Neuro
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| Claw Hand | show | ulnar nerve (medial cord C8 & T1 ventral rami) supplies FLEXOR CARPI ULNARIS, MOST SMALL HAND MUSCLES & SKIN OVER MEDIAL HAND & FINGERS) | fracture of med. epicondyle, mid-forearm or Colle's; elbow dislocation; post-sx complication; leprosy; compression from handcuffs, motorcycling; repetitive strain; contusion or laceration at wrist or hand | towel roll on palmar side to support hand/digits; tx C/spine -> unaffected arm -> affected arm; PROM (flex. & adduct. of MCP, extens. 4th & 5th IPs); AFROM (later stage 75% regeneration, have them push objects away using 4th & 5th digits)
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| show | affected scapula located further down midline than unaffected side; SYMPTOMS- paralysis of rhomboids | dorsal scapular nerve (C4 & C5 ventral rami) supplies RHOMBOIDS & part of LEVATOR SCAPULAE | (blank) | (blank)
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| Sciatic Nerve injury (aka Piriformis Syndrome) | pain in low back or hip radiating down posterior thigh and into leg; | show | compression of piriformis muscle; herniation of lumbar IV disc which compresses & compromises either L5 & S1 nerve root | focus on glutes, greater trochanter (spoking); TP -> piriformis, glute max, min & med), hold/relax -> seg. stretch to glute med. then heat; jt play (anter. glide to hip/sacrum; friction anywhere along piriformis followed by ice. End with thorough flush
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| Winged Scapula | injury to long thoracic nerve; scapula prominent when patient presses hands against wall; medial border moves lateral & posterior; arm unable to abduct above horizontal position | show | (blank) | (blank)
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| Musculocutaneous Nerve injury | weakened elbow flexion; SYMPTOMS- paralysis of coracobrachialis, biceps & brachialis; loss of sensation on lateral surface of forearm | musculocutaneous nerve (C5, C6, C7 spinal nerves) supplies all mm in anterior compart. - coracobrachialis, biceps & brachialis. Terminal branch -> lateral antebrachial cutaneous nerve which supplies lateral side of forearm | uncommon but may be inflicted by weapon | show 🗑
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| Obturator Nerve Injury | show | obturator nerve (L2, L3, L4) supplies ADDUCTOR muscles of thigh | pelvic surgery | (blank)
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| Saphenous Nerve Injury | show | saphenous nerve arise from femoral nerve (L2, L3, L4 ventral rami) & it's the terminal cutaneous branch, which supplies skin & fascia of anteromedial aspect of KNEE, LEG & FOOT | (blank) | (blank)
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| show | median nerve injury; 2nd & 3rd digits of hand remain partially extended when attempting to make a fist; flaccidity in opponens pollicis thus unable to oppose esp. medial rotation; atrophy of forearm flexors & thenar mm; causalgia (burning sensation) | median nerve (C6,C7 spinal nerves is lateral cord + C8,T1 spinal nerve is medial cord) supplies skin over lateral hand bisecting 4th digit, FLEXORS of forearm EXCEPT FLEX. CARPI ULNARIS & ulnar 1/2 of FDP | perforating wound in elbow region -> fracture or dislocation @ elbow, wrist or carpal bones (lunate & scaphoid). Compression-> fibrosis & hypertonicity: CTS/Pronator Teres synd.. Trauma-> traction, contusion, laceration at wrist & hand | elevate limb above heart. MLD. Towel roll <-> first 2 digits to increase adduction
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| Thoracodorsal Nerve Injury | show | thoracodorsal nerve (C6,C7,C8 spinal nerves) supplies latissimus dorsi | vulnerable during sx of inferior axilla | (blank)
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| Axillary Nerve Injury | show | Axillary nerve (C5,C6 spinal nerves) supplies TERES MAJ., DELTOID & SHOULDER JT | damage during dislocation of shoulder or fracture of prox. humerus | (blank)
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| Drop Foot | injury to common peroneal nerve; foot & toes drag on floor when walking; loss of ankle dorsiflex.& foot eversion. SYMPTOMS-> paralysis of all mm in anterior & lateral leg, loss of sensation on anterolat. leg & dorsum of foot; steppage gait for clearance | common fib. nerve is LATERAL branch of sciatic nerve @ 1/2 way down thigh (L4-S3). It supplies extensor & abductor mm, knee jt & skin of distal 3rd of anterior leg, dorsum of foot & all digits | show | (blank)
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| Wrist Drop | radial nerve injury; inability to extend wrist & digits @ MCP jts. Minimal sensory loss. SYMPTOMS -> elbow flexed, hand pronated, thumb adducted | Radial nerve (C5-T1) arise from posterior cord of brachial plexus. It supplies all extensor mm of upper limb-> triceps, anconeous, all extensors | show | towel roll under wrist & in elbow crease. Treat C/spine -> unaffected arm -> affected arm. PROM in early stage for wrist extension, fingers & thumb. AFROM in later stage (75% regeneration) of piano playing exercise
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| Superior Gluteal Nerve Injury | gluteus medius limp (Trendelenburg gait). Weakened thigh abduction, severely impaired medial thigh rotation | Superior gluteal nerve (L4,L5,S1) supplies glute med, glute min & tensor fascia lata | (blank) | show 🗑
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| Tibial Nerve Injury | inability to plantarflex ankle &/or flex toes. SYMPTOMS-> paralysis of flexor mm, intrinsic mm of sole of foot & loss of sensation on sole of foot | show | uncommon but can be injured by deep lacerations or wounds | (blank)
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| Tarsal Tunnel Syndrome | entrapment of tibial nerve in ankle. | re: tibial nerve injury | caused by edema & tightness in ankle involving synovial sheaths of tendons of mm in posterior leg compartment. | show 🗑
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| show | SYMPTOMS-> pain along lateral side of leg & dorsum of ankle & foot; possible numbness & paresthesia w/ increased activity. Paralysis of all mm in anterior & lateral leg (nerve severed); loss of sensation on anterolat. leg & dorsum of foot | Superficial fibular nerve supplies FIBULARIS LONGUS & BREVIS, DISTAL 3RD OF ANTERIOR LEG, DORSUM OF FOOT & ALL DIGITS EXCEPT LATERAL SIDE OF 5TH & 1ST INTERDIGITAL CLEFT | recurrent stretching of nerve - chronic ankle sprains | (blank)
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| Pronator Teres Syndrome | show | median nerve (C6-T1) supplies skin over lateral hand bisecting 4th digit & forearm flexors EXCEPT Flexor Carpi Ulnaris | entrapment of median nerve | (blank)
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| Cubital Tunnel Syndrome | show | re: claw hand | ulnar nerve compression in cubital tunnel. Tendinous arch joining humeral/ulnar heads of attachments of Flexor Carpi Ulnaris | (blank)
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| Carpal Tunnel Syndrome | entrapment of median nerve. SYMPTOMS-> paresthesia, hypoesthesia, anesthesia in lateral 3 & 1/2 digits; progressive loss of coordination & strength in thumb; eventually radiates into forearm & axilla | show | lesion reduces size of carpal tunnel | (blank)
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| Guyan's Canal Syndrome | entrapment of ulnar nerve AT WRIST | show | compression of ulnar nerve | (blank)
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