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NMSP - Exam 2 > Approach to Peripheral Neuropathies > Flashcards

Approach to Peripheral Neuropathies Flashcards

1
Q

What feeds nerves with nutrients and blood?

A

Vasa Nervorum

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2
Q

If a peripheral nerve is myelinated it has a ____ conduction speed

A

FAST

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3
Q

If a peripheral nerve is unmyelinated, it has a ____ conduction speed

A

Slow

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4
Q

What is a Radiculopathy?

A

Nerve root dysfunction

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5
Q

Skin area supplied by a single spinal root

A

Dermatome

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6
Q

Muscle group supplied by a single spinal root

A

Myotome

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7
Q

Area of bone supplied by a single spinal root

A

Sclerotome

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8
Q

In the Cervical region, what level/nerve root is most commonly compressed?

A

Level = C6-C7

Nerve root compressed = C7

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9
Q

Most common etiology of Brachial Plexopathy?

A

Compression/stretch with CABG for ex.

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10
Q

Parsonage-Turner Syndrome is a Brachial Plexopathy. Where is there pain, weakness and atrophy?

A

Shoulder area

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11
Q

Single nerve affected with specific sensory loss and weakness

A

Mononeuropathy

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12
Q

Stocking/glove sensory loss with distal weakness

A

Polyneuropathy

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13
Q

Focal involvement of 2+ nerves with some systemic disorders like DM/vasculitits

A

Mononeuritis Multiplex

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14
Q

Which motor neurons are affected with Peripheral neuropathies?

A

LMN

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15
Q

DTRs with Peripheral Neuropathies

A

Hypoactive

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16
Q

Distal paresis, atrophic muscles and flaccid tone characterize central or peripheral neuroapthies?

A

Peripheral neuropathies

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17
Q

Carpal Tunnel Syndrome traps which nerve and where will pain/numbness/paresthesias be felt?

A

Median Nerve

= Thumb and first 2 fingers

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18
Q

What is another syndrome besides Carpal Tunnel Syndrome that can trap the Median Nerve?

A

Pronator Syndrome

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19
Q

Where is the pain and when with Pronator Syndrome?

A

Pain of the proximal forearm and with pronation

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20
Q

What movement can the patient not do if they have Anterior Interosseous Syndrome and what nerve is affected?

A

They cannot make a good circle when trying to make the “OK” sign
– Median Nerve

21
Q

What syndrome affects the Ulnar nerve and where?

A

Cubital Tunnel Syndrome

– At the elbow

22
Q

What will the patient have an abnormality in if they have an Ulnar Mononeuropathy?

A

Cannot grasp something well between thumb and first finger

– will have thumb flexion

23
Q

What is a common Radial Mononeuropathy?

A

Saturday Night Palsy

24
Q

As the Radial Nerve is damaged with Saturday Night Palsy, what will the sign be?

A

Wrist drop

25
Q

Where is the radial nerve compressed with Saturday Night Palsy?

A

Spiral groove

26
Q

What is the most common lower limb entrapment Neuropathy?

A

Peroneal Mononeuropathy

27
Q

Where does Peroneal Mononeuropathy usually occur?

A

Fibular head entrapment

28
Q

What will be present with Peroneal Mononeuropathy?

A

Foot drop - loss of dorsiflexion and possible sensory loss on top of foot

29
Q

If large fibers are affected, what senses will be altered?

A

Position and vibratory

30
Q

If small fibers are affected, what senses will be altered?

A

Pain and temperature

31
Q

What are the 2 most common causes of Polyneuropathy?

A

Diabetes

Alcohol

32
Q

What is the most common Hereditary Polyneuroathy?

A

Charcot-Marie-Tooth

33
Q

Hereditary Motor Sensory Neuropathies (HMSN) like charcot-marie-tooth have many forms. Which forms are demyelinating or axonal?

A 
HMSN1 = demyelinating
HMSN2 = axonal
34
Q

What is a unique finding with HMSN1?

A

Skeletal deformities

– pes cavus and hammer toes

35
Q

With HMSN1, what will the EMG show and why?

A

Slowing of motor nerve conduction

– demyelinating type

36
Q

HMSN2 has similar symptoms to type 1 without the?

A

No skeletal abnormalities

37
Q

What will the EMG show with HMSN2 and why?

A

NORMAL conduction velocities of motor nerve

– Axonal type

38
Q

Charcot-Marie-Tooth inherited polyneuropathy is also called?

A

Hereditary Motor Sensory Neuropathies (HMSN)

39
Q

What usually causes Guillain Barre Syndrome?

A

Campylobacter Jejuni enteritis

40
Q

What will be seen in the CSF with Guillain Barre Syndrome?

A

Increased protein (albumino-cytologic dissociation) with normal cell count

41
Q

Will the conduction velocity be slowed with Guillain Barre?

A

Yes

42
Q

What is the treatment options for Guillain Barre?

A

Plasmapheresis

IVIg

43
Q

A poor prognosis with Guillain Barre is associated with?

A

Low amplitude motor nerves

44
Q

What is a common variant of Guillan Barre?

A

Miller-Fisher Syndrome

45
Q

What antibodies are (+) with Miller-Fisher Syndrome?

A

(+) GQ1b

(+) GT1a

46
Q

What are the symptoms of Miller-Fisher Syndrome and what is it a variant of?

A

Variant of Guillain Barre

= Ophthalmoplegia, ataxia, arreflexia, facial weakness

47
Q

What antibodies are (+) with Miller-Fisher Syndrome?

A

(+) GQ1b

(+) GT1a

48
Q

What is similar to Guillain Barre syndrome but is more persistent?

A

Chronic Inflammatory Demyelinating Polyneuropathy

49
Q

How can you treat Chronic Inflammatory Demyelinating Polyneuropathy that you cannot do with Guillan Barre?

A

Steroids
Immune suppressants
– can still do plasma exchange, IVIg

NMSP - Exam 2 (29 decks)

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