Nerve Pathology Part 3

Question 1

Median N entrapment will cause what syndromes?

Answer 1

Pronator Syndrome
Carpel Tunnel Syndrome
Anterior Interosseous Syndrome (motor)

Question 2

Ulnar N entrapment will cause what syndromes?

Answer 2

Cubital Tunnel Syndrome

Tunnel of Guyon Syndrome

Question 3

Radial N entrapment will cause what syndromes?

Answer 3

Radial Tunnel Syndrome

Posterior Interosseous Syndrome (motor)

Question 4

What are the mechanical causes of carpel tunnel syndrome?

Answer 4

Overuse
RA/Tenosynovitis
Lipoma
Fx/Dislocations

Question 5

What are the physiologic causes of carpel tunnel?

Answer 5

Diabetes
Hypothyroidism
Pregnancy

Question 6

Symptoms of carpel tunnel syndrome include?

Answer 6

Wrist/Hand pain that may radiate to forearm, elbow, and shoulder

Question 7

Other symptoms of carpel tunnel syndrome includes?

Answer 7

Numbness/paresthesias of radial 3 and 1/2 digits sparing the thenar eminence
Nocturnal Exacerbations

Question 8

What are the physical examination tests for carpel tunnel syndrome?

Answer 8

Phalen's
Tinel's or Compression
Abductor Policis Brevis Weakness
Objectifiable Sensory Loss over Radial 3 and 1/2 digits
Eventual Thenar Atrophy

Question 9

Electrodiagnostic studies for carpel tunnel syndrome shows what with NCV studies?

Answer 9

Latency

Question 10

What is the term for entrapment or compression of the lateral femoral cutaneous nerve?

Answer 10

Meralgia Paresthetica

Question 11

Sites of entrapment/compression for meralgia paresthetica include?

Answer 11

Inguinal Ligament

External Forces such as being overweight and sitting for long periods of time.

Question 12

What N travels through a tunnel formed by the flexor retinaculum, calcaneus and distal tibia (malleolus)?

Answer 12

Posterior Tibial N

Question 13

What syndrome is most often due to hyperpronantion which stretches the N in the tunnel?

Answer 13

Tarsal Tunnel Syndrome

Question 14

How do you test for for tarsal tunnel syndrome?

Answer 14

Dorsiflexion and Eversion of the Ankle

Question 15

What disease is extremely common and on the rise?

Answer 15

Diabetic Neuropathies

Question 16

What causes diabetic neuropathies?

Answer 16

Deposition of sorbitol

Blockage of Vascular Supply

Question 17

What are the different types of neuropathy?

Answer 17

Symmetric Distal
Asymmetric
Amyotropy
Autonomic

Question 18

When a patient complains of bilateral leg weakness following either a viral infection or immunization the disease is known as?

Answer 18

Guillain-Barre Syndrome

Question 19

A patient with guillain barre syndrome may complain of?

Answer 19

Distal Paresthesias

Question 20

What’s the cause of Guillain-Barre syndrome?

Answer 20

Unknown, but believed to be a demyelinating autoimmune disorder.

Question 21

What is the association with guillain barre syndrome?

Answer 21

Post-viral Illness

Question 22

What are some of the symptoms for guillain barre syndrome?

Answer 22

Loss of deep tendon reflexes
Fluctuations in BP
Abnormalities in Sweating
Sphincter Dysfunction

Question 23

With guillain barre syndrome the weakness will progress how?

Answer 23

Variably and involves arms and face

Question 24

10% of patients with guillain barre syndrome have?

Answer 24

Respiratory Involvement

Question 25

Patients with guillain barre syndrome demonstrate high protein content where?

Answer 25

CSF (may take 2-3 weeks)

Question 26

Guillain-Barre syndrome is self-resolving in how many patients within months?

Answer 26

80%-90%

Question 27

10% of patients with guillain barre syndrome will have what?

Answer 27

Residual Disability

Question 28

What medication should not be given for guillain barre syndrome because of the possibility of prolonging recovery time?

Answer 28

Prednisone

Question 29

What medication will benefit a patient with guillain barre syndrome?

Answer 29

Plasmapheresis | IV Immunoglobulin

Question 30

Myastenia gravis involves what?

Answer 30

Neuromuscular Junction

Question 31

What are the symtoms of myasthenia gravis?

Answer 31

Double Vision Difficulty Swallowing Weakness of the arm with repeated use Weakness of jaw muscles when chewing

Question 32

What is blocked by autoantibodies that bind to Ach receptors and makes them unavailable?

Answer 32

Neuromuscular Transmission

Question 33

Myastenia Gravis may be idiopathic or associated with?

Answer 33

Thymoma, thyrotoxicosis, RA, or lupus

Question 34

What are common in older men?

Answer 34

Thymomas

Question 35

What is considered in a search for a thymoma?

Answer 35

Chest Radiograph | Computed Tomography

Question 36

In an older man with thymoma electrophysiologic testing will reveal a decreased response to?

Answer 36

Stimulation

Question 37

What lab tests are used to test for myasthenia gravis?

Answer 37

A test to assay circulating levels of Ach receptor antibodies

Question 38

Medical evaluation for myasthenia gravis involves drug testing using a short acting anticholinesterase which causes?

Answer 38

Temporary Increase in Strength

Question 39

Symptomatic treatment for myasthenia gravis involves the use of?

Answer 39

Anticholinesterase medications such as Neostigmine or Pyridostigmine

Question 40

What is often dramatically effective and is often recommended to patients under age 60 years old with myasthenia gravis?

Answer 40

Thymectomy

Question 41

What disease is idiopathic but 50% of them are associated with neoplasm?

Answer 41

Lambert-Eaton Syndrome

Question 42

Lambert-eaton syndrome forms antibodies with?

Answer 42

Calcium

Question 43

The antibodies prevent the opening of calcium channels and thus prevent the release of?

Answer 43

Acetylcholine

Question 44

With lambert eaton, weakness is apparent immediately upon testing but improves on?

Answer 44

Sustained contraction

Question 45

Lambert eaton doesn't usually include?

Answer 45

Cranial Nerves

Question 46

The treatment for lambert eaton is similar to the treatment for?

Answer 46

Myastenia Gravis