Nerve Compression

Where do spinal nerves arise?

Spinal cord

How can spinal nerves be compressed?

By bulging IVDs

What are peripheral nerves?

All nerves outside the brain and spinal cord, including cranial nerves and spinal nerves

Where would you check for median nerve sensation?

Palm

Where would you check for radial nerve sensation?

Dorsal first web space (snuff box)

Where would you check for ulnar nerve sensation?

Anywhere ulnar on hand

Median nerve roots

C5-T1 medial and lateral cords

Median nerve supply

Main: Abductor Pollicis Brevis

Radial nerve roots

C5-T1 posterior cord

Radial nerve supply

Main: Extensor Carpi Radialis Longus/Brevis

Ulnar nerve supply

C8-T1 Medial cord

Ulnar nerve supply

Main: Interossei

Abductor Pollicis Brevis movement

Abduct thumb

ECRL/B movement

Extends wrist/fingers

Interossei movement

Finger abduction

Damage to the which nerve leads to carpal tunnel syndrome?

Median

Symptoms of carpal tunnel syndrome

• Pain and altered sensation in a median nerve distribution

• Can waken patients at night

• Worse when the wrist is flexed

• Patients classically say shaking their hand relieves symptoms “to get the circulation back”

Physical examinations for carpal tunnel syndrome

• Thenar wasting

• Tinsel’s test

• Phalen’s test

What diagnoses carpal tunnel syndrome?

Nerve conduction studies which are graded 0-6

Non surgical treatments for carpal tunnel syndrome

Splints and steroid injections

Surgical treatments for carpal tunnel syndrome

Carpal tunnel decompression

What nerve damage can cause guyon’s canal syndrome

ulnar nerve compression

Guyon’s canal symptoms

• Numbness and tingling

• Pain

• Weakness

Test for Guyon’s canal

Tinel’s test over ulnar palm

Non surgical treatment for guyon’s canal

Splint

Steroid injection

Surgical treatment for Guyon’s canal

Guyon’s canal decompression

Which nerve damage causes cubital tunnel syndrome?

Ulnar

Cubital tunnel syndrome symptoms

Reduced sensation of ulnar nerve in hand

Intrinsic muscle weakness and wasting

Test for cubital tunnel syndrome

Tinel’s at elbow

Non surgical treatment for cubital tunnel syndrome

Splints

surgical treatment for cubital tunnel syndrome

Cubital tunnel decompression