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NEUROPATH 1 > Lecture 10 - PNS Pathologies pt 1 > Flashcards

Lecture 10 - PNS Pathologies pt 1 Flashcards

1
Q

what are the 3 subdivisions of PNS?

A

Somatic (voluntary) NS: cranial and spinal nerves that contain sensory and motor fibers
Autonomic (involuntary) NS: autonomic nerves
Enteric NS

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2
Q

what is involved in somatic (voluntary) NS?

A

neurons from cutaneous and special sensory receptors to the CNS
motor neurons to skeletal muscles tissue

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3
Q

what is involved in the autonomic (involuntary) NS?

A

sensory neurons from visceral organs to CNS

motor neurons to smooth and cardiac muscle and glands (ParaNS and SymNS)`

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4
Q

what is involved in the enteric NS?

A

involuntary sensory and motor neurons controlling GI tract

- neurons function independently of ANS and CNS

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5
Q

endoneurium surrounds each…

A

axon

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6
Q

perineurium surrounds each…

A

fascicle

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7
Q

epineurium surrounds each…

A

entire nerve

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8
Q

what are 3 overarching SSx of disease of the PNS?

A

motor/somatic (LMN)
ANS/autonomic motor (pre and postganglionic fibers)
sensory/somatic AND autonomic (dorsal root ganglion, nerve root, peripheral nerve)

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9
Q

where are cell bodies of lower motor neurons located?

A

anterior grey horn of spinal cord and cranial nerves of the brain stem

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10
Q

where are axons of motor neurons located?

A

spinal and cranial nerves

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11
Q

define ‘neuromuscular junctions’

A

muscle fibers innervated by motor nerve

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12
Q

what are 5 main causes of peripheral nerve injuries?

A 
hereditary
trauma
infections (herpes zoster)
toxins (tetanus; botulism)
metabolic (DM)
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13
Q

how well does neurapraxia recover?

A

with segmental demylinisation the Schwann cells divide (mitosis) and new Schwann cells envelop demyelinised axons allowing for good recovery

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14
Q

with axonotmesis, regeneration is possible if…

A

the never cell body remains viable

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15
Q

new axons can sprout from the ….end of damaged axons

A

proximal

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16
Q

what is required for successful functional regeneration of axons?

A

prox and distal end of CT must be aligned

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17
Q

segmental demyelisation is caused by….and involves…

A

nerve compression/disease

loss of myelin in segments, but axon is intact

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18
Q

what does peripheral nerve degeneration directly affect?

A

axons (axon degenerated distal to lesion)

19
Q

what are 3 classifications of nerve injuries?

A

neurpraxia
axonotmesis
neurotmesis

20
Q

does the muscle atrophy with neurapraxia?

A

no - axon stays intact

21
Q

what causes axonotmesis?

A

prolonged nerve compression = damaged axon but CT intact (due to infarction and necrosis)

22
Q

what can cause neurotmesis?

A

gunshot or stab wounds = muscle fibers rapidly atrophy (axon degenerates distal to injury)

23
Q

when it comes to neurotmesis, what allows for re-mylinisation to occur?

A

axon establishes a distal connection

24
Q

what are 4 neuropathy classifications?

A

mononeuropathy
polyneuropathy
radiculoneuropathy
polyradiculitis

25
Q

define ‘mononeuropathy’

A

focal neuropathy disorder involving a single peripheral nerve

26
Q

what are main causes of mononeuropathy?

A

entrapment, compression, stretch injury, ischemia, infection, inflammation of nerve

27
Q

define ‘polyneuropathy’

A

neuropathy involving multiple peripheral nerves

28
Q

what are 4 main causes of polyneuropathy and polyradiculitis?

A

DM (listed only for polyneuropathy)
infections/toxins/drugs
cancers
nutritional deficiencies (vit B)

29
Q

define ‘radiculoneuropathy’

A

disease of spinal nerve roots (radix) and nerves

30
Q

what causes radiculoneuropathy?

A

compression / irritation of the nerves as they exit the spine (herniation, osteophytes, thickened ligaments, tumors, DM)

31
Q

define ‘polyradiculitis’

A

inflammation of nerve roots

32
Q

what are two major categories of SSx related to neuropathy?

A

loss of sensitivity following peripheral nerve distribution (dermatome when spinal nerve or root is involved)
paresis or paralysis (mm distal to peripheral nerve - whole myotome)

33
Q

what two things are affected first with paresthesia?

A

longest nerve and distal sensory deficits (hands and feet = tingling, pricking, burning)

34
Q

what does ‘glove and stocking distribution’ relate to?

A

polyneuropathy of sensory nerves (dying back of fibers from distal to proximal)

35
Q

what are 3 presentation of symptoms for distal muscle weakness/myopathy?

A

hypotonicity/flaccidity
difficult to walk on heels or toes
diminished or absent deep tendon reflexes

36
Q

how does proximal muscle weakness present with myopathies?

A

muscle tenderness or cramping

37
Q

what is the most common ANS motor disturbances presentations?

A

deficits in vascular control and sweating (hypotension and cardiac irregularities)

38
Q

basic neurological assessment should be done in order from _______ of neurological function, down to ________ covering

A

highest level

the lowest

39
Q

what are 5 categories covered in a basic neurological assessment?

A
  1. mental status and speech
  2. cranial nerve function (only if required for sensory or motor functions)
  3. sensory function (focus on pain, touch, numbness)
  4. motor function (tone, power - includes cerebellar function or abnormal muscle movements)
  5. reflexes (deep tendon)
40
Q

what nerves are being assessed with deep tendon reflex tests of the biceps tendon?

A

C5, C6

41
Q

what nerves are being assessed with deep tendon reflex tests of the triceps tendon?

A

C7, C8

42
Q

what nerves are being assessed with deep tendon reflex tests of the patellar tendon?

A

L2, L3, L4

43
Q

what nerves are being assessed with deep tendon reflex tests of the achilles tendon?

A

S1, S2

NEUROPATH 1 (11 decks)

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