Lecture 5: Peripheral Neuropathies Flashcards

1
Q

How can radiation injury vs. neoplastic etiology be differentiated on the basis of involvement and pain in terms of brachial plexopathy?

A
  • Radiation injury: upper trunk, lateral cord, painless
  • Neoplastic: medial cord, painful (breast and lung)
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2
Q

What are 6 motor signs/sx’s of peripheral nerve disease?

A
  • Distal weakness
  • Cramps
  • Muscle fasciculations (twitching)
  • Atrophy
  • DTRs
  • Reduced tone
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3
Q

What are sx’s of a small unmyelinated fiber neuropathy?

A
  • Pain
  • “Burning” dysesthesias
  • Paresthesias
  • Temperature sensation abnormalities
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4
Q

What will be seen on skin biopsy in a small (unmyelinated) fiber polyneuropathy?

A

↓ epidermal nerve fiber density

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5
Q

Weakness in shoulder abduction with loss of sensation in the lateral arm is seen with lesion of what nerve root?

A

C5

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6
Q

Weakness in shoulder abduction + elbow flexion with sensory loss in the 1st and 2nd digit is due to lesion of what nerve root?

A

C6

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7
Q

Sensory loss in the medial calf + weakness in hip flexion and knee extension is due to lesion of which nerve root?

A

L4

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8
Q

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?

A

L5

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9
Q

What is the dermatomal distribution for T1?

A

Medial forearm

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10
Q

When diagnosing a plexopathy which 2 muscle can help identify proximal lesions?

A
  • Rhomboids (Dorsal Scapular n. - C5)
  • Serratus Anterior (Long thoracic n. - C5)
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11
Q

What are the negative vs. positive sx’s associated with a large (myelinated) fiber peripheral neuropathy?

A
  • Negative: ↓ vibration + ↓ joint position sense + arreflexia + ataxia + hypotonia
  • Positive: tingling + pins and needles + numbness
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12
Q

Which median mononeuropathy is associated with an insidious onset of diffuse/dull ache about th proximal forearm (rarely acute or sharp)?

A

Pronator Syndrome

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13
Q

Pronator syndrome will have associated sensory loss where in the hand?

A

Diffuse numbness of hand, mostly 2nd-3rd fingers

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14
Q

Which median nerve mononeuropathy is associated with an abnormal pinch sign w/ normal sensation?

A

Anterior Interosseous Syndrome

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15
Q

What is a common site in the elbow and wrist contributing to ulnar mononeuropathy?

A
  • Elbow: between medial epicondyle and olecranon
  • Wrist: Guyon’s canal
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16
Q

Which muscle and motion of the thumb will be impaired in ulnar mononeuropathy?

A

ADductor policis = weak thumb ADduction = Froment Sign

17
Q

What is the most common site for radial mononeuropathy to develop; presents with what deficit?

A
  • Spiral groove of the humerus
  • Presents with wrist drop due to paresis of extensor ms. of the wrist, finger, and thumb
  • Elbow extension is SPARED!