Term
| what is the "march of recovery"? |
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Definition
| 1 inch/month or 1 mm/day speed at which nerves reconnect - which is too slow for some longer nerves if damaged, such as the sciatic. therefore you need to know the course of the nerve damaged to determine if sx will be necessary to speed up regeneration. |
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Term
| what type of nerve injury has the best prognosis? |
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Definition
| sharp b/c the nerve is cut cleanly |
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Term
| what type of nerve injury has the worst prognosis? (*know this*) |
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Definition
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Term
| what are the 3 kinds of nerve injury from a mechanical view? (*know this*) |
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Definition
| *neuropraxia (disruption of axonal flow, no discontinuity of nerve, complete recovery in hrs-wks, but acutely all nerve injury looks the same)*, axonotmesis (axonal disruption, incomplete recovery, subject to "march of recovery"), and neurotmesis (anatomic disruption, recovery always incomplete - requires sx) |
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Term
| what are the 2 common compressive neuropathies? |
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Definition
| radial nerve palsy (saturday night palsy = alcoholic falling asleep on arm = wrist drop) and peroneal nerve palsy (compression around fibular head = numb dorsum and foot drop). not just nerve compression, but vascular compression adds to this pathology. |
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Term
| what characterizes one kind of entrapment neuropathy? |
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Definition
| occipital neuritis/neuralgia involves C2 and may be treated via: injection, *OMT, and necrectomy |
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Term
| what is thoracic outlet syndrome (scalenus anticus syndrome)? (*know this*) |
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Definition
| causes: muscular(thickening of scalene)/osseous(prominent 1st rib). symptoms: vascular(subclavian compression)/nerve (brachial plexus compression). dx: **adson's maneuver - extend, rotate toward, elevate arms, and radial pulse should diminish (if positive)**. tx: section muscle, remove 1st rib |
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Term
| what is the **most common compressive neuropathy? (*know this*) symptoms? |
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Definition
| median nerve compression (carpal tunnel - transverse carpal ligament makes roof of tunnel) due to trauma or repetitive use. symptoms: **tinel's sign - finger at thenar crease at wrist and tap with reflex hammer, patients gets shock in 3 fingers** (can be done for ulnar nerve at elbow [cubital tunnel] and thoracic outlet for scalene), numbness in *first 3 fingers of the hand at night which requires shaking to correct (if from C5-T1 in neck, shaking won't help), decreased sensation to pinprick in the area of nerve distribution, and phalen's test. |
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Term
| what is diagnostic testing for median nerve compression/carpal tunnel? |
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Definition
| EMG w/nerve conduction systems, slower is a positive test |
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Term
| what is surgical tx for median nerve compression/carpal tunnel? |
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Definition
| usually last resort, includes: traditional open procedure, endoscopic procedure and retinaculotome |
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