BIOL 4376 Study Guide - Final Guide: Carpal Tunnel Syndrome, Carpal Tunnel, Muscle Tone

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Published on 29 Jul 2020
Department
Course
1
Basic Sensory Function Assessment
Assess patient’s ability to detect different stimuli (pain, light touch, vibratory sensation)
Technique
Ask patient to close his/her eyes; start distally and work proximally, comparing
left/right sides of body
Ask patient to identify when and where he/she is touched using:
Light touch (gauze/tissue, cotton)
Pain (sharp objects - blund end of a Q-tip)
Vibration (vibrating tuning fork over a bone)
Normal finding: “sensory function: light touch, pain, vibration intact”
Abnormalities
Carpal tunnel syndrome: compression of median nerve within the carpal tunnel
Sensory impairment occurs in the first 3 digits and some of the 4th digit;
pain may be felt in the palm, anterior wrist, forearm, and proximally to the
shoulder
Causes: obesity, pregnancy, workplace factors (i.e. repetitive hand and
wrist se, sustained wrist pressure)
Peripheral neuropathy (polyneuropathy): symmetrical damage to peripheral
nerves
Causes: diabetes mellitus, drug-induced from neurotoxic medications (i.e.
cisplatin, vincristine)
Screening tool: monofilament test
Also looking for any ulcers on the feet.
Basic Motor Function Assessment
Observe involuntary muscle movements:
Abnormalities
Asterixis (aka “liver flap”) caused by hepatic encephalopathy
Dystonia, resting tremor caused by Parkinson’s disease
Observe muscle characteristics
Muscle tone: resistance to passive stretch
Instruct the patient to relax the extremity, support and stabilize joint
Provide passive flexion, extension, abduction and adduction
Abnormalities
Rigid tone: found in Parkinson’s disease
Flaccid tone: found in comatose patients
Muscle strength
Hold extremity appropriately
Instruct patient to push then pull against resistance; rate strength according
to scale
Normal finding: “Muscle strength = 5+
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Document Summary

Assess patient"s ability to detect different stimuli (pain, light touch, vibratory sensation) Ask patient to close his/her eyes; start distally and work proximally, comparing left/right sides of body. Ask patient to identify when and where he/she is touched using: Pain (sharp objects - blund end of a q-tip) Vibration (vibrating tuning fork over a bone) Normal finding: sensory function: light touch, pain, vibration intact . Carpal tunnel syndrome: compression of median nerve within the carpal tunnel. Sensory impairment occurs in the first 3 digits and some of the 4th digit; pain may be felt in the palm, anterior wrist, forearm, and proximally to the shoulder. Causes: obesity, pregnancy, workplace factors (i. e. repetitive hand and wrist se, sustained wrist pressure) Peripheral neuropathy (polyneuropathy): symmetrical damage to peripheral nerves. Causes: diabetes mellitus, drug-induced from neurotoxic medications (i. e. cisplatin, vincristine) Also looking for any ulcers on the feet. Asterixis (aka liver flap ) caused by hepatic encephalopathy.

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