Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

year 2 neuro - Robbie > Muscle and Nerve Diseases > Flashcards

Muscle and Nerve Diseases Flashcards

1
Q

Image showing the motor pathway

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Muscle converts chemical energy to what?

A

designed to convert chemical energy → mechanical energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the components of the process needed to convert chemical energy to mechanical energy?

A
  • Structural components
  • Contractile mechanism
  • Excitation-contraction coupling (ion channels)
  • Energy system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms of msucle disease?

A

• Weakness of skeletal muscle

Short of breath (respiratory muscles)

Poor swallow/aspiration (bulbar muscles)

  • Cardiomyopathy
  • Cramp, pain, stiffness, myoglobinuria - start to destroy muscle and myoglobin is peed out and will turn urine dark brown/bloody

(Babies: poor suck / feeding / failure to thrive / floppy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the signs of muscle disease?

A
  • Wasting/hypertrophy
  • Normal or reduced tone and reflexes
  • Motor weakness…NOT sensory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations can be carried out for muscle disease?

A
  • History and examination
  • Creatine Kinase (CK)
  • EMG - evaluating and recording the electrical activity produced by skeletal muscles
  • Muscle biopsy

Structure

Biochemistry

Inflammation

• Genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 categories that muscle disease can be put into?

A

congenital/genetic

acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some types of genetic/congenital muscle diseases and examples?

A

Structural: muscular dystrophies

Contractile: congenital myopathies

Coupling: channelopathies

Energy: enzymes/mitochondria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some examples of aquired muscle diseases?

A

Metabolic (Ca2+, K+)

Endocrine (thyroid, adrenal, vit D)

Inflammatory muscle disease

Iatrogenic: medication (steroids / statins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When do muscular dystrophies start?

A

young or old onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the severity of muscular dystrophies?

A

Progressive, variable severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens in muscular dystrophies?

A

Cell degeneration (often high CK)

muscle diseases that results in increasing weakening and breakdown of skeletal muscles over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some examples of muscular dystrophies?

A

Duchenne’s/Becker’s (dystrophin) - most common

Facioscapulohumeral/oculopharyngeal/limb girdle

Myotonic dystrophy (cataracts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment of muscular dystrophies?

A

No specific treatments yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What cannels do Channelopathies effect and what are the symptoms? and treatment?

A

disorders of Ca2+, Na+, K+ and Cl- channels

often paroxysmal symptoms e.g. periodic paralysis / myotonia - toruble relaxing muscle

partially treatable - drugs can alter channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are energy production (metabolic myopathy) induced and what is the reason?

A

Exercise induced: early = disorders of carbohydrate metabolism
late = disorders of lipid metabolism

Mitochondrial problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Are problems with energy production treatable?

A

partially treatable - alter diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

WHat are the 2 types of inflammatory muscle disease and their difference?

A

Polymyositis vs dermatomyositis (DM)

DM also comes with a rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

WHat are the features of inflammatory muscle disease?

A

Any age

Acute or subacute, painful, weak muscles

Characteristic rash of DM

20
Q

How can inflammatory muscle diseases be diagnosed and investigated?

A
  • High CK, autoantibodies, tumour screen (esp DM)
  • EMG & biopsy
  • Polymyositis: CD8 cells
  • Dermato: humeral-mediated, B cells and CD4 cells
21
Q

What is the treatment of inflammatory muscle diseases?

A

immunosuppresion

22
Q

What else may be present alongside DM apart from a rash

A

Often all have a underlying tumour in DM – 50%

If you treat DM then miss tumour then problem

23
Q

Where do disorders of neuromuscular junction effect?

A
24
Q

How is ACh taken up from the synaptic cleft?

A

When you release ACH into synaptic cleft there is a recycling system and cholinesterase is what dose this

25
Q

What is Myasthenia Gravis?

A

affects neuromuscular junction

a rare long-term condition that causes muscle weakness

26
Q

What is the clinical presentation of Myasthenia Gravis?

A

Clinical presentation = Fatiguable weakness:

  • Ocular: eyelids (ptosis)
    muscles of eye movement (diplopia)
  • Generalised: limbs
    bulbar (chew, swallow, talk)
    breathing
27
Q

What investigations are carried out for Myasthenia Gravis?

A

AChR, Anti MuSK antibodies - looking ofr the antibody that is causing it

Neurophysiology (Repetitive stimulation, Jitter)

CT chest (10% have an underlying thymoma)

28
Q

What is the treatment of myathenia gravis?

A
  • Symptomatic - Acetylcholinesterase inhibitor (pyridostigmine) - inhibits acetylcholinesterase from breaking down acetylcholine into choline and acetate, thereby increasing both the level and duration of action of the neurotransmitter acetylcholine
  • Immunosuppression

Prednisolone - block cholinesterase so much more ACH but not removing antibody so use an immunosuppressant to try and reduce it​

Steroid saving agent (e.g. azathioprine)

  • Immunoglobulin/plasma exchange
  • Thymectomy
29
Q

Where does peripheral nerve disease affect?

A
30
Q

What do peripheral nerves consist of?

A

•Sensory axons:

  • Small fibres (pain + temperature)
  • Large fibres (joint position sense + vibration)
  • Motor axons
  • Autonomic axons
  • Nerve sheath (myelin)
31
Q

Whata re the 3 different types of nerve disease?

A
  • Root disease
  • Lesion of individual peripheral nerve

Compressive/entrapment neuropathy

Vasculitic (mononeuritis multiplex)

• Generalised peripheral neuropathy

Motor/sensory/both

+/- autonomic features

32
Q

Generalised peripheral neuropathy can either be __________ or _________

A

Axonal vs demyelinating

33
Q

WHat are the causes of generalised peripheral neuropathy?

A

Hereditary

Metabolic: diabetes, alcohol, renal failure, B12

Toxic: drugs

Infectious: Lyme, HIV, leprosy

Malignancy: paraneoplastic

Inflammatory demyelinating:

Acute = Guillain Barre syndrome

Chronic = chronic inflammatory demyelinating polyneuropathy

34
Q

What are the symptoms and signs of nerve root nerve disease?

A

Myotomal wasting and weakness

Reflex change

Dermatomal sensory change

symptoms and signs tend to be quite localised to the are of the nerve root

35
Q

What are the symptoms and signs of individual nerve disease?

A

Wasting and weakness of innervated muscle

Specific sensory change

36
Q

What are the symptoms and signs of generalised peripheral neuropathy

A

Sensory and motor symptoms, usually starting distally and moving proximally

37
Q

What are the investigations for nerve disease?

A

Investigations depend on the cause:

  • Blood tests
  • Genetic analysis
  • Nerve Conduction Studies
  • Lumbar puncture (CSF analysis)
  • Nerve biopsy (nb sensory nerve)
38
Q

What is the treatment of nerve disease?

A

Treat the cause eg stop drug, surgery, immunoglob

39
Q

Where do disorders of the anterior horn cell effect?

A
40
Q

As the anterior horn cell is affected, what else is therefore effected?

A

LMN

41
Q

What is motor neuron disease?

A

an uncommon condition that affects the brain and nerves. It causes weakness that gets worse over time. It’s nearly always fatal and can significantly shorten life expectancy, but some people live with it for many years

42
Q

Where does motor neuron disease spread to and from?

A

Usually limb → bulbar (swallowing, speech etc)→ respiratory

43
Q

What are the signs of motor neuron disease?

A

combination of UMN and LMN signs:

LMN = muscle fasciculations, wasting, weakness

UMN = increased tone, brisk reflexes

No sensory involvement

10%+ have cognitive decline

44
Q

What is the prognosis of motor neuron disease?

A

Median 3-5 years from symptom onset, 2-3 years from diagnosis

50% die within 14 months of diagnosis

45
Q

What is the diagnosis of motor neuron disease?

A

Basically a clinical diagnosis

Unique combination of UMN + LMN signs with no sensory signs

EMG - an electrodiagnostic medicine technique for evaluating and recording the electrical activity produced by skeletal muscles

46
Q

What is the treatment of motor neuron disease?

A

Supportive - important:

PEG feed, non invasive ventilation, physio, OT, SALT, care

Riluzole - not great

Anticipatory / palliative care

year 2 neuro - Robbie (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions