[CLMD] Peripheral Neuropathies [Sachen] *Eriks Flashcards
In addition to scapular pain in all of these levels, match the pain with the nerve root:
C5, C6, C7, C8
Medial forearm, Proximal arm, Shoulder, Elbow/forearm
C5 = Shoulder
C6 = Proximal arm
C7 = Elbow/forearm
C8 = Medial forearm
Associate the pain pattern with the nerve root
L4, L5, S1
Latearl calf/Dorsal thigh
Medial calf/knee
Posterior thigh/posterior calf
L4 = Medial calf/knee
L5 = Lateral calf/dorsal thigh
S1 = Posterior thigh/posterior calf
What DTR is lost with:
L4
L5
S1
L4 = Patella
L5 = None
S1 = Achilles
How can radiation injury vs. neoplastic etiology be differentiated on the basis of involvement and pain in terms of brachial plexopathy?
- Radiation injury: upper trunk, lateral cord, painless
- Neoplastic: medial cord, painful (breast and lung)
What are 6 motor signs/sx’s of peripheral nerve disease?
- Distal weakness
- Cramps
- Muscle fasciculations (twitching)
- Atrophy
- ↓ DTRs
- Reduced tone
What are sx’s of a small unmyelinated fiber neuropathy?
- Pain
- “Burning” dysesthesias
- Paresthesias
- Temperature sensation abnormalities
What will be seen on skin biopsy in a small (unmyelinated) fiber polyneuropathy?
↓ epidermal nerve fiber density
Weakness in shoulder abduction with loss of sensation in the lateral arm is seen with lesion of what nerve root?
C5
Weakness in shoulder abduction + elbow flexion with sensory loss in the 1st and 2nd digit is due to lesion of what nerve root?
C6
Sensory loss in the medial calf + weakness in hip flexion and knee extension is due to lesion of which nerve root?
L4
Sensory loss in the lateral calf/dorsum of foot + weakness in hamstrings + foot dorsiflexion, inversion, and eversion is due to lesion of what nerve root?
L5
What is the dermatomal distribution for T1?
Medial forearm
When diagnosing a plexopathy which 2 muscle can help identify proximal lesions?
- Rhomboids (Dorsal Scapular n. - C5)
- Serratus Anterior (Long thoracic n. - C5)
What are the negative vs. positive sx’s associated with a large (myelinated) fiber peripheral neuropathy?
- Negative: ↓ vibration + ↓ joint position sense + arreflexia + ataxia + hypotonia
- Positive: tingling + pins and needles + numbness
Which median mononeuropathy is associated with an insidious onset of diffuse/dull ache about th proximal forearm (rarely acute or sharp)?
Pronator Syndrome