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Pathology ii final > final > Flashcards

final Flashcards

1
Q

4 causes of peripheral nerve lesions

A

1: Compression
2. Trauma
3.systemic disorders
4. Systemic edematous conditions

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2
Q

First Degree classification
compression of a nerve causing local conduction block
Recovery to area occurs as damage is repaired
good progonosis

A

Neuropraxia

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3
Q

Second degree classification
Prolonged severe compression
degeneration of axon distal to injury
Regnereration can occur, good prognosis
* if lesion is too close to cell body = no regeneration

A

Aconotmesis

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4
Q

3rd degree classification
severing of the nerve trunk
surgery is type of repair

A

Neurotmesis

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5
Q

Regeneration of a nerve takes how long?

A

1-2mm a day

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6
Q

what direction does a nerve grow

A

Proximal to distal

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7
Q

Edema is present with complete lesion:

A

present initally, remain until fibers regenerate. the more fibres affected the worse the edema will be

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8
Q

Edema present with partial:

A

less the nwith complete, muscle function assists with lymphatic return

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9
Q

Altered tissue health with complete and Partial

A

complete: loss of autonomic function affects hair skin nails, tissue fragile, *loss of piloerection loss of swelling

Partial: increase piloerector over area of denervation

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10
Q

Motor function with complete and partial

A

Complete: Muscle flaccid
Partial: Muscle weakness, diminished deep tendon reflex

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11
Q

Holding pattern with complete and partial:

A

Complete: Sciatic nerve lesion = foot drop, drop wrist drop with radial nerve

Partial: finger drop rather than wrist

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12
Q

Contractures with complete and partial:

A

Complete: Contractures in atagonist mm

Partial: less severe then complete

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13
Q

Pain with Complete and Partial:

A

Complete: may not be interpreted as painful
Partial: an area of hyperesthesia (increased sensitivity) and dysesthesia ( abnormal sense of touch)

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14
Q

Permanent Lesion symptoms

A

Edema
holding pattern
scar tissue
Pain-more with partial permenant lesions
compensatory changes
several months before function returns if any

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15
Q

Compression syndromes eg: TOS, Carper tunnel, periformis syndrome

A

Neuropraxia

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16
Q

Causes of compression

A

External force ie: Crutches, backpack straps, splints

internal force: Hypertonic mm, trigger points, posture imbalances, saturday night palsy, pregnancy

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17
Q

Symptoms of compression

A

Pain tingling numbness weakness
the longer the disruption, the longer the recovery time*

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18
Q

Radial Nerve pathway

A

C5-T1

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19
Q

Radial nerve muscles innervated

A

Triceps
Aconeus
Brachioradialis
Extgensor carpi radialis longus and brevis
SUPINATOR
Extensor digitorum
Ex Carpi ulnaris
ex digiti minimi
Extenso Pollicis longus and brevis
extensor indicis

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20
Q

Ulnar nerve Pathway

A

C8-T1
under pec minor
Guyons canal is compression site for ulnar
M

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21
Q

Muscles innervated by ulnar nerve

A

Plexor carpi ulnaris
flexor digitorum profundus(medial half)
Adductor Pollicis *

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22
Q

Causes of ulnar lesions:

A

Fractures-Medial condyle
Dislocations
Post surgery complications
pathlogy -leprosy
prolonged compression
repetive action
direct trauma

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23
Q

Symptoms of ulnar nerve lesion

A

Claw hand
Fromonts sign positive

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24
Q

Median nerve Pathway

A

M c8-t1 L C5-c7
Between heads of pronator teres

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25
Q

Muscles innervated by median nerve

A

Pronator teres
Flex Carpi radialis
Thenar muscles - abductor pollicis brevis
palmaris longus
Flex digit profundus
1 and 1 lumbricles

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26
Q

Causes of median nerve lesion

A

Fracture at elbow
Dislocation - Lunate and scaphoid
duble crush compression

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27
Q

Symptoms of Median nerve lesion

A

Ape and oath hand

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28
Q

Sciatic Nerve pathway

A

L4-S1
Passes through greater sciatic foramen and UNDER periformis
Dorsal aspect of the foot

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29
Q

Muscles innervated by sciatic Nerve

A

Hamstrings & 1/2 adductor magnus-Sciatic
Tibial:
Gastroc Tib Post

Cmmon peroneal:
Tib ant
peroneals

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30
Q

Causes of Sciatic nerve lesion

A

Crossing your legs

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31
Q

Symptoms of Sciatic nerve lesion:

A

Foot drop
tibial nerve lesion may lead to claw toe-intrinisc foot mms
anesthesia experienced in dorsal of foot at webspace between toe 1&2

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32
Q

Facial- Bells palsy nerve pathway

A

CN Vii
Flaccid Paralysis of mm of facial expression
Pg 6 lp 17

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33
Q

A condition that involves the compression of the brachial plexus and artery between:
The middle and anterior scalenes,
coracoid precess and pec minor,
Clavicle and 1st rib :

A

TOS

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34
Q

Two types of mood disorders:

A

1.Depression- Major and Dysthymia
2. Bipolar Disorder

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35
Q

Symptoms of depression

A

depressed mood
Anhedonia (decreased pleasure)
weight loss or gain
insomnia or hypersominia
agitation or slowing down
fatigue
feelins of worthlessness
lack of concentration
thoughts of suicide over 2 weeks
5 or more of these

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36
Q

The earlier amd more frequent of the onset of these symptoms the more likely it is that the person will require medication

A

True

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37
Q

Major Depressive Disorder symptoms

A

presistant unpleasant mood
depressed mood, anhedoinia, feelings of worthlessness, guilt, decreased concentration
psychomotor agitation,
insomnia ,
decreased libido
changes in weight
thoughts of death/suicide

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38
Q

Dysthemia Symptoms

A

Chromic mild depressive disorder
same as above but milider form
Low self esteem*

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39
Q

Classes of depression symptoms

A

Melancholic- depression worse in morning
Atypical- opposite of melancholic
Psychotic- delusions and hallucinations
Catatonic- excessive mobility, negativism,
repetative speech
Chronic- depression for 2+ years
Postpartum- within 6 weeks of birth

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40
Q

bipolar disease is also called

A

Manic depression

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41
Q

Clinical manifestations of Bipolar/ manic episodes

A

decreased need for sleep and food, labile mood, irritability, racing thoughts, highly distracted, inflated self esteem, escessive involvement in pleasurable experiences

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42
Q

how fast does mania develop

A

within hours or days, or over a few weeks

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43
Q

mania without depression is called

A

Unipolar and is rare

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44
Q

Anxiety disorders affect what precentage of people and more men or women

A

28.8%
women more then men

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45
Q

5 categories of anxity disorders

A

Panic disorder-intense fear, cardiac, respiratory
PTSD-Tramautic event
Generalized anxiety disorder-excessive worry
Soicial phobia-social interaction
OCD-repeat thoughts and actions

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46
Q

is Panic disorder more common in men or women

A

Women- peak mid adolesence and again in mid 30s

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47
Q

symptoms of a Panic disorder

A

headaches, dizzy, fainting
cardiac symptoms, chest pain
respiratory symptoms
sweating
nausea or abdominal distension
psycholigical symptoms- fear of dying

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48
Q

does OCD affect men or women more

A

Both equally
can occur in children
usual 20 years

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49
Q

Social Phobia is also known as

A

social anxiety disorder

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50
Q

how long must the fear from social phobia be present

A

6 months

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51
Q

5 types of Dementia

A

Alzhimers
Vascular dementia
Creutzfeltdt- jakob disease
Wernicke- korsakoff syndrome
Huntingron Chorea

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52
Q

most common type of dementia

A

Alzhimers 60-80%

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53
Q

Is there a cure for alhzimers?

A

No

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54
Q

Main clinical feature of Vascular dementia

A

Slowness in psychomotor function

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55
Q

what type is most common due to alcoholism

A

Wenmicke- Korsakoff

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56
Q

Is there a cure for huntingtons Disease

A

No, drugs to help

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57
Q

The consequece of pain Eg: stubbing toe

A

Nociceptive Pain

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58
Q

Arises from direct injury or dysfunction of the sensory axons of peripheral or central nerves
eg: nerve pain due to MS or phantom limb
No outside stimulus

A

Neuropathic Pain

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59
Q

Regards pain as Seperate sensory modality evoked by the activity of specific receptors that transmit information to pain centers or regions in the forbrain where pain is experienced

A

Specificity theory

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60
Q

A modification of specificity theory
eg: repeated sweeping of a soft bristled brush on the skin, over or near a painful area may result in pain reduction for several minutes to several hours

A

Gate control theory

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61
Q

These neurons and their receptive endings detect stimuli that threaten the integrity of innervated tissues

A

First order Neurons

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62
Q

these neurons are located in the spinal cord and process nociceptive information

A

Second order neurons

63
Q

These neurons project pain information to the brain. The thalamus and somatosensory cortex integrate and modulate pain as well as the persons subjective reaction to the pain experience.

A

Third Order Neurons

64
Q

Pain conducted by mylenated A fibers is typically

A

Fast and sharp

65
Q

Pain conducted by Unmyelinated C fibers is typically

A

Slow, dull continously conducted pain

66
Q

In the spinal cord, the transmission of impulses between the nociceptive neurons and the dorsal horn neurons is mediated by what

A

Chemical neurotransmitters carry the impulse

67
Q

Fast conducting fibers travel to the

A

Thalamus
Conrtalateral
bright sharp or stabbing

68
Q

Slow conducting fibers

A

difuse, dull, aching, unpleasant.
chronic and visceral pain

69
Q

a neuroanatomic pathway that begins in the midbrain is called

A

PAG region
periaquedductal gray region

70
Q

The PAG area is often reffered to as

A

Endogenous analgesia center

71
Q

Three families of endogenous opiod peptides are?

A

Enkephalins
endorphins
Dynorphins

72
Q

The point at which a stimulas is preceived as painful

A

Pain threshold

73
Q

Total pain experience
the pain scale

A

Pain tolerance

74
Q

is pain tolerance variable?

A

yes

75
Q

is threshold pain variable?

A

no. uniform from one person to another

76
Q

6 types of pain

A

-Cutaneous pain- sharp burning on skin and tissues
-Deep somatic pain- more diffuse and throbbing, muscles bones, tendons
-Visceral Pain: diffuse - organs
-Acute Pain: less than 6 months
-Chronic Pain- More than 6 months
-Referred Pain- orginates at visceral, radiates elsewhere

77
Q

a form of self distraction or cognitive control in which individuals focus their attention on the positive aspects of the experience and away from their pain

A

Cognitive Reappraisal

78
Q

___ and ____ are physical agents that provide pain relief

A

Heat and Cold

79
Q

when excessive heat is used, the heat itself becomes ___

A

a noxious stimulus

80
Q

how does Cold effect pain

A

Cold may reduce afferant activity reaching the posterior horn of the spinal cord by modulating sensory input.
15-20 minutes at a time
caution to anyone whose circulation is compromised

81
Q

Aspirin, NSAIDS or acetaminophen

A

Non-narcotic analgesics

82
Q

Narcotics, Morphine, codeine etc

A

Opioid analgesics

83
Q

tricyclic anti depressants, anti-seizure, corticosteriods

A

Adjuvant analgesics

84
Q

Reduced tactile sensation

A

Hypoesthesia

85
Q

Lost Tactile sensation

A

Anesthesia

86
Q

unpleasant sensation

A

Paresthesia

87
Q

Absence of pain

A

Analgesia

88
Q

Increased pain

A

Hyperalgesia

89
Q

Reduced Pain

A

Hypoalgesia

90
Q

Reduced temperature sensation

A

Hypothermia

91
Q

Lost temperature Sensation

A

Athermia

92
Q

The puzzling phenomenon of pain that follows a non-noxious stimulus to apparently normal skin.
wind touching sheets ect.

A

Allodynia

93
Q

Pain that results from pathology of the nervous system ( internal source)

A

Neuropathic pain

94
Q

Severe, brief, often repetitive attacks of lightning like or throbbing pain

A

Neuralgia

95
Q

one of the most common and severe neuralgias, manifested by facial tics or spasms

A

trigeminal neuralgia

96
Q

Herpes Zoster is also called

A

Shingles, same virus that causes chickenpox

97
Q

abnormally exaggerated response to pain

A

Hyperpathia

98
Q

A rare disorder of the extremeties characterized by autonomic and vasomotor instability

A

Complex regional pain syndrome ( CRPS)
formally known as Reflex sympathetic dystrophy (RSD)

99
Q

Two forms of CRPS

A

CRPS i - RSD
CRPS ii- Causalgia

100
Q

CRPS ii is diagnosed as

A

The presence of continuing pain

101
Q

CRPS i is diagnosed as

A

The presence of an initiating traumatic event

102
Q

what age do you number or word graphic pain scale for children

A

8 and older

103
Q

a tumor comprised of nerve scales

A

Neuroma

104
Q

what is the treatment for someone with a painful neuroma

A

relaxation to decrease SNS firing, Local massage is Ci’d if painful. AF and AA ROM proximal and distal

105
Q

4 types of primary headaches

A
  1. Migraine
  2. Tension
  3. Cluster
  4. Chronic Daily
106
Q

Headaches associated with a condition of illness

A

Secondary

107
Q

Red flags of secondary headaches

A

pregression of headache, new headache under 5 or over 50, pregnant, immunosuppressants, cancer

108
Q

Two types of migranes

A

Without Aura- %85
With Aura- %15

109
Q

symptoms of a migrane without aura

A

lasts 1-2 days
Visual disturbances, stars, sparks, flashes of lights

110
Q

Symptoms of migraine with Aura

A

Similar as without but reversible visual symptoms
lasts 5 min to an hour
Preheadache symptoms such as fatigue and irritability that happen hours or days before the attack

111
Q

Prodrome is also called

A

Pre headache

112
Q

symptoms of a prodrome

A

Food craving
contipation/Diarrhea
mood changes
mm stiffness, in the neck
fatigue
increased urination

113
Q

Symptoms of an Aura

A

Visual
olfactory hallucinations
tingling numbness on side where headache is
difficult speaking
confussion
vertigo
partial paralysis
hearing things
decreased hearing
decreased sensation
increased sensation

114
Q

Aura without a migraine

A

silent migraine

115
Q

before puberty, migraines are equally distributed between the sexes

A

True

116
Q

Diagnosis of 3 symptoms for migraines in children

A

abdominal pain, nausea vomitting, throbing headache, unilateral location, aura, relief during sleep, positive family history

117
Q

A common feature of migraine in children is

A

intense nausea and vomiting
may be confused with appendicitis

118
Q

what age do many children undergo spontaneous prolonged remission with migraines

A

after their 10th birthday

119
Q

A type of primary neurovascular headache that includes severe unrelenting, unilateral pain in the orbital, retro-orbital, temporal, supraorbital and infraorbital region

A

Cluster Headaches

120
Q

Pain behind the eye radiated to the

A

ipsilateral trigeminal nerve (temple cheek and gum)

121
Q

Symptoms of Cluster headaches

A

restlessness
lacrimation
nasal congestion
rhinorrhea
forehead sweating
miosis
ptosis
eyelid edema

122
Q

what is the most common type of headache

A

Tension

123
Q

what can cause a tension headache

A

overuse of analgesics or caffeine

124
Q

what type of headache occurs 15 days or more a month

A

Chronic Daily headaches

125
Q

trigger points in what muscles can result in dizziness when a person rotates their head quickly while driving

A

SCM

126
Q

know phases of MVA injury and symptoms of whiplash LP 9 pg 6

A
127
Q

abnormal positioning of the head and neck relative to the body

A

Torticollis

128
Q

Affected muscles of torticollis

A

IPSILATERAL SCM
upper trap
levator scap
scalenes
contralateral splenius capitis
multifidi & Rotators
suboccipitals

129
Q

Acute acquired torticollis may result from

A

Activated trigger pioints by holding phone to one ear, sleeping funny, prolonged exposure to cold

130
Q

Torticollis present from infancy

A

Congenital torticollis
not usually painful

131
Q

Symptom picture of spasmatic torticollis

A

Adult onset
typical position
affected muscles twitch and shoulder shrugs
laying down with arms raised sleeping improves

132
Q

what is a common cause of head pain

A

TMJ

133
Q

how does the pain present with TMJ

A

almost always referred as fascial muscle pain, headache , neckache, earache
can cause chronic pain problems in adults and children

134
Q

degeneration of the annular fibres of the intervertebral disc

A

Degenerative disc disease

135
Q

which discs are mostly affected wit DDD

A

C/S and L/S

136
Q

What age is common for traumatic rupture in lumbar spine

A

30-45
less likely after 50 as disc fibrosed

137
Q

annual fibres are intact

A

Protrusion (posteriolateral)

138
Q

Outermost annular fibres are intact

A

Prolapse

139
Q

rupture of entire annulus fibrosus no fragmentation of disc

A

Extrusion

140
Q

Disc fragments in epidural space

A

Sequestration

141
Q

with disc prolapse is pain worse in the morning or night

A

worse in the morning when the person is inactive

142
Q

central herniation in the C/S can lead to

A

UMN lesion

143
Q

herniation in the lumbar spine can lead to

A

Cauda equina syndrome

144
Q

caused by sensitized helpter T cells and an antibody directed attack on the achetocoline receptor in the neuromuscular junction

A

Myasthenia gravis

145
Q

generalized infection of the Parenchyma, caused by a virus, also by bacteria, fungi, or other organisms

A

Encephalitis

146
Q

Reduced or interrupted blood flow

A

Ischemia

147
Q

an interrpution of blood flow in the cerebral vessel due to thrombi or emboli OR bleeding into the brain tissue

A

Stroke

148
Q

deprivation of oxygen with maintained blood flow

A

Hypoxia

149
Q

progressive deterioation of skeletal muscles because of mixed muscle hypertrophy, atrophy, and necrosis

A

Muscular Dystrophy

150
Q

damage to the immature brain
Hypoxia and ischemia in utero, post partum
Trauma or rupture of the cerebral blood vessels, toxicity and ifection can all cause

A

Cerebral Palsy

151
Q

Cleft spine
neural tube defects

A

Spina Bifida

152
Q

inflammation and selective destruction of the CNS myelin

A

Multiple Sclerosis

153
Q

result of vascular injury and bleeding

A

Hematoma

154
Q

uncontrolled cell growth in brain

A

Brain tumor

Pathology ii final (1 decks)

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