DOCSLIB.ORG

MEDIAN NERVE COMPRESSION in the CARPAL TUNNEL on September 23, 2021 by Guest

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
MEDIAN NERVE COMPRESSION in the CARPAL TUNNEL on September 23, 2021 by Guest Postgrad Med J: first published as 10.1136/pgmj.24.271.264 on 1 May 1948. Downloaded from 264 POST GRADUATE MEDICAL JOURNAL May 1946 portant that the physiotherapist should supervise Mrs. G. F., aged 53, housewife. The right and the movements and make sure that the metacarpal left bones were excised in November, I945 (Fig. I). is again moved through a full active range at the She is now very satisfied and has no pain, but new joint. states that her hands are not quite so strong for This treatment is continued until the patient turning taps as previously. The radiographs can return to light work, which is usually a matter taken in January, 1948, show a satisfactory result of four to six weeks. Some patients complain of on 'the right, but on the left a fragment of the pain for longer than this, but others are surpris- trapezium remains in situ (Fig. 5). It is interest- ingly pain free; one started milking cows within ing to note how this fragment has increased in a month of operation. size since the film taken one year after operation (Fig. 6). Results and Case Reports Miss E. W., aged 46, sempstress. Four years of All the patients have been very satisfied with the pain and difficulty in carrying out her work. The results of the operation, and have reported im- right trapezium was excised in April, 1944. She proved function and little or no pain. Removal has been working full time since with no pain. of the trapezium leaves the thumb a little weaker Miss N., aged 58. Symptoms following an in- than the normal, but a full range of movement of jury nine months before. Pain on using. left the metacarpal is regained with no obvious thumb and a marked cystic swelling over the deformity. trapezio-metacarpal joint (Fig. 3). The trapezium Mr. E. B., aged 48, farm worker. Pain and swel- was excised in April, i944. In 1948 she reported ling at the base of the right thumb which he dated that her thumb was quite satisfactory and she from an injury two years before. The right was very pleased that she had undergone the trapezium was excised in April, 1944. He worked operation. full time after this, but attended again in I947, Mr. Q. W., aged 62, retired, is an example of ihe complaining of pain in the left thumb (Fig. 2). results in older patients. He gave a history of in The left trapezium was excised February, 1947. pain over a period of five years. with unsuccessfulby copyright. He was able to do full work inside two months and treatment by physiotherapy. The right trapezium has been doing full farm work since. He states was excised in February, 1947. He now amuses there is no pain and he can do anything. On himself sawing up logs. examination in January, I948, there was a full and painless range of movement with good power in BIBLIOGRAPHY GERVIS, W. H. ('947), Proc. Roy. Soc. Med., 40; 492. both thumbs, but slight crepitus on movement on RAY, M. B. (I933), Proc. Roy. Soc. Med., 27, I93. the right side (Fig. 4). FORESTIER, J. (1927), La Presse Medicale. http://pmj.bmj.com/ MEDIAN NERVE COMPRESSION IN THE CARPAL TUNNEL on September 23, 2021 by guest. Protected By P. H. NEWMAN, D.S.O., M.C., F.R.C.S. Assistant Orthopa dic Surgeon, The Middlesex Hospital, A4sista at Surgeon, Thv Royal National Orthopaedic Hospital- The carpal tunnel is a very confined space. It and the hook of the hamate, and on the lateral has been designed as a trough with a hard floor side, of the tubercle of the scaphoid and the ridge and rigid bony walls in order to protect the im- on the trapezium, have stretched across between portant structures within its confines. But for their peaks a fibrous sheet forming a roof known this anatomical arrangement, it is unlikely that the as the transverse carpal ligament. This is a tough flexor tendons with their delicate sheaths and the structure giving additional protection and acting median nerve could withstand the trauma of re- as a bar to forward prolapse of the structures when current falls on the outstretched hand. The walls, the wrist is in fiexion. which consist on the the medial side of the pisiform The tendons and nerve pass from the loose en- Postgrad Med J: first published as 10.1136/pgmj.24.271.264 on 1 May 1948. Downloaded from May 1948 NEWMAN: Median Nerve Compression in the Carpal Tunnel 265 vironment of the soft tissues ofthe forearm through a directly traumatic nature. Briefly speaking the this bottleneck into the comparative freedom of the changes in order of severity are: palm. As the price of protection from exposure to I. Oedema of nerve without loss of conductivity. danger at this point, they forfeit as it were their 2. Transient paralysis with spontaneous liberty of expansion and freedom of movement recovery. other than that which is essential for the function 3. More severe loss of function with slow of the hand and fingers. There is no place for an recovery after release of pressure. abnormal body or for any hypertrophic process 4. Complete loss of conductivity without the within this tunnel. possibility of recovery, due to total nerve Acute compression of the median nerve at this degeneration. level occurs from forward dislocation of the lunate Recently Brain, Wright and Wilkinson (I947) bone (Fig. i), and may occasionally occur in other have described symptoms of carpal tunnel com- injuries of the carpus with displacement. In a pression of the median nerve arising spontaneously comminuted Colles' fracture a fine spicule of bone in six patients. In no case was there any obvious may project forwards between the flexor tendons encroachment upon the space of the tunnel. The and impinge directly on the median nerve. A patients were all women in the second half of life more insiduous onset of symptoms due to com- and five were occupied in household duties. pression may occur as a result of hypertrophic Experimentally a tambour was placed in the arthritis of the wrist as from an old fracture of the carpal tunnel of a cadaver and it was found that scaphoid (Fig. 2), or even from a malunited Colles' the tension was three times greater when the wrist fracture. In these cases there is some process was extended to a right angle than when flexed to which takes up space within the tunnel and undue the same degree. They point out that the duties pressure falls upon the normal contents. The of a housewife necessitates much work with the tendons derive some protection from their sheaths wrist in the extended position and they consider and do not register symptoms of lateral com- that this, combined with some degeneration in pression unless it be severe. The nerve has no the artery of the nerve, is responsible for the com- by copyright. such sheath, is anchored laterally and is sus- mencement of a vicious circle of oedema and in- ceptible to alteration in pressure. creasing tension. Denny-Brown and Brenner (I944) in two articles have given the results of experiments in which Clinical Types different degrees of pressure were applied to peri- Clinically three types of compression of the pheral nerves. They found that the effect on con- median nerve in the carpal tunnel are found. ductivity of the nerve varies considerably according Firstly, an acute traumatic type associated with to the degree of pressure and the length of time injuries such as anterior dislocation of the lunate during which it is applied. The pressure plate bone; the symptoms recover with replacement of http://pmj.bmj.com/ was i i mm. in length. In one series of experi- bone, provided that this is not delayed too long. ments, if a light pressure of 5 to 7 gm. was applied Secondly, slow compression of the nerve of continuously there was no interference of con- spontaneous onset. Thirdly, slow compression duction, but narrowing of the nerve occurred at secondary to malunion or arthritis in the region. the site of pressure with swelling above and below the site of pressure. An increased pressure of 9 Symptoms and Signs of Slow to io gm. was attended with impairment of motor Compression function within six days and progressed to com- The symptoms are generally those of weakness of on September 23, 2021 by guest. Protected plete paralysis shortly afterwards. If, however, the hand and loss of the power to grip, especially the pressure was continued, the nerve overcame with the thumb. There may be a history of drop- this critical stage and function returned slowly. ping such articles as a cup of tea or saucepan. At the site of pressure, ischaemic and degenerative Tingling or pins and needles are felt over the changes took place, but there was no nerve or median nerve distribution. Pain is common and muscle degeneration distal to this area. extends from the thumb or index finger below, to Continued pressure for several days of 44 gm. the forearm, upper arm or even to the neck above; was followed by complete loss of all conductivity it is worse at night and aggravated by carrying and degeneration of the nerve both distally and for heavy objects. It is sometimes relieved by working some distance proximally. Release of pressure was the fingers and wrist backwards and forwards. not followed by return of function. Compression The following signs may be found in cases of by much greater pressure, e.g.
Load more

Recommended publications
  • An Unusual Cause of Pseudomedian Nerve Palsy
    Hindawi Publishing Corporation Case Reports in Neurological Medicine Volume 2011, Article ID 474271, 3 pages doi:10.1155/2011/474271 Case Report An Unusual Cause of Pseudomedian Nerve Palsy Zina-Mary Manjaly, Andreas R. Luft, and Hakan Sarikaya Department of Neurology, University Hospital Zurich, Frauenklinikstraße 26, 8091 Zurich,¨ Switzerland Correspondence should be addressed to Zina-Mary Manjaly, [email protected] Received 20 July 2011; Accepted 9 August 2011 Academic Editors: J. L. Gonzalez-Guti´ errez,´ V. Rajajee, and Y. Wakabayashi Copyright © 2011 Zina-Mary Manjaly et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We describe a patient who presented with an acute paresis of her distal right hand suggesting a peripheral median nerve lesion. However, on clinical examination a peripheral origin could not be verified, prompting further investigation. Diffusion-weighted magnetic resonance imaging revealed an acute ischaemic lesion in the hand knob area of the motor cortex. Isolated hand palsy in association with cerebral infarction has been reported occasionally. However, previously reported cases presented predominantly as ulnar or radial palsy. In this case report, we present a rather rare finding of an acute cerebral infarction mimicking median never palsy. 1. Case median nerve, which was normal (Figure 1(c)). Magnetic resonance imaging (MRI) on the same day revealed a small A 60-year-old woman presented to the emergency depart- diffusion restriction in a part of the left precentral gyrus that ffi ment with di culty in moving the thumb, index, and middle is known as “the hand knob” area (Figure 1(d))[2].
    [Show full text]
  • Is the Diagnosis Written in the Palm?
    CLINICAL Is the diagnosis written in the palm? Compression neuropathy from a walking frame Anupam Datta Gupta ANSWER 1 cause significant functional limitations. The diagnosis is compression neuropathy In late cases where the hand muscles of the right ulnar nerve and bilateral have already undergone atrophy, the CASE carpal tunnel syndrome at the wrist. motor recovery of those muscles, even A man aged 72 years requires a walking Pigmentation, callosity and atrophy on the after surgical decompression, may frame for mobility because of weakness ulnar side (hypothenar) of the right hand be incomplete. For early diagnosis of of both legs secondary to poliomyelitis. are indicative of ulnar nerve compression compression neuropathies, it is important He presents to the rehabilitation around the Guyon’s tunnel. This is either to routinely look at the hands of patients medicine outpatient clinic with soreness caused or exacerbated by the excessive who are taking increased weight through and weakness of both hands, which he pressure around the wrist during walking their hands because of a lower extremity developed following the use of the walking with the frame. Wasting of the first web problem and using mobility aids. If not frame. He also complains of loss of grip space caused by denervation of the picked up early, compression neuropathies strength and tingling of his hands. He is first dorsal interosseous and adductor can compound the disability. using the heel of the hand to manipulate pollicis muscles is a telltale sign of ulnar objects. Examination reveals skin neuropathy. On the left hand, the pressure ANSWER 3 pigmentation and callosities on the ulnar areas are around the carpal tunnel, causing To establish a diagnosis, the patient side of both palms, distal to the wrist crease median nerve compression.
    [Show full text]
  • Tendon Transfer for Triple Nerve Paralysis of the Hand in Leprosy
    Lepr Rev (2002) 73, 319±325 Tendon transfer for triple nerve paralysis of the hand in leprosy ELAINE MCEVITT & RICHARD SCHWARZ Green Pastures Hospital, Box 5, Pokhara, Nepal Accepted for publication 27June 2002 Summary Paralysis of ulnar, median and radial nerves is seen in less than 1% of those affected with leprosy. This condition is a particular challenge for the surgeon, physiotherapist, and patient. A retrospective chart review was conducted at the Green Pastures Hospital and Rehabilitation Centre (GPHRC) and Anandaban Leprosy Hospital (ALH) in Nepal, and results were graded by the system outlined by Sundararaj in 1984. Thirty-one patients were identi®ed, and 21 charts were available for review. Excellent or good results were obtained in 93% of patients for wrist extension, 85% of patients for ®nger extension, 90% of patients for thumb extension, 71% of patients for intrinsic reconstruction, and 63% of patients for thumb opposition reconstruction. These results are reasonable but inferior to those obtained by Sundararaj in his study. Surgical intervention offers a very signi®cant improvement in function in these very dif®cult hands. Intensive physiotherapy is required both pre- and postoperatively. Introduction Hansen's disease results from infection with Mycobacterium leprae with subsequent involvement of skin, nerve, and mucosal tissue. Nerve damage occurs in 20±25% of patients.1 In the upper limb the nerve paralysis most frequently affects the ulnar nerve. Median nerve dysfunction may occur later or develop simultaneously, most frequently affecting the distal innervation (simian hand).2 High radial nerve involvement is least common (wrist drop), with 1% of patients having combined ulnar, median, and radial paralysis (triple nerve palsy).1,2 The typical pattern is that of high radial nerve palsy combined with high ulnar nerve and low median nerve loss.
    [Show full text]
  • Brachial Plexus Injuries: an Interactive Teaching and Learning Academic Model
    International Journal of ChemTech Research CODEN (USA): IJCRGG, ISSN: 0974-4290, ISSN(Online):2455-9555 Vol.11 No.03, pp 01-08, 2018 Brachial plexus injuries: An interactive teaching and learning academic model Tarek M. El-gohary1,2*, Samiha M. Abdelkader3 1) Biomechanics Department, Faculty of Physical Therapy, Cairo University, Egypt 1) Board Certified Orthopedic Clinical Specialist, USA 1) Mechanical Diagnosis& Therapy, McKenzie Institute, USA 1) Pediatric Physical Therapy Consultant, NY,NY,USA 2) College of Medical Rehabilitation Sciences, Taibah University, Saudi Arabia 3) Physical Therapy Department, College of Applied Medical Science, King Saud University, Saudi Arabia Abstract : The purpose of this educational paper is to report the feedback from academics and students regarding newly introduced interactive teaching- learning model aiming to master brachial plexus injuries. An interactive questions and answers format was presented to number of academics and students at college of medical rehabilitation sciences. All academics and 90% of students reported that the newly introduced interactive teaching- learning model was helpful. It has been concluded that the interactive teaching- learning model is feasible and self- explanatory to be used and adopted by students and academics to facilitate the educational process. Keywords : Brachial plexus, injuries, teaching, learning, educational model. Introduction Brachial plexus is a group of intertwined nerves that emerge from the spinal cord in the cervical region and travel down the
    [Show full text]
  • A Randomized Controlled Trial
    Int J Physiother. Vol 8(2), 143-149, June (2021) ISSN (P): 2349-5987, ISSN (O): 2348-8336 ORIGINAL ARTICLE Mulligan Versus Conventional Neurodynamic Mobilization in Patients with Cervical Radiculopathy - A Randomized Controlled Trial *1Amita Aggarwal, (Ph.D.) 2Ruvitte Gomes 3Tushar J Palekar, Ph.D IJPHY ABSTRACT Background: Cervical radiculopathy is a type of neck disorder. Here a nerve root in the cervical spine becomes inflamed or impinged, resulting in neurological functions. They may radiate anywhere from the neck into the shoulder, arm, hand, or fingers. While the clinical diagnostic tests of cervical radiculopathy are well established in the literature, studies finding the usefulness of rehabilitation interventions are few. Therefore, the objective of the present study was to compare the effectiveness of mulligan mobilization versus conventional neurodynamics in cervical radiculopathy. Methods: 30 subjects with age group 30 – 55 years who were clinically diagnosed with cervical radiculopathy &having one Upper Limb Tension Test positive were included in the study. They were randomized to Mulligan Neurodynamic Mobilization Group or Conventional Neurodynamics Group. The treatment sessions (3 repetitions, 3 sets) in both groups lasted for 5 consecutive days. Outcomes were measured using the Numerical Pain Rating Scale(NPRS) for pain, Cervical ranges, and patient-specific functional scale (PSFS) for disability. Results: Wilcoxon test was used for within-group whereas the Mann-Whitney test was used for between-group comparisons. The test revealed similar improvements in pain and disability in both groups (p>0.05); however, the Mulligan Neurodynamic Mobilization Group showed better results in terms of cervical ranges (p<0.05). Conclusion: Both the techniques were equally effective, but Mulligan Group had better cervical ranges, especially extension, rotation, and lateral flexion.
    [Show full text]
  • Ulnar Nerve and Median Nerve Neuropathy in the Cyclist See Also Ulnar Neuropathy See Also Median Nerve Compression See Also Peripheral Neuropathy
    Ulnar Nerve and Median Nerve Neuropathy in the Cyclist See also Ulnar neuropathy See also Median nerve compression See also Peripheral neuropathy Background 1. General info o Overuse injuries occur in cyclists who regularly ride, especially those involved in competition o Ensuring that bike fit is correct is major factor in preventing overuse syndromes 2. Definitions o Ulnar neuropathy . Compression of ulnar nerve at wrist "handlebar palsy" o Median neuropathy . Compression of median nerve in carpal tunnel Pathophysiology 1. Pathology of dz o Ulnar neuropathy . Compression of ulnar nerve at Guyon's canal in wrist . Motor/sensory symptoms or both o Median neuropathy . Compression of median nerve at carpal tunnel from Direct pressure on handlebars and/or stretch of median nerve d/t hand and wrist extension . Paresthesias and/or motor function deficit 2. Incidence/ prevalence o Actual incidence unknown o Study of 25 cyclists . 23 cyclists reported subjective motor and/or sensory symptoms after extended cycling tour 3. Risk factors o Mountain bikers have more symptoms than road bikers o Forward position on bike causing extra wt distribution on hands . Predisposing fit issues Handlebars too low Saddle too far forward Saddle tilted down Handlebar stem too long o Extended time cycling o Rough terrain producing trauma and/or vibration 4. Morbidity/ mortality o Long term morbidity can be reduced and prevented in most cases by . Early recognition and prevention of further compression Bicycling-Ulnar & Median Nerve Neuropathy Page 1 of 5 8.23.07 Diagnostics 1. History o Ulnar neuropathy (at hand and wrist) . Sensory symptoms in fifth digit and medial half of fourth digit Paresthesias Hypoesthesia Hyperesthesia .
    [Show full text]
  • Tendon Transfers for Nerve Palsies
    Tendon Transfers for Nerve Palsies Comprehensive Hand Review Course American Association of Hand Surgeons Annual Meeting, Friday January 23rd, 2015 Atlantis in Paradise Island, Bahamas Amy M. Moore, MD Washington University School of Medicine I. Introduction Functional deficits after nerve injury are determined by the specific nerve involved and location of the injury. Reconstruction of function after nerve injury is dependent on time from injury, presence of concomitant injuries (bone and soft tissue) and availability of donors (i.e. redundancy of function). Definition: Tendon transfer – transfer of a functional muscle-tendon unit to replace a lost or missing muscle-tendon unit in order to restore motion or balance to the wrist and/or hand. II. Principles In order for successful return of function, certain principles should be considered: Tissue Equilibrium: Resolution of Wound Healing, Bony Union, and Correction of Contractures Local tissue should be in optimal condition: soft, mobile, no evidence of induration Full passive joint ROM is necessary preoperatively . This may require contracture releases, therapy and splinting Avoid transfers across scar tissue and skin grafted areas. Plan incisions to place tendon junctions beneath flaps rather than beneath incisions or scars Expendable Donor Avoid downgrading function with unacceptable donor loss Patients’ needs vary for “priority” Goal: maintain at least one wrist flexor (not PL alone), wrist extensor, extrinsic finger flexor and extensor. Adequate Strength Goal: balance of power Consider: lost muscle strength, donor muscle strength and remaining counterbalance strength Force is proportional to muscle cross sectional area at resting length Expect the muscle to lose one grade of strength after transfer Try to avoid using previously denervated muscle Appropriate Excursion Tendon Excursion must match for function Proportional to fiber length Methods to Augment “effective” Excursion: .
    [Show full text]
  • Diagnosis of the of the Extremities
    Postgrad Med J: first published as 10.1136/pgmj.22.251.255 on 1 September 1946. Downloaded from DIAGNOSIS OF THE COMMON FORMS OF NERVE INJURY OF THE EXTREMITIES By COLIN EDWARDS, M.B., B.S., M.R.C.P., D.P.M. History-taking is the first step in diagnosis and panying diminution or loss of reflexes. In the it is useful to know how varied the causes of peri- absence of an external wound or contusion near the pheral nerve injuries can be. Otherwise the true nerve concerned these muscle changes may be the nature of a traumatic lesion sometimes may not only guide. be suspected. Look first at the most peripheral muscles and The commoner ones are the result of:- particularly those which move the hands and feet. (I) Cutting and laceration. If these are normal (indicating an intact nerve (2) Stretching, which may be sudden (e.g. supply) it is uncommon, although not impossible, stretching of the sciatic by jumping upon the for muscles to be involved whose supply leaves extended foot) causing fibre rupture and those same nerves at a more proximal level. And haemorrhage, or prolonged (e.g. lying with the proximal involvement with normal peripheral arm extended for hours above the head) muscles only occurs close to the actual spot where ischaemia. causing the nerve is injured. The state of innervation of Contusion. the muscles moving the hands and feet gives no (3) to that of the limb (4) Concussion (including that produced by a guide, however, girdle muscles,Protected by copyright. "near miss" when a missile passes through as they are supplied by comparatively short nerves neighbouring tissues without touching the nerve).
    [Show full text]
  • Distal Ulna Fracture with Delayed Ulnar Nerve Palsy in a Baseball Player
    A Case Report & Literature Review Distal Ulna Fracture With Delayed Ulnar Nerve Palsy in a Baseball Player Charles B. Pasque, MD, Clark Pearson, ATC, Bradley Margo, MD, and Robert Ethel, BS a high and inside pitched ball from a right-handed pitcher Abstract struck the volar-ulnar aspect of his right forearm. Examina- We present a case report of a college baseball player tion in the training room and emergency department revealed who sustained a blunt-trauma, distal-third ulna fracture moderate swelling and ecchymosis over the distal third of the from a thrown ball with delayed presentation of ulnar ulna. He had a normal neurovascular examination, including nerve palsy. Even after his ulna fracture had healed, the normal sensation to light touch and normal finger abduction/ nerve injury made it difficult for the athlete to control a adduction and wrist flexion/extension. He was otherwise baseball while throwing, resulting in a delayed return to healthy. Radiographs of the right forearm showed a minimally full baseball activity for 3 to 4 months. He had almost displaced transverse fracture of the distal third of the ulna complete nerve recovery by 6 months after his injury (Figures 1A, 1B). and complete nerve recovery by 1 year after his injury. The patient was initially treated with a well-padded, remov- able, long-arm posterior splint for 2 weeks with serial exami- nations each day in the training room. At 2-week follow-up, he reported less pain and swelling but stated that his hand lnar nerve injury leads to clawing of the ulnar digits had “felt funny” the past several days.
    [Show full text]
  • Mrcp Paces Manual
    MRCP PACES MANUAL Louise Pealing MA Hons (Cantab) MBBS MSc MRCP MRCGP General Practitioner and Clinical Research Fellow, Nuffield Department of Primary Care Health Sciences, University of Oxford Benjamin Mullish MB BChir MA (Cantab) MRCPAFHEA Specialty Registrar/Academic Clinical Fellow, Gastroenterology and Hepatology, St Mary’s Hospital, London Philip J Smith BMedSci (Hons) BMBS (Hons) MRCP MSc (Nutrition) Gastroenterology Specialist Registrar and MRC Clinical Research Training Fellow Gastroenterology Department, University College London Hospital, London Edited by Douglas C Macdonald BM (Hons) BSc (Hons) MRCP PhD Consultant Hepatologist, Royal Free London NHS Foundation Trust Royal Free Hospital, London Contents Preface vi Introduction vii STATION 1 ^ Respiratory and Abdominal Examinations 1 The abdominal examination 3 Abdominal scenarios 7 The respiratory examination 47 Respiratory scenarios 52 STATION 2 ^ History-Taking Examination 71 History-taking scenarios 77 STATION 3 ^ Cardiovascular and Neurological Examinations 169 The cardiovascular examination 170 Cardiovascular scenarios 175 The neurological examination 220 Neurological scenarios 241 STATION 4 ^ Communication skills and Ethics’ Examination 353 Approach to the communication skills and ethics station 355 Communication skills and ethics scenarios 359 STATION 5 ^ Integrated Clinical Assessment 393 Approach to Station 5 398 Integrated clinical assessment scenarios 407 Abbreviations 599 Index 605 v Station 3 Neurological scenarios 1. Multiple sclerosis 17. Median nerve palsy 2. Parkinson’s disease 18. Ulnar nerve palsy 3. Motor neuron disease 19. Radial nerve palsy 4. Hemiparesis 20. Common peroneal nerve 5. Spastic paraparesis palsy and L4–5 root lesions 6. Cervical myelopathy 21. Nystagmus 7. Syringomyelia/Syringobulbia 22. Ophthalmoplegia 8. Myotonic dystrophy 23. Visual field defect 9. Myasthenia gravis 24.
    [Show full text]
  • Fingerprints June 2021
    Fingerprints June 2021 Fingerprints June 2021 Table of Content Editors’ Note What about radial tunnel syndrome? Poster: Counterforce brace for tennis elbow (by Nico Magni) Featured Article - Thumbelina - a case study (By Leigh Law) Educational opportunities Consent for clients’ information and images 2 Editors’ Note Kia Ora Colleagues, We are back with another edition of fingerprints. In this edition, we shine the spotlight on our occupational therapists colleagues. The latest issue of the occupational therapy newsletter OTInsight had a hand therapy focus. Selected articles will be showcased in this and coming editions. We would like to remind our colleagues of the Hand Therapy Conference in Dunedin, September 2021. See you there!!! Last and certainly not least, we would like to beseech you, our readers, to utilise this platform. It is with your help that we can further improve upon the content in subsequent editions. The success of the newsletter is tied to the contributions of the hand therapy community. Nico and myself would be delighted to hear from you and to showcase articles, splinting and clinical pearls which will enrichen the discourse. We can be contacted at [email protected]. 3 What about radial tunnel syndrome? Radial tunnel syndrome: definition, distinction and treatments. Bo Tang, J. (2020) Level of Evidence: 5 Follow recommendation: Type of study: Diagnostic, Therapeutic Topic: Posterior interosseous nerve entrapment - Radial tunnel syndrome vs PIN syndrome This is a narrative review on radial tunnel syndrome (RTS) and posterior interosseous nerve syndrome (PINS). These two presentations are both entrapment neuropathies of the posterior interosseous nerve, however, RTS is a mild entrapment neuropathy while PIN is a severe entrapment neuropathy (similar to mild vs severe carpal tunnel syndrome).
    [Show full text]
  • B.Sc. NEUROSCIENCE TECHNOLOGY COURSE • 2019
    Revised Ordinance Governing Regulations and Curriculum of B.Sc. NEUROSCIENCE TECHNOLOGY COURSE • 2019 Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore 1 The Emblem The Emblem of the Rajiv Gandhi University of Health Sciences is a symbolic expression of the confluence of both Eastern and Western Health Sciences. A central wand with entwined snakes symbolises Greek and Roman Gods of Health called Hermis and Mercury is adapted as symbol of modern medical science. The pot above depicts Amrutha Kalasham of Dhanvanthri the father of all Health Sciences. The wings above it depicts Human Soul called Hamsa (Swan) in Indian philosophy. The rising Sun at the top symbolises knowledge and enlightenment. The two twigs of leaves in western philosophy symbolises Olive branches, which is an expression of Peace, Love and Harmony. In Hindu Philosophy it depicts the Vanaspathi (also called as Oushadi) held in the hands of Dhanvanthri, which are the source of all Medicines. The lamp at the bottom depicts human energy (kundalini). The script “Devahitham Yadayahu” inside the lamp is taken from Upanishath Shanth i Manthram (Bhadram Karnebh i Shrunuyanadev…), which says “May we live the full span of our lives allotted by God in perfect health” which is the motto of the Rajiv Gandhi University of Health Sciences. 2 3 REVISED ORDINANCE GOVERNING REGULATIONS & CURRICULUM OF B.Sc. NEURO SCIENCE TECHNOLOGY - 2019 1. Eligibility for admission: A candidate seeking admission to the BSc. Neuro Science Technology shall have studied English as one of the principal subject during the tenure of the course and shall have passed: 1. Two year Pre-University examination or equivalent as recognized by Rajiv Gandhi University of Health Sciences with, Physics, Chemistry and Biology as subjects of study.
    [Show full text]