene MFR: Force?

Answer 38

Perpendicular force. Wait for creep

Question 39

Scalene ME: Position

Answer 39

Same as MFR | W/ME principles

Question 40

Seated Scalene Tx w/inhalation dysfunction rib?

Answer 40

1. Oppo leg on table and drape pt oppo arm over 2. Thumb on anteromedial aspect of ant. scalene 3. rotate head 30-45 deg away from effected side 4. Hand side of affected head side. ME principles 5. Reasses rib dysfunction

Question 41

Pec minor MFR: How?

Answer 41

1. Grab moth mecs 2. Cephalad force Linear stretch to pec minor Parallel stretch to pec major

Question 42

Pec Minor MFR Dirct:

Answer 42

- Pt supine w/ affected arm abducted 180 deg w/slight distraction (linear stretch). - Apply perpendicular force into muscle - Wait for creep

Question 43

Pt home stretches: general

Answer 43

1. 5-15 sec | 2. multiple reps few times a day

Question 44

Home stretch: Pec?

Answer 44

Wall corner and push

Question 45

Home stretch scalene

Answer 45

just pull your head with arm

Question 46

Test for cubital tunnel -elbow?

Answer 46

Tinel sign

Question 47

What is Froments sign/ what does it test?

Answer 47

1. Ulnar N. 2. Paper between thumb and fingers. Pull. 3. If thumb doesn't go flat = positive test

Question 48

Carpal Tunnel N and test?

Answer 48

1. Median N. | 2. Phalen's and Tinel's test

Question 49

DTRs: Knee Achiles

Answer 49

1. L4 | 2. S1

Question 50

Common Fib N. Compression (3)

Answer 50

1. Post Fib Head 2. Gastroc/Soleus M. Dysfunction 3. Biceps Femoris M. Dysfunction

Question 51

Ant. Tarsal Tunnel Syndrome =?

Answer 51

Deep Fib. N. Compression

Question 52

Causes and Tx of Ant. Tarsal Tunnel Syndrome?

Answer 52

1. Cuboid-navicular dysfunction (Hiss whip) | 2. Extensor Retinaculum (MFR)

Question 53

Tarsal Tunnel Syndrome: Causes and Tx

Answer 53

1. Flexor Retinaculum (MFR) | 2. Eversion of SD of ankle (HVLA)

Question 54

Meralgia paresthetica N.?

Answer 54

Lat. Fem Cutaneous N.

Question 55

Meralgia Paresthetica Tx?

Answer 55

Ant. Hip Dysfuntion (Flexion SD) Tx: ME and MFR