Radiology - Haemorrhage- Intra-axial
- Extra-axial
- Extradural
- Usually from middle meningeal artery
- Bi-concave
- Never crosses suture lines
- Strips dura away
- Check for a fracture!
- Subdural
- From bridging veins
- Crosses sutures
- Tracks dural reflections - Look for "blood lines" - high intensity lines
- Falx cerebri
- Tentorium cerebelli
- Crescent shape
- Common in older people
- Contraction => More subdural space => Longer bridging veins
- Subarachnoid
- From arteries
- Basal cisterns highlighted
- Sulci, sylvian fissure highlighted
Peripheral neuropathies- Mononeuritis multiplex
- Ssimultaneous or sequential involvement of individual noncontiguous
nerve trunks, either partially or completely
- Evolves over days to
years
- Typically presents with acute or subacute loss of sensory and
motor function of individual nerves
- The pattern of involvement is asymmetric
- Mononeuropathy
- Peripheral polyneuropathy
- Sensory
- Motor
- Sensory-motor polyneuropathy
Median nerve- Thenar muscles
- Opponens policis
- Make a ring between thumb + little finger
- Abductor policis brevis
- Flexor policis brevis
- Anterior interosseous nerve
- Supplies terminal flexors of thumb + index finger
- Isolate joint, flex + resist
Ulnar nerve- 1st dorsal interosseous
- 1st thing to go => Check muscle bulk!
- Forearm flexors
- ALL the interossei
- Hold piece of paper between fingers (both of you)
- Pull apart
- Damage:
- Leaning on your elbow (protected only by skin)
- Supracondylar fracture
Radial nerve
- Extensors
- HARD-CORE - Should not ever be able to overcome
- => Posterior interosseous nerve => Finger extensors
Leg stuff
- Meralgia paresthetica
- Compression of lateral cutaneous femoral nerve of thigh
- => numbness or pain in the outer thigh
- Caused by entrapment or compression where it passes between the ilium and the inguinal ligament near the attachment at the ASIS
- Causes:
- Weight gain (belly roll)
- Pistol
- Tight underwear
- Roots
- L1,2,3 => Femoral
- Check hip flexion + knee extension
- c.f. buckling gait
- L4,5,S1 => Sciatic
- => Tibial nerve (posterior leg)
- => Common peroneal nerve
- => Superficial peroneal nerve (lateral
compartment - peroneus longus and peroneus brevis)
- => Deep peroneal nerve (anterior compartment - tibialis anterior, EHL, EDL, peroneus tertius)
- Common peroneal nerve wraps round the fibular head => Risk of injury
Falx cerebri / Tentorium cerebelli Notes- Electrophysiology parameters
- CV - Conduction velocity
- DML - Distal motor latency
- SL - Sensory latency
- Put the muscle in action; Resist the action
- Susceptibility to neuropathy
- Diabetes
- Hereditary neuropathy with liability to pressure palsies
- Myelin deficiency due to peripheral myelin protein 22 mutation
- Alcohol
- Vitamin B12 deficiency
- Median nerve entrapment in CTS occurs at the DISTAL CREASE OF THE WRIST
- Femoral nerve runs ABOVE the inguinal ligament in 15% of people => Susceptible to injury
- Sensory supply to the hand:
|
|
