Template:Peripheral nerve syndromes: Difference between revisions

Revision as of 13:47, 30 March 2017

Peripheral nerve syndromes

Median Nerve Syndromes

Ulnar Nerve Syndromes

Ulnar neuropathy at the elbow and wrist

Radial Nerve Syndromes

Radial neuropathy at the spiral groove (ie. "Saturday night palsy")
Posterior interosseous neuropathy

Proximal Neuropathies

Other

Peripheral nerve syndromes

Upper extremity
- Ulnar
  - Cause of Injury: Elbow injury.
  - Sensory changes in the 5th and medial half of 4th digits, weak wrist flexors, “claw hand”
- Radial
  - Cause of Injury: Distal humeral shaft fracture, anterior shoulder dislocation, supra-condylar fracture, Radial neuropathy at the spiral groove, Posterior interosseous neuropathy
  - “Wrist drop,” weakness of finger extensors. +/- sensory loss over the dorsum of the hand, weak thumb adduction
- Median, distal
  - Cause of Injury: Wrist dislocation, laceration, Carpal Tunnel Syndrome
  - Weak flexion of radial half of digits and thumb, loss of abduction and opposition of thumb. Ape hand deformity, benediction sign. Loss of sensation of lateral three and one-half digits and nail beds
- Median, proximal
  - Cause of Injury: Supracondylar humeral fracture, Pronator teres syndrome, Anterior interosseous neuropathy, tight cast
  - See Median, distal above, loss of forearm pronation, loss of radial half digits and thumb flexion
- Musculocutaneous
  - Cause of Injury: Anterior shoulder dislocation, entrapment due to hypertrophy
  - Elbow flexion and supination weakness, radial forearm sensory deficits
- Axillary
  - Cause of Injury: Anterior shoulder dislocation, inferior shoulder dislocation, proximal humerus fracture
  - Weak arm abduction (from 15 to 90 degrees), weak shoulder flexion, extension and rotation of shoulder, loss of sensation of upper lateral arm
Lower extremity
- Femoral
  - Cause of Injury: Pubic rami fracture, pelvic fractures
  - Weak knee extension, anterior knee sensory deficits
- Obturator
  - Cause of Injury: Obturator ring fracture, obturator nerve entrapment
  - Weak hip adduction, medial thigh sensory deficit
- Posterior tibial
  - Cause of Injury: Knee dislocation
  - Weak toe flexion, plantar foot sensory deficit
- Superficial peroneal
  - Cause of Injury: Fibular neck fracture, knee dislocation
  - Weak ankle eversion, lateral dorsal foot sensory deficits
- Deep peroneal
  - Cause of Injury: Fibular neck fracture, compartment syndrome
  - Sensory deficit at dorsal 1st web space, weak ankle and toe dorsiflexion
- Sciatic
  - Cause of Injury: Posterior hip dislocation
  - Lower leg weakness, foot drop, leg sensory deficits
- Superior gluteal
  - Cause of Injury: Acetabular pelvic fracture
  - Trendelenburg’s gait, Trendelenburg’s sign
- Inferior gluteal
  - Cause of Injury: Acetabular pelvic fracture, s/p hip replacement
  - Abnormal gait, gluteus maximus weakness resulting in gluteus maximus lurch

@@ Line 22: / Line 22: @@
 *[[Brachial plexopathy]]
 *[[Cervical rediculopathy]]
+===[[Peripheral nerve syndromes]]===
+*'''Upper extremity'''
+**'''Ulnar'''
+***Cause of Injury: [[Elbow diagnoses | Elbow]] injury.
+***Sensory changes in the 5th and medial half of 4th digits, weak wrist flexors,  “claw hand”
+**'''Radial'''
+***Cause of Injury: Distal humeral shaft fracture, anterior shoulder dislocation, supra-condylar fracture, [[Radial neuropathy at the spiral groove]], [[Posterior interosseous neuropathy]]
+***“Wrist drop,” weakness of finger extensors. +/- sensory loss over the dorsum of the hand, weak thumb adduction
+**'''Median, distal'''
+***Cause of Injury: Wrist dislocation, laceration, [[Median Mononeuropathy (Carpal Tunnel Syndrome)|Carpal Tunnel Syndrome]]
+***Weak flexion of radial half of digits and thumb, loss of abduction and opposition of thumb. Ape hand deformity, benediction sign. Loss of sensation of lateral three and one-half digits and nail beds
+**'''Median, proximal'''
+***Cause of Injury:  Supracondylar humeral fracture, [[Pronator teres syndrome]], [[Anterior interosseous neuropathy]], tight cast
+***See Median, distal above, loss of forearm pronation, loss of radial half digits and thumb flexion
+**'''Musculocutaneous'''
+***Cause of Injury: [[Anterior shoulder dislocation]], entrapment due to hypertrophy
+***Elbow flexion and supination weakness, radial forearm sensory deficits
+**'''Axillary'''
+***Cause of Injury: [[Anterior shoulder dislocation]], [[inferior shoulder dislocation]], [[proximal humerus fracture]]
+***Weak arm abduction (from 15 to 90 degrees), weak shoulder flexion, extension and rotation of shoulder, loss of sensation of upper lateral arm
+*'''Lower extremity'''
+**'''Femoral'''
+***Cause of Injury: Pubic rami fracture, [[pelvic fractures]]
+***Weak knee extension, anterior knee sensory deficits
+**'''Obturator'''
+***Cause of Injury:  Obturator ring fracture, [[obturator nerve entrapment]]
+***Weak hip adduction, medial thigh sensory deficit
+**'''Posterior tibial'''
+***Cause of Injury:  [[Knee dislocation]]
+***Weak toe flexion, plantar foot sensory deficit
+**'''Superficial peroneal'''
+***Cause of Injury:  Fibular neck fracture, [[knee dislocation]]
+***Weak ankle eversion, lateral dorsal foot sensory deficits
+**'''Deep peroneal'''
+***Cause of Injury:  Fibular neck fracture, [[compartment syndrome]]
+***Sensory deficit at dorsal 1st web space, weak ankle and toe dorsiflexion
+**'''Sciatic'''
+***Cause of Injury:  Posterior [[hip dislocation]]
+***Lower leg weakness, foot drop, leg sensory deficits
+**'''Superior gluteal'''
+***Cause of Injury: [[Acetabular pelvic fracture]]
+***Trendelenburg’s gait, Trendelenburg’s sign
+**'''Inferior gluteal'''
+***Cause of Injury: [[Acetabular pelvic fracture]], s/p hip replacement
+***Abnormal gait, gluteus maximus weakness resulting in gluteus maximus lurch