Nerve Injury Flashcards

1
Q

Double crush syndrome

A

two separate lesions along the same nerve that create more severe symptoms thatn if only one lesion existed

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2
Q

Mononeuropathy

A

Isolated nerve lesion; associated conditions include trauma and entrapment

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3
Q

Neuroma

A

abnormal growth of nerve cells, associated conditions include vasculitis, AIDS, and amyloidosis

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4
Q

Peripheral neuropathy

A

Impairment or dysfunciton of the peripheral nerves, associated conditions include diabetic peripheral nueropathy, trauma, alcoholism

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5
Q

Polyneuropathy

A

diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma, associated conditions include Guillain Barre syndrome, peripheral neuropathy, use of neurotoxic drugs, and HIV

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6
Q

Wallerian Degeneration

A

Degeneration that occurs distally specifically to the myelin sheath and axon

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7
Q

Acute Nerve Injury - Neurapraxia (6)

A
  1. Mildest form, no nerve fiber damage, typically pressure injuries
  2. Conduction block with axonal continuity
  3. Axon, epi/peri/endoneurium intact
  4. Conduciton preserved proximally and distally to the injury
  5. Sx: pain, min mm atrophy, numbness/sensory loss, dec proprioception
  6. complete, rapid recovery in 4-6 wks
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8
Q

Acute Nerve Injury - Axonotmesis

A
  1. More severe, due to traction, compression, cursh injury
  2. Reversible injury b/c fibers maintain anatomical relationship to each other
  3. Damage to axon
  4. Preservation of endo/epineurium, schwann cells
  5. Distal wallerian degeneration cna occur
  6. recovery varies/is spontaneous, rate of regrowth 1mm/day
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9
Q

Neurotmesis

A
  1. Most severe
  2. Damage/transectoin to axon, myelin, CT
  3. Irreversible, no sontaneous recovery (requires surgery)
  4. All motor/sensory distal to the injury is lost
  5. Flaccid paralysis, mm wasting
  6. If surgically reattached, 1mm/day regrowth, sensory returns before motor
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10
Q

Cause of Axillary N Injury (2)

A
  1. humeral neck fx
  2. anterior shoulder dislocation
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11
Q

Cause of Musculoskeletal N Injury

A
  1. Clavical fx
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12
Q

Cause of Radial N Injury

A
  1. Humeral fx
  2. Compression in radial tunnel
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13
Q

Cause of Median N Injury (2)

A
  1. Pronator teres entrapment
  2. Compression in carpal tunnel
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14
Q

Cause of Ulnar N Injury

A
  1. Guyon’s canal entrapment
  2. Compression of cubital tunnel
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15
Q

Cause of Femoral N Injury

A
  1. THA
  2. Displaced acetabular fx
  3. Anterior femur dislocation
  4. Hypterectomy
  5. Appendectomy
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16
Q

Cause of Sciatic N Injury (3)

A
  1. Blunt force to buttocks
  2. THA
  3. Accidental injection into nerve
17
Q

Cause of Obturator N Injury

A
  1. Fixation of femoral fx
  2. THA
18
Q

Cause of Peroneal N Injury (2)

A
  1. Femoral/Tibial/Fibular Fx
  2. Positioning during surgical procedure
19
Q

Cause of Tibial N Injury (2)

A
  1. Tarsal tunnel entrapment
  2. Popliteal fossa compression
20
Q

Cause of Sural N Injury

A
  1. Calcaneal/Lateral malleolus fx
21
Q

Anterior Horn Cell Pathology (5)

A
  1. Sensory intact
  2. Motor weakness/atrophy
  3. Fasciculations
  4. Decreased DTR
  5. Ex: ALS, poliomyelitis
22
Q

PNS Muscle Pathology (4)

A
  1. Sensory intact
  2. Motor weakness, fasciculation rare
  3. Normal or decreased DTR
  4. Ex: muscular dystrophy
23
Q

Neuromuscular Junction Pathology (4)

A
  1. Sensory intact
  2. Motor fatigue greater than actual weakness
  3. Normal DTR
  4. Ex: myasthenia gravis
24
Q

Peripheral Nerve (Mononeuropathy) Pathology (4)

A
  1. Sensory loss along nerve route
  2. Motor weakness/atrophy in peripheral distribution
  3. May have fasciculations
  4. Ex: trauma
25
Q

Peripheral Polyneuropathy Pathology

A
  1. Sensory impariment in “stocking glove” distribution
  2. Motor weakness/atrophy, weaker distally than proximally
  3. May have fasciculations
  4. Decreased DTR
  5. Ex: diabetic peripheral polyneuropathy, T4 syndrome
26
Q

Spinal Roots/Nerve Pathology

A
  1. Sensory component will have dermatomal deficits
  2. Motor weakness in an innervated pattern
  3. May have fasciculations
  4. Decreased DTR
  5. Ex: herniated disc
27
Q

UMN Disease (3)

A
  1. Lesion in descending motor tracts within cerebral motor cortex, internal capsule, brainstem or spinal cord (lateral white column)
  2. Sx: weakness, hypertonicity, hyperreflexia, mild atrophy, abnormal reflexes
  3. Ex: cerebral palsy, hydrocephalus, ALS, CVA, MS, huntington’s, TBI, psuedobulbar palsy, brain tumor
28
Q

LMN Disease (3)

A
  1. Lession in nerves/axons below the level of the brainstem, ventral gray column of spinal cord
  2. Sx: flaccidity, weakness, decreased tone, fasciculations, atrophy, decreased/absent reflexed
  3. Ex: ALS, Guillian Barre, tumors, trauma, Bell’s palsy, CTS, muscular dystrophy, spinal muscular atrophy
29
Q

UMN vs LMN

  1. Reflexes
  2. Atrophy
  3. Fasciulations
  4. Tone
A
  1. UMN = hyper, LMN = dec, absent
  2. UMN = mild, LMN = present
  3. UMN = absent, LMN = present
  4. UMN = hyper, LMN = hypo, flaccid
30
Q

Forms of hypokinesia (3)

A
  1. Apraxia
  2. Rigidity
  3. Bradykinesia
31
Q

Forms of hyperkinesia (6)

A
  1. Ataxia
  2. Athetosis
  3. Chorea Tics
  4. Tremors
  5. Dysmetria
  6. Dystonia
32
Q

Tremor (4)

A
  1. Involuntary, rhytmic, oscillatory movements
  2. Resting: occur at rest, may increase with mental stress
  3. Postural: observable during voluntary contraction to maintain posture
  4. Intention: absent at rest, observable with activity, increase at target approaches, lesion in cerebellum
33
Q

Tic (2)

A
  1. sudden, brief, repetitive coordinated movement occuring at irregular intervals
  2. simple and complex
34
Q

Chorea

A
  1. Brief, irregular contractions that are rapid
  2. Due to damage to caudate nucleus
  3. Alternative form: Ballism (jerks of large amplitude, flailing), damage to subthalamic nucleus
35
Q

Dystonia

A
  1. sustained mm contraction causing twisting/abnormal posture/repetitive movement
36
Q

Athetosis (3)

A
  1. Movement disorder with slow twisting/writhing large amplitude movement
  2. Primarily seen in face, tongue, trunk, extremities
  3. Lie between chorea and dystonia