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Biochemistry 2 > Module 0 > Flashcards

Module 0 Flashcards

1
Q

During the history what symptoms would indicate radiculopathy? Select all that apply.

A. Muscle weakness in a peripheral nerve pattern
B. Parenthesis in a cutaneous pattern
C. Pain that is unrelieved by rest
D. Parenthesis in a dermatomal pattern

A

C and D

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2
Q

What is the significance of the endoceurium in the context of positive atonal repair>? Endometrium acts:

A. As a guide conduit for the sprouting axons
B. As a source of nerve growth factors
C. In creation of scar tissue

A

A

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3
Q

Define Wallerian Degeneration. Choose all that apply

A. A process at the distal stump of a damaged axon, preparing the way for axonal sprouting
B. A process organized by Schwann cells following a lesion of an axon
C. A process only occurring in CNS axonal damage
D. A process involving the breakdown of the proximal stump of a damaged axon

A

A, B

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4
Q

Define transneuronal degeneration

A

When one neuron is lost, the neuron ahead or behind in the synaptic chain may also be lost

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5
Q

Define axonotmesis

A

Axonal disruption of some of the axons in a nerve, without displacement of the endoneurium

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6
Q

The axon reaction refers to:

A. The process of degeneration occurring at the distal stump of the disrupted axon
B. The reaction of the axon to the loss of connection with its cell body
C. The total effect on the cell body due to the loss of its axon
D. Depersal of the nucleolus, only

A

C

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7
Q

Describe the process of chromatolysis. Choose TWO.

A. Displacement of the nucleus
B. Dispersal of the Nissl Substance
C. Dispersal of the rER
D. Dispersal of the nucleolus

A

B, C

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8
Q

Axonal sprouting of PNS axons occurs due to growth factors released from:

A. Oligodendrocytes
B. Mast cells
C. Schwann cells
D. Endothelial cells

A

C

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9
Q

What is a neuroma? Choose all that apply.

A. Enlarged knot of axonal sprouts and scar tissue
B. Malignant tumor of neurons
C. Tissues created in a nerve affected by neurotmesis
D. Incomplete sprouting of axons unable to enter the endoneurial tube

A

A, C, D

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10
Q

Describe the process of recovery following axonal damage in the CNS. Choose the best single answer.

A. Wallerian regeneration
B. Neuronal mitosis
C. Axonal sprouting
D. Neuroplasticity

A

D

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11
Q

Which one of these describes the Dermatome affected most by an L5-S1 disc herniation

A. L4
B. S1
C. L5

A

B

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12
Q

The Achilles reflex would be lost in an __ nerve root lesion.

A. S1
B. L4
C. L5

A

A

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13
Q

Desires entrapment at the intervertebral disc by disc herniation, what other structure may be responsible for the pain syndrome called sciatica?

A. Entrapment by the gastrocnemius muscle
B. Entrapment by the piriformis muscle
C. Entrapment by the gluteus Maximus muscle

A

B

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14
Q

There is an orthopedic test that is well-known to be specific to diagnosis of spinal root involvement and disc herniation. What is it:

A. Provacative test called Babinski’s test
B. Stretch test called Gaenslen’s Test
C. Tension test called the Straight Leg Raise (SLR)

A

C

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15
Q

T or F
Disc herniation always require surgery to reduce them

A

F

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16
Q

What are the four cardinal sings of inflammation ?

A

Pain, heat, swelling, redness

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17
Q

What helps to differentiate involvement of MSK damage versus NM system damage?

A

Pain progression
Pattern of pain

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18
Q

Does lumbar sprain strain while causing soft tissue damage typically affect spinal nerves?

A

No

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19
Q

What is a common cause of Spinal nerve injury?

A

Intervertebral disk injury

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20
Q

Symptoms of spinal nerve entrapment:

A

Pain not affected by rest
Pain progression
Pain pattern includes areas not directly impacted by mechanism of injury

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21
Q

Signs of spinal nerve entrapment:

A

Antalgic posture
Weakness
Reflex changes
Sensory changes
Positive orthopaedic testing

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22
Q

What is shooting pain called?

A

Radicular pain

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23
Q

What is radiculopathy?

A

Injury or irritation of a nerve with pain that radiates from the injured area in a recongnizable pattern

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24
Q

What was the type of onset for Mrs. Cornwell?

A

Acute, stopped her from finishing her job

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25
Q

What are some sprain/strain findings?

A

Pain on movement, rest relieves pain
Pain only in area of injury
No radiating pain
Improves with time

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26
Q

Is pain subjective or objective?

A

Subjective

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27
Q

What contributes to and complicates both the presentation and the healing of physical trauma?

A

Emotional trauma and stress

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28
Q

What makes up the CNS?

What makes up the PNS?

A

Brain and spinal cord

Cranial and spinal nerves

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29
Q

How many spinal nerves are there and where do they originate?

A

31, spinal cord, part of PNS

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30
Q

Composition of peripheral nerves

A

Sensory, motor, autonomic fibers

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31
Q

Radic/o, radicul/o, rhiz/o

A

Nerve root

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32
Q

Path/o

A

Disease

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33
Q

Myel/o

A

Spinal cord

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34
Q

Encephal/o

A

Brain

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35
Q

Praxi/o

A

Action or movement

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36
Q

Cept/o

A

To receive or detect

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37
Q

Noci-

A

To harm or injure

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38
Q

-tmesis

A

To cut

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39
Q

-paresis

A

Weakness

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40
Q

What is the first thing to relieve a stimulus?

A

Primary Afferent axon’s receptor

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41
Q

What are some of the least specific receptive end organs?

A

Receptors for tissue damage typically affect

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42
Q

What type of receptor receives all types of damaging stimuli?

A

Polymodal C-fiber free nerve ending

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43
Q

What does the receptor on the primary afferent axon receive?

A

Stimulus

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44
Q

Where does perception occur?

A

Cortex of cerebrum

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45
Q

Define receptive fields

A

Area innervated by C-fiber axon further refined at level of cord and cortex

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46
Q

What are bundles of axons in the periphery?

A

Nerves

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47
Q

What are bundles in the CNS?

A

Tracts

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48
Q

Axons of C-fibers are myelinated or unmyelinated?

A

Unmyelinated

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49
Q

The areas that have smaller receptive fields do what?

A

Project more strongly to the cerebral cortex

50
Q

T or F

Pain localization is more accurate in the face than low back

A

T

51
Q

Does nervous tissue itself exhibit receptive field patterns?

A

No

52
Q

Spinal nerve irritation results in what type of pain pattern?

A

Dermatomal

53
Q

Peripheral nerve irritation results in what type of pain pattern?

A

Cutaneous

54
Q

Does irritation of the CNS result in conscious awareness? Why?

A

No, there are no sensory receptors on the brain

55
Q

What are the receptive fields of the spinal nerve afferent axons?

A

Dermatomes

56
Q

In what dermatome was Mrs. Cornwell having pain?

A

S1

57
Q

What direction to lumbar discs typically herniate?

A

Dorsolaterally

58
Q

What disc was affected with Mrs, Cornwell?

A

L5-S1
S1 NR affected

59
Q

Where did Mrs. Cornwell describe her pain to be?

A

Shooting down her leg pain in lateral calf, lateral foot, little toe

60
Q

How is the integrity of the spinal nerves evaluated?

A

MSRs

61
Q

L4 muscle indicator

A

Tibialis anterior

62
Q

L4 reflex indicator

A

Patellar

63
Q

Medial leg, foot, great toe, anterior knee

A

L4 dermatome pattern

64
Q

L5 muscle indicator

A

Extensor hallicus longus

65
Q

L5 reflex indicator

A

Medial hamstring

66
Q

L5 Dermatome pattern

A

Dorsum of the foot, heel

67
Q

S1 muscle indicator

A

Fibularis longus/brevis

68
Q

S1 reflex indicator

A

Achilles

69
Q

S1 dermatome pattern

A

Lateral leg, foot, little toe

70
Q

What nerve root is affected if the patient cannot extend their big toe?

A

L5

71
Q

What nerve root is affected if the patient cannot do eversion?

A

S1

72
Q

Surrounds all the fascicles of the nerve

A

Epineurium

73
Q

Surrounds each nerve fasicle

A

Perineurium

74
Q

Surrounds individual axons

A

Endoneurium

75
Q

What is the majority of endoneurium made of?

A

Non-living product of fibroblasts (matrix)

76
Q

What type of connective tissue is endoneurium?

A

Loose connective tissue

77
Q

What type of connective tissue is Epineurium and Perineurium?

A

Dense irregular

78
Q

What is the part of the axon that always degenerates if a nerve is severely damaged?

A

Part distal to the injury

79
Q

Process of nerve repair.

A

Proximal stump sprouts into the uninterrupted endoneurial tube

80
Q

PNS or CNS

Always has connective tissue investments

What are connective tissue investments important?

A

PNS

Provides nutrients blood supply, waste transport ion to axon protects axon.

81
Q

How can lesions occur?

A

As compressions or entrapments

82
Q

If the axon is disrupted in the PNS…

A

The distal stump degenerates

83
Q

If there is damage to the axon in the CNS….

A

The neuron will likely die

84
Q

Explain retrograde transeuronal degeneration

A

Neuron before the lesion might undergo degeneration

85
Q

Explain orthography transneuronal degeneration

A

Neuron after the lesion might also undergo degeneration

86
Q

What is neuronal irritation or damage from compression, mild injury, resulting in a non-severed axon?

A

Neuropraxia

87
Q

What is said about recovery for neuropraxia?

A

Full recovery can be achieved

88
Q

What is moderate to severe compression, where the distal stump begins to undergo Wallarian degeneration but the endoneurium is not displaced?

A

Axonotmesis

89
Q

What is said about recovery for Axonotmesis?

A

Regeneration of proximal stump can occur 1-2 mm per day

90
Q

What is transection of an axon where the whole nerve is severed and the 2 ends of the endoneurium are displaced so the axon sprouts cannot find their way back?

A

Neurotmesis

91
Q

What is said about the recovery for neurotemesis?

A

Surgery might be required, won’t heal on its own

92
Q

What can cause a neuroma?

A

Neurotemesis

93
Q

What is the axon reaction?

A

Reaction of the cell body to the loss of its axon

94
Q

What is a complex ball of axon sprouts a scar tissue on a damage nerve axon?

A

Neuroma

95
Q

What nerve is irritated in Morton’s neuroma?

Where is the nerve irritated?

A

Medial plantar nerve

Between 3rd and 4th toes

96
Q

Important features of the axon reaction

A

Chromatolysis
Neuronal cell body swelling
displacement of nucleus
Dispersal of nucleolus

97
Q

What is the first thing that happens after an axon is damaged?

A

Swelling of the proximal and distal stumps

98
Q

What is the axon reaction also called?

A

Retrograde reaction

99
Q

T or F

Neurons recover in the PNS

A

T

100
Q

T or F

Neurons will die in the CNS

A

T

Likely die

101
Q

What causes swelling of the cell body?

A

Dispersal of ribonucleic acid acid attracts water into cell body swelling displacement

102
Q

What directs the recovery of axonal sprouts?

A

Endoneurial tube

103
Q

Define hypoxia

A

Deficiency of oxygen in the tissues

104
Q

Damage to axons in the CNS can occur by

A

Hypoxia from stroke or TBI

105
Q

What do fMRIs show?

A

Level of brain engagement or activity

106
Q

During history, what symptoms would indicate radiculopathy?

A

Pain unrelieved by rest parenthesis in dermatomal pattern

107
Q

What organizes wallerian degeneration?

A

Schwann cells

108
Q

Define transneuronal degeneration

A

When one neuron is lost, the neuron ahead or behind in the synaptic chain may also be lost

109
Q

What is axonal disruption of some of the axons in a nerve without displacement of the endoneurium?

A

Axonotmesis

110
Q

Describe the process of chromatolysis

A

Dispersal of the Nissl substance dispersal of the rER

111
Q

What type of nerve entrapment involves cutaneous patterns of sensory loss?

A

Peripheral

112
Q

What type of nerve entrapment involves more muscles being affected?

A

Peripheral

113
Q

What type of nerve entrapment involves motor loss linked to nerve and muscles innervated by nerve?

A

Peripheral

114
Q

What segments are more vulnerable to spinal nerve entrapments?

A

After L2 when the spinal cord ends

115
Q

Where is the nucleus found during swelling in the cell body of the axon reaction ?

A

Periphery

116
Q

Why is there dispersal of the nucleolus of the cell during the axon reaction?

A

Ribosomal RNA is made by the nucleolus and it is no longer needed

117
Q

How is learning and memory constantly happening in the brain?

A

Neuronal plasticity

118
Q

Ways to make sure that nerve recovery is effective?

A

Brain getting all nutrients

119
Q

Describe the process of recovery following axonal damage in the CNS

A

Neuroplasticity

120
Q

Neuroapraxia

A

(Irritation) = peripheral nerve gets “dinged”

121
Q

Axonotmesis

A

(moderate to severe compression) = gets interruption, can recover by 2mm a day, endoneural tube is fine

122
Q

Neurotemsis

A

(Transection) = real problem - (can only be reconnected though possible surgery) injury/degeneration/neuroma formation (Endoneuronal tubes do not line up anymore - neuroma forms)

Biochemistry 2 (22 decks)

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