Raghavendra Nayak OMS IV

Anatomy Etiology Symptoms Case

Spinal column Cervical Vertebrae Cervical Spinal Nerve Roots

7 Vertebral Bodies Zygapophyseal Joints Uncovertebral Joints Intervertebral Joints

Intervertebral Foramina Nerve Roots

Degenerative Changes Disc Herniations Trauma

AKA Spondylosis Age related changes Possible pathophysiology

Pathophysiology MRI Studies

Root avulsion due to trauma More common in younger population

Pain Paresthesias Weakness Reflexes

Lhermitte’s Spurling’s

Root Numbness Weakness Reflex

C5 Lateral arm Elbow Flexion Biceps

C6 Lateral forearm Wrist Extension Brachioradialis

C7 Middle finger Elbow Extension Triceps

C8 Medial forearm Finger Flexion

T1 Medial elbow Finger Adduction

45 y/o male presenting for a consult for weakness of the left upper extremity.

CC: Continued weakness and atrophy of muscles of Left arm and forearm.

Course of injury: Dec 2011 - Suffered a “stinger” to his left upper extremity while playing basketball. Feb 2012 – couldn’t lift a gallon of milk, couldn’t do pushups, noticed his left arm was smaller than his right. Feb 2012 – EMG with Dr. Andary. March 2012 Surgery.

Physical Exam pertinent positives: Left arm and forearm smaller than right.

No paresthesias, dysesthesias. Denies numbness, tingling or pain.

Weakness (4/5) in shoulder abduction, elbow flexion, wrist extensors on the left side. MSR 2/4 bilaterally at triceps, 1/4 at brachioradialis and biceps on left, 2/4 at brachioradialis and biceps on the right.

Diagnosis