midterm

Question 1

flaccidity

Answer 1

motor loss

Question 2

paresis

Answer 2

weakness

Question 3

anesthesia

Answer 3

sensory loss

Question 4

parasthesia

Answer 4

sensory impairment

Question 5

dysesthesia

Answer 5

pain

Question 6

4 causes of peripheral nerve lesions

Answer 6

compression
trauma
systemic disorders
systemic edematous conditions

Question 7

causes of peripheral nerve lesions - compression can happen in two ways…

Answer 7

internally (from bony callus, hypertonic mm or tumor)

externally (from crutches or prolonged leaning)

Question 8

trauma that causes peripheral nerve lesions

Answer 8

crushing or severance wounds

Question 9

systemic disorders causing peripheral nerve lesions

Answer 9

leprosy (most common)

Question 10

systemic edematous conditions causing peripheral nerve lesions

Answer 10

pregnancy, hypothyroidism, diabetes, kidney & heart conditions

Question 11

types of nerve lesions

Answer 11

neuropraxia
axonotmesis
neurotmesis

Question 12

1st degree, compressions of nerve with local conduction block, no structural damage to axon/ tissue distal, block caused by local demyelination of nerve fibers, weeks/ months to recover, loss of motor function but sensory & autonomic fibers unaffected, prognosis good

Answer 12

neuropraxia

Question 13

2nd degree, prolonged severe nerve compression, lesion at compression sight, degeneration of axons distal to injury, sensory & autonomic losses, prognosis good

Answer 13

axonotmesis

Question 14

3rd-5th degree, severance of part of/ all of nerve trunk, degeneration, difficulty regenerating because of scar tissue/ edema/ bleeding, prognosis poor, surgical repair

Answer 14

neurotmesis

Question 15

nerve lesions may be…

Answer 15

complete - all fibers affected

incomplete - some fibers affected

Question 16

healing process - the lesions may be…

Answer 16

regenerating - repairing itself

permanent - nerve unable to regrow

Question 17

peripheral nerve pain can be due to…

Answer 17

neuritis
neuralgia
causalgia
RSD

Question 18

inflammation of nerve, sheath & CT affected, axon NOT affected, constant dull pain, paresthesia, dysesthesia, motor & sensory deficit - pathology / trauma, massage CI’d

Answer 18

neuritis

Question 19

pain syndrome, abnormal sympathetic reflex, arterial spasm, burning pain, edema, mm wasting, osteoporosis may be present

Answer 19

reflex sympathetic dystrophy (RSD)

Question 20

CI’s for hydro in RSD

Answer 20

tissue dystrophy or lack of vasomotor control

Question 21

tumor composed of nerve cells, partial/ complete severance, poorly localized pain, altered sensation

Answer 21

neuromas

Question 22

nerve pain, recurrent attacks or sudden, paroxysmal pain along distributing nerve, “lighting like”, no pathological change, “trigger zone” - trigeminal & intercostal - massage Ci’d in acute

Answer 22

neuralgia

Question 23

AKA tic douloureux, painful tic, CN V, trigger zone may be lips/ face/ tongue, massage over trigger zone CI’d

Answer 23

trigeminal neuralgia

Question 24

affects intercostal nerve - rib springing & massage over trigger zone CI’d

Answer 24

intercostal neuralgia

Question 25

severe pain syndrome, sudden intense burning pain, associated with traumatic injury to peripheral nerve

Answer 25

causalgia

Question 26

peripheral nerves have ability to regenerate if axon is damaged, cell body intact

Answer 26

Wallerian degeneration

Question 27

regenerating lesions - symptom picture

Answer 27

edema, altered tissue health, motor function affected, holding patterns, contractures, pain, scar tissue

Question 28

permanent lesion - symptom picture

Answer 28

edema, holding patterns, scar tissue, pain, compensatory changes, disfigurement of limb

Question 29

Ci's for nerve lesions

Answer 29

do not traction limb, no hydro until autonomic & vasomotor control returned, frictions avoided

Question 30

causes of a radial nerve lesion

Answer 30

fractures dislocations post-surgical complications compression ("saturday night palsy) supinator syndrome

Question 31

signs & symptoms of a radial nerve lesion

Answer 31

wrist drop

Question 32

mm innervated by the radial nerve

Answer 32

triceps, anconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, supinator, extensor digitorum, extensor carpi ulnaris, extensor digiti minimi, extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus, extensor indicis

Question 33

causes of an ulnar nerve lesion

Answer 33

fractures dislocations post-surgical complications compression repetitive action direct trauma pathology

Question 34

signs & symptoms of an ulnar nerve lesion

Answer 34

claw hand, Bishop's hand

Question 35

which special test would be positive with an ulnar lesion?

Answer 35

Froment's sign

Question 36

mm innervated by the ulnar nerve

Answer 36

flexor carpi ulnaris, FDP, palmaris brevis, flexor digit minimi, abductor digiti minimi, opponens digiti minimi, lumbricals 3 & 4, dorsal & palmar interossei, adductor pollicis

Question 37

causes of a median nerve lesion

Answer 37

fractures dislocations post-surgical complications compression trauma

Question 38

signs & symptoms of a median nerve lesion

Answer 38

ape hand, oath hand

Question 39

mm innervated by the median nerve

Answer 39

pronator teres, flexor carpi radialis, flexor digitorum profundus (lateral half), palmaris longus, pronator quadratus, abductor pollicis brevis. flexor pollicis longus, flexor pollicis brevis, opponens pollicis, 1st & 2nd lumbricals

Question 40

neurological condition involving lesion of facial nerve (CN VII) that causes weakness / paralysis of mm on same side of face

Answer 40

Bell's Palsy

Question 41

signs & symptoms of Bells' Palsy

Answer 41

-unilateral weakness -flaccid paralysis of mm of facial expression -unable to open/ close eye -inability to flare nostrils, raise corners of mouth, whistle, pucker -loss of control of lacrimation -loss of taste to anterior 2/3 tongue

Question 42

differentiating stroke from Bell's Palsy

Answer 42

stroke: upper 1/3 of face not affected

Question 43

Tx for bell's Palsy

Answer 43

unaffected side: pressure toward affected site, lateral to midline of face affected side: strokes from midline on face to lateral (toward lesion site) *no fascial techniques

Question 44

rapidly progressing inflammatory disease resulting in demyelination of peripheral nerves

Answer 44

Guillian-Barre syndrome

Question 45

causes of Guillian-Barre syndrome

Answer 45

cause unknown, may be related to autoimmune response by viral infection or immunization (covid vaccine)

Question 46

signs & symptoms of Guillian-Barre syndrome

Answer 46

begins as tingling in hands & feet, mm weakness (within 24-72hrs)

Question 47

mm innervated by the sciatic nerve

Answer 47

hamstrings: semitendinosus, semimembranosus, long head of biceps femoris (tibial), short head of biceps femoris (peroneal), ½ of adductor magnus

Question 48

mm innervated by the tibial nerve

Answer 48

gastrocnemius, plantaris, popliteus, soleus, tibialis posterior, flexor digitorum longus, flexor hallucis longus, intrinsic foot muscles:, flexor digitorum brevis, flexor hallucis brevis, abductor hallucis, abductor digiti minimi, adductor hallucis, lumbricals, interossei

Question 49

mm innervated by the peroneal nerve

Answer 49

extensor digitorum longus, peroneus longus, tibialis anterior, extensor hallucis longus, peroneus brevis, peroneus tertius, extensor digitorum brevis, extensor hallucis brevis

Question 50

causes of a sciatic nerve lesion

Answer 50

fractures dislocations iatrogenic reactions compression from internal/ external sources trauma

Question 51

signs & symptoms of a sciatic nerve lesion

Answer 51

foot drop -person must lift leg to walk = STEPPAGE GATE

Question 52

signs & symptoms of a tibial nerve lesion

Answer 52

claw toe

Question 53

which condition presents with Horner's syndrome?

Answer 53

Klumpke's paralysis

Question 54

traction or compression injury involving lower brachial plexus (C8/T1 nerve roots) - results in a combination of median & ulnar nerve lesion

Answer 54

Klumpke's paralysis

Question 55

symptom picture of Klumpke's paralysis

Answer 55

claw hand deformity

Question 56

presentation of arm & hand called “waiter’s tip” deformity with shoulder adducted & internally rotated, elbow extended, forearm pronated, & wrist and fingers flexed

Answer 56

Erb's palsy

Question 57

ULTT - median nerve, anterior interosseous nerve

Answer 57

ULTT 1

Question 58

ULTT - median nerve, musculocutaneous, axillary nerve

Answer 58

ULTT 2

Question 59

ULTT - radial nerve

Answer 59

ULTT 3

Question 60

ULTT - ulnar nerve

Answer 60

ULTT 4