Fundamentals of Pain Medicine Quotes

“Lateral femoral cutaneous nerve; anatomical path and sensory area innervation. Lateral femoral cutaneous neuropathy is also known as meralgia paresthetica.”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“The lateral femoral cutaneous nerve is purely sensory, derived from the L2 and L3 nerve root. It passes just medial and inferior to the anterior superior iliac spine, where it is accessed for a nerve block. The nerve then passes beneath the inguinal ligament. It enters the thigh and supplies sensation to the anterolateral aspect of the thigh, starting just below the hip (Fig. 2-21).”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“Myelopathy is any functional disturbance and/or pathologic change in the spinal cord.”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“The most common sites of spinal canal stenosis in the lower lumbar region are L4–L5 and L5–S1. There is no cord to be impinged at these levels, as the spinal cord usually ends at L1, thus the nerve roots only are impinged. Lumbar spine stenosis may result in radicular pain, neurogenic claudication, or both”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“a vertebral body slips out of alignment, perfect symmetry is lost and the spinal canal becomes narrowed at that area (Fig. 2-17). This phenomenon is known as spondylolisthesis (spon-dee-low-lis-THEE-sis), spondylo meaning spine, and listhesis meaning slippage.”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“the patient has had surgery, it is necessary to order an MRI with contrast to help differentiate between new pathology and scar tissue.”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“Motor testing on physical examination also helps identify which nerve root may be affected. If there is weakness in the biceps, this indicates C5 and C6, whereas triceps weakness is C7. If a patient also has upper motor neuron signs on examination (increased reflexes, increased tone, fasciculations, clonus), it indicates that not only the nerve root is affected but the spinal cord may be involved.”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“when paresthesia is felt into the thumb, it is the C6 nerve root; when it goes into the middle finger, it is the C7 nerve root; and when paresthesia is felt into the pinky, it is the C8 nerve root”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“Figure 2-13 Motor testing for lower-extremity radicular level. A: Quad strength corresponding to the L4 nerve root. B: Dorsiflexion corresponding to L5 nerve root. C: Plantar flexion corresponding to the S1 nerve root.”
― J.D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients

“Motor testing also helps identify which nerve root may be the source of the problem. If there is weakness in quadriceps strength, it indicates that the L4 nerve root may be affected. Weakness on dorsiflexion indicates that the L5 nerve root may be affected, whereas plantar flexion weakness is indicative of an S1 radiculopathy (Fig. 2-13). A good way to help remember these is as follows. “Quad” means four—L4. Bending five toes toward the patient (dorsiflexion) tests L5. Pressing down on the gas (plantar flexion) of a new S1 Porsche tests S1. A positive straight-leg test is a nonspecific sign for lumbar disc herniation. The patient experiences pain in the back when”
― J. D. Hoppenfeld, Fundamentals of Pain Medicine: How to Diagnose and Treat your Patients