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  • Pronator Teres Syndrome

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    api-2518191
    940 vues14 pages
    This document summarizes various peripheral nerve entrapment syndromes, including their locations, affected nerves, and provocative tests. It describes carpal tunnel syndrome, pronator syndrome, anterior interosseous nerve syndrome, radial nerve entrapment, posterior interosseous nerve syndrome, radial tunnel syndrome, superficial radial nerve entrapment, cubital tunnel syndrome, and Guyon's canal compression. Provocative tests are outlined to help identify each condition. Diagrams are provided illustrating the relevant anatomy.

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    Pronator Teres Syndrome

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    This document summarizes various peripheral nerve entrapment syndromes, including their locations, affected nerves, and provocative tests. It describes carpal tunnel syndrome, pronator syndrome, anterior interosseous nerve syndrome, radial nerve entrapment, posterior interosseous nerve syndrome, radial tunnel syndrome, superficial radial nerve entrapment, cubital tunnel syndrome, and Guyon's canal compression. Provocative tests are outlined to help identify each condition. Diagrams are provided illustrating the relevant anatomy.

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    Signaler comme contenu inapproprié
    940 vues14 pages

    Pronator Teres Syndrome

    Transféré par

    api-2518191
    This document summarizes various peripheral nerve entrapment syndromes, including their locations, affected nerves, and provocative tests. It describes carpal tunnel syndrome, pronator syndrome, anterior interosseous nerve syndrome, radial nerve entrapment, posterior interosseous nerve syndrome, radial tunnel syndrome, superficial radial nerve entrapment, cubital tunnel syndrome, and Guyon's canal compression. Provocative tests are outlined to help identify each condition. Diagrams are provided illustrating the relevant anatomy.

    Droits d'auteur :

    Attribution Non-Commercial (BY-NC)
    Téléchargez comme PPT, PDF, TXT ou lisez en ligne sur Scribd
    Signaler comme contenu inapproprié
    sur 14

    Peripheral nerve entrapment

    Provocative test
    Pronator teres Median Nerve
    Flexor carpi radialis
    Palmaris longus
    Flexor digitorum superficialis
    Abductor pollicis brevis
    ½ Flexor pollicis brevis
    Opponens pollicis
    1st lumbrical
    2nd lumbrical
    ½ Flexor digitorum profundus 1st 2nd Ligament of struther
    Pronator teres muscle
    Flexor pollicis longus AIN
    Bicipital aponeurosis (Lacertus fibrosus)
    Pronator quadratus FDS arch
    Carpal tunnel syndrome
    • Phalen test *
    • Tinel test *
    • Durkan test

    *Positive เมื่อเป็น sunderland 2 ขึ้นไป (CTS ส่วนใหญ่เป็น Sunderland 1 ส่วนน้อยเป็น 2 หรือ 3)


    * * Kaplan (success of non-operative treatment)
    * * P-R-A-G-M-A-T-I-C
    Pronator syndrome
    • PROVOCATIVE TEST
    – LIGAMENT OF STRUTER
    • resist to elbow flexion 120-135 degree

    – BICIPITAL APONEUROSIS
    • resist elbow flexion in supination position

    – TWO HEAD OF PRONATOR TERES M.


    • resist forearm pronate when elbow extension

    – FIBROUS ARCH OF FDS


    • resist flexion of PIP jt. Of middle finger
    Anterior Interosseous Nerve Syndrome

    – Pinch deformity (Spinner ‘s sign)

    *Pure motor neuropathy ( FPL, 2nd &3rd FDP, pronator quadratus)


    *DDX Parsonage Turner Syndrome
    Triceps
    Brachioraldialis
    Anconeous
    Extendor carpi radialis longus
    Extendor carpi radialis brevis
    Supinator
    Radial Nerve
    Extensor carpi ulnaris
    Extensor digitorum communis
    Extensor digiti quinti PIN
    Abductor pollicis longus
    Extensor pollicis longus
    Fibrous band of radiocapitellar joint
    Extensor pollicis brevis
    Recurrent radial artery (leash of Henry)
    Extensor indicis propius
    ECRB
    Proximal supinator (Arcade of Frohse )
    Superficial radial nerve Distal supinator
    Posterior interosseous nerve syndrome

    • Finger and thumb extension weakness*


    • Radial deviation**

    *No sensory loss


    **Intact ECRL
    Radial tunnel syndrome

    • Provocative test:
    – Pain with resist forearm supination
    – Pain at the edge of ECRB with resist middle finger extension
    Superficial radial nerve entrapment (Wartenberg syndrome)

    • Provocative test:
    – Forearm pronation with ulnar flexion
    – Pressure over junction of brachioradialis/ECRL

    *Cheiralgia paresthetica
    *แยกจาก radial nerve 8 cm เหนือ radial styloid
    *ถูกกดจาก BR กับ ECRL
    *DDx de Quervain ‘s disease
    Flexor carpi ulnaris
    ½ Flexor digitorum profundus 3rd 4th
    Abductor digiti minimi
    Ulnar Nerve
    Opponens digiti minimi
    Flexor digiti minimi
    3rd & 4th lumbrical

    1st -3rd palmar interosseous Deep Motor br.


    1st -4th dorsal interosseous
    ½ Flexor pollicis brevis Arcade of struther
    Medial intermuscular septum
    Adductor pollicis
    Medial epicondyle
    Cubital tunnel
    Dorsal cutaneous branch Osbourne ‘ s ligament
    Palmar cutaneous branch Flexor pronator aponeurosis
    Superficial terminal branch
    Cubital tunnel syndrome

    • Provaocative test:
    Elbow flexion-forearm supination-wrist extension

    Symptom developed
    in 1 min = + ve

    Elbow Flexion
    Test
    Guyon ‘s canal compression
    • Zone 1: motor+ sensory
    • Zone 2: motor+/- sensory
    • Zone 3: sensory
    END

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