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BMB Test 1 > B7.008 Prework 1: Peripheral Nerve Clinical Concepts > Flashcards

B7.008 Prework 1: Peripheral Nerve Clinical Concepts Flashcards

1
Q

radiculopathy

A

damage at the root

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2
Q

plexopathy

A

damage at the plexus

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3
Q

neuropathy

A

damage at the nerve / peripheral nerve

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4
Q

myelopathy

A

damage at the spinal cord

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5
Q

encephalopathy

A

damage at the brain

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6
Q

diagnosis of neuro conditions

A 
syndrome
lesion
-identify system
-identify likely localization based on pattern
-confirm and refine localization
etiology
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7
Q

focal lesion

A

unilateral, asymmetric pattern
structural etiology
anatomic

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8
Q

diffuse lesion

A

bilateral, symmetric pattern
toxic or metabolic etiology
physiologic

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9
Q

midline lesion

A

bilateral, symmetric pattern in LOWER LIMBS
no arm symptoms
structural etiology
anatomic

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10
Q

multifocal lesion

A

bilateral, asymmetric pattern
inflammatory or infiltrative etiology
anatomic or physiologic

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11
Q

examples of system involvement

A
  1. motor
  2. sensory
    - spinothalamic = pain/temp
    - dorsal column = fine touch/ proprioception
  3. autonomic
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12
Q

pathologies associated with neuropathies

A

myelinopathies

axonopathies

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13
Q

small fibers

A

spinothalamic
pain
temp

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14
Q

large fiber

A

dorsal column
vibration
touch
proprioception

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15
Q

temporal evolution of neuropathy

A

acute (days to 4 wks)
subacute (4-8 wks)
chronic (>8 wks)

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16
Q

most common cervical radiculopathies

A 
C7 = 46%
C6 = 18%
C5 = 7%
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17
Q

T4

A

nipple level

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18
Q

T10

A

umbilicus

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19
Q

C5 weakness

A

deltoid
infraspinatus
biceps

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20
Q

C5 reflex decrease

A

biceps

pectoralis

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21
Q

C5 region of sensory abnormality

A

shoulder

upper lateral arms

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22
Q

C6 weakness

A

wrist extensors

biceps

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23
Q

C6 reflex decrease

A

biceps

brachioradialis

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24
Q

C6 region of sensory abnormality

A

1st and 2nd fingers

lateral forearms

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25
Q

C7 muscle weakness

A

triceps

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26
Q

C7 reflex decrease

A

triceps

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27
Q

C7 region of sensory abnormality

A

third finger

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28
Q

most common lumbar radiculopathies

A 
S1 = 45-50%
L5 = 40-45%
L4 = 3-10%
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29
Q

L4 weakness

A

iliopsoas

quads

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30
Q

L4 reflex decrease

A

patellar tendon (knee jerk)

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31
Q

L4 region of sensory abnormality

A

knee

medial lower leg

32
Q

L5 weakness

A

foot dorsiflexion
bio toe extension
foot eversion, inversion

33
Q

L5 reflex decrease

A

none

34
Q

L5 region of sensory abnormality

A

dorsum of foot

big toe

35
Q

S1 weakness

A

foot plantar flexion

36
Q

S1 reflex decrease

A

Achilles tendon

37
Q

S1 region of sensory abnormality

A

lateral foot
small toe
sole

38
Q

radial nerve

A

extension at all arm, wrist, and proximal finger joints below the shoulder
forearm supination
thumb abduction in plane of palm

39
Q

median nerve

A

thumb flexion and opposition
flexion of digits 2 and 3
wrist flexion and abduction
forearm pronation

40
Q

ulnar nerve

A

finger adduction and abduction other than the thumb
thumb adduction
flexion of digits 4 and 5
wrist flexion and adduction

41
Q

axillary nerve

A

abduction of arm at shoulder beyond first 15 deg

42
Q

musculocutaneous nerve

A

flexion of arm at elbow

supination of forearm

43
Q

femoral nerve

A

leg flexion at hip

leg extension at knee

44
Q

obturator nerve

A

adduction of the thigh

45
Q

sciatic nerve

A

leg flexion at the knee

46
Q

tibial nerve

A

foot plantar flexion and inversion

toe flexion

47
Q

superficial peroneal nerve

A

foot eversion

48
Q

deep peroneal nerve

A

foot dorsiflexion

toe extension

49
Q

common causes of focal neuropathies

A

acute: trauma
chronic: entrapment

50
Q

traumatic neuropathy

A 
acute mechanical compression of nerve
duration and magnitude of forces determines severity of injury
-neuropraxic
-axonotmetic
-neurotmetic
51
Q

neuropraxia

A

focal demyelination
axon and connective tissue intact
recovery 1-8 weeks

52
Q

axonotmesis

A

axon injury
connective tissue intact
recovery length dependent, 1 mm/day

53
Q

neurotmesis

A

axon transected
connective tissue disrupted
no recovery without surgical intervention
(penetrating injury)

54
Q

entrapment neuropathy

A 
mechanical compression of a nerve in a narrowed anatomic compartment
dysfunction related to a combination of:
-nerve ischemia
-focal demyelination
-axon crush injury
55
Q

describe in detail the pattern associated with distal symmetric peripheral neuropathy

A 
bilateral, symmetric, sensory, distal
length dependent: longest nerves most susceptible bc they work the hardest (often due to a toxin)
-stocking and glove sensory loss
absent ankle reflexes
with or without motor involvement
56
Q

causes of distal symmetric peripheral neuropathy

A

most common : diabetic
cryptogenic
less common: hereditary (charcot marie tooth, toxins)

57
Q

describe the pattern associated with a distal symmetric small fiber neuropathy

A 
bilateral, symmetric, sensory, distal
diffuse & length dependent
pain and temp loss ONLY
preserved posterior column (fine touch, proprioception, vibration)
preserved reflexes
no weakness
58
Q

describe the pattern seen in AIDP and CIDP

A 
bilateral, symmetric, motor, proximal and distal
diffuse, NON length dependent
symmetric sensory loss
generalized hyporeflexia
proximal and distal weakness
59
Q

describe the injury associated with AIDP and CIDP

A

myelinopathies

immune-mediated

60
Q

AIDP

A

Guillain Barre
acute, inflammatory, demyelinating polyneuropathy
immune mediated attack against peripheral nerve myelin
may occur after infection

61
Q

ttx for AIDP

A

IVIg

plasmapheresis

62
Q

CIDP

A

chronic, inflammatory, demyelinating polyneuropathy
autoimmune polyneuropathy
responsive to chronic immunosuppression

63
Q

types of lesions to consider with multifocal pattern

A 
multiple roots (polyradiculitis) : look at meninges (CSF bathes all roots)
multiple nerves: monneuropathy multiplex, vasculitis
64
Q

acute to subacute etiologies of polyradiculopathy mononeuropathy multiplex

A

neoplastic
autoimmune
infectious (lyme)

65
Q

chronic etiologies of polyradiculopathy mononeuropathy multiplex

A

hereditary predisposition to pressure palsies

66
Q

acute

focal

A

trauma

67
Q

acute

diffuse, distal

A

acute toxin (drugs) exposure

68
Q

acute

diffuse, distal and proximal

A

AIDP

69
Q

acute

midline

A

cauda equina
trauma
hematoma

70
Q

acute

multifocal

A

inflammatory
neoplastic
infectious

71
Q

chronic

focal

A

entrapment

72
Q

chronic

diffuse, distal

A 
diabetes
cryptogenic
hereditary
chronic toxin
organ failure
73
Q

chronic

diffuse, distal and proximal

A

CIDP

74
Q

chronic

midline

A

cauda equina entrapment
spinal stenosis
tumor

75
Q

chronic

multifocal

A

predisposition to pressure palses

BMB Test 1 (29 decks)

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