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Histo and Neuro > CC1: Peripheral Neuropathies > Flashcards

CC1: Peripheral Neuropathies Flashcards

1
Q

What classification of nerve injury is neuropraxia?

A

Class 1

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2
Q

What is the cause of neuropraxia?

A

Compression or acute ischemia

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3
Q

What does neuropraxia do to the nerve?

A

Conduction block, no axon changes (MILD)

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4
Q

What classification of nerve injury is axonotmesis?

A

Class II

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5
Q

What is the cause of axonotmesis?

A

A crash injury to a limb causing axonal disruption

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6
Q

What does axonotmesis do to the nerve?

A
  • Axonal damage results in loss of continuity
  • Wallerian degeneration distally
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7
Q

How long is axonotmesis recovery?

A

Depends on nerve regeneration 1-3 mm/d (slow)

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8
Q

What classification of nervy injury is neuronotmesis?

A

Class III

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9
Q

What causes neuronotmesis?

A

Connective tissue elements severance, injuries that separate entire nerve

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10
Q

What does neuronotmesis do to the nerve?

A

Separates entire nerve from tissue - endoneuro and schwann cell tube

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11
Q

Can axonal regeneration occur in neuronotmesis?

A

Is very limited, little hope of functional recovery without surgery

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12
Q

What can ocurr in neuronotmesis malformation?

A

Neuroma formation and aberrant regeneration

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13
Q

Peripheral neuropathies can be subdivided into two major categories:

A

Primary axonopathies
Primary myelinopathies

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14
Q

What are neuropathic disorders?

A

Diseases of the neuron cell body and their peripheral processes

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15
Q

Large myelinated axons project:

A

Motor and sensory axons responsible for proprioception, vibration, and light touch

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16
Q

Thinly myelinated axons project:

A

Sensory fibers responsible for light touch, pain, temperature, and preganglionic autonomic functions

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17
Q

Small unmyelinated fibers project:

A

Pain, temperature, and postganglionic autonomic functions.

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18
Q

What type of spacial distribution does a mononeuropathy have?
Ex. Entrapment neuropathies as in carpal tunnel or local trauma

A

Focal spatial distribution - one nerve affected

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19
Q

What type of spacial distribution does a multiple mononeuropathy have?
Ex. Vasculitis

A

Multifocal - usually asymmetric

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20
Q

What type of spacial distribution does a polyradiculopathy have?
Ex. Sensory/motor diabetic neuropathy

A

Diffuse - symmetric

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21
Q

Which fiber is involved with :
LMN weakness
Muscle loss atrophy
Loss of tendon reflex
Impaired proprioception
Abnormal Romberg test

A

Large fiber type neuropathy

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22
Q

Which fiber is involved with :
Contact hyperalgesia
Burning, aching, stabbing pain
(non specific)
Mild distal disturbance in sharp- dull discrimination
Normal DTR’s
Orthostatic hypotension

A

Small fiber neuropathies

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23
Q

Which type of neuropathy involves axonal atrophy, impaired transport, chromatolysis, dying back?

A

Axonal neuropathy

24
Q

Which type of neuropathy has a gradual insidious of tingling and prickling onset found in lower extremities?

A

Axonal neuropathy

25
Q

Which type of neuropathy has a normal CSF protein level?

A

Axonal neuropathy

26
Q

Which type of neuropathy has a decreased ankle reflex?

A

Axonal neuropathy

27
Q

Which type of neuropathy has toxins, B vitamins, diabetes, hypothyroid, HIV?

A

Peripheral Sensory Motor Axonal Polyneuropathy

28
Q

Which type of neuropathy has autoimmune diseases?

A

Demyelinating neuropathies

29
Q

Where does destruction of myelin sheath often begin at in demyelination?

A

Nodes of Ranvier

30
Q

Which type of neuropathy has elevated CSF protein?

A

Demyelinating neuropathy

31
Q

Which type of neuropathy has fast progressive weakness?

A

Demyelinating neuropathy

32
Q

Which type of neuropathy has cranial nerve involvement?

A

Demyelinating neuropathy

33
Q

Which type of neuropathy has mild sensory loss?

A

Demyelinating neuropathy

34
Q

Which type of neuropathy has multifocal hereditary adquision?

A

Demyelinating neuropathy

35
Q

Which type of neuropathy has absent Deep tendon Reflexes?

A

Demyelinating neuropathy

36
Q

What type of studies are done in laboratories for peripheral neuropathies?

A

EMG and nerve conduction studies

37
Q

The most common cause of neuropathy worldwide:

A

Clinical Diabetic Neuropathy

38
Q

What type of neuropathy is Clinical Diabetic?

A

Distal axonopathy, focal and multifocal, sensory snd autonomic manifestations

39
Q

Unilateral oculomotor nerve palsies occur in what type of neuropathy? CN III

A

Cranial neuropathy

40
Q

Burning type of pain in
thigh and pain with sensory loss with unilateral proximal muscle weakness and atrophy occurs in what type of neuropathy?

A

Proximal Diabetic Neuropathy of the Lower Limbs

41
Q

What accumulates in the nerve creating a hypertonic condition and water accumulation?

A

Sorbitol

42
Q

Chronic hyperglycemia increases ______ of proteins producing accumulation in tissues and endothelial cell membranes (causing microvascular disease)

A

glycosylation

43
Q

Alteration in polyol metabolism

A

Glucose → Sorbitol → Fructose

44
Q

Vascular pathogenesis of diabetics involves:

A
  • hypoxia or ischemia of microvasculature of the nerve
  • mitochondria in DRG
  • oxidative stress
45
Q

Guillain Barre syndrome is what type of neuropathy?

A

Acute Inflammatory Demyelinating Polyneuropathy

46
Q

2/3 of the patients have a predisposing factor such as respiratory infection or gastroenteritis:

A

Guillain Barre

47
Q

In Guillain Barre CSF protein is _____

A

Elevated

48
Q

Pathogenesis is immune mediated: “molecular mimicry”

A

Guillain Barre

49
Q

What are the 2 groups of vessels involved in vaculitic neuropathies?

A
  • nerve large arteriole vasculitis
  • nerve microvasculitis
50
Q

A diverse group of disorders characterized by the acute-to-subacute onset of painful sensory and motor deficits that result from inflammatory destruction of nerve blood vessels and subsequent ischemic injury:

A

Vaculitic neuropathies

51
Q

The two main pathways that lead to ischemic vasculitic nerve damage are:

A
  • Immune complex deposition
  • Cell-mediated immunity
52
Q

Ooccurs when antigen-presenting cells present relevant antigens to circulating T cells producing proinflammatory cytokines and other inflammatory mediators that cause

A

Cell mediated immunity

53
Q

What type of ischemic pathways is within the vessel walls with complement deposition and release of proinflammatory cytokines.

A

Immune mediated complex deposition

54
Q

The most common is the median nerve entrapment in the wrist

A

Carpal tunnel syndrome

55
Q

Weakness in ankle dorsiflex and eversion - compression in the knee is what type of neuropathy?

A

Peroneal

56
Q

Tibial nerve compression in the region of the ankles as the nerve passes under the transverse tarsal (laciniate) ligament

A

Tarsal tunnel syndrome

57
Q

Impingement of the Lateral Femoral Cutaneous Nerve under the inguinal ligament

A

Meralgia paresthetica

Histo and Neuro (5 decks)

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