Neuro Flashcards
Sequence of nerve recovery after injury?
Pain Temp Touch Proprioception Motor
What is the seddon classification?
Neuropraxia
Axonotmesis - Walerian regeneration.
Neurotmesis
Sunderland classification
First degree: Conduction deficit without axonal damage.
Second degree: Axon is severed without reaching the neural tube. Wallerian degeneration will occur.
Third degree: Degeneration and destruction of the fascicle with irregular degeneration.
Fourth degree: Destruction of the axon and fascicle and no destruction of the nerve trunk with a neuroma in existance.
Fifth degree: complete loss of the nerve with a likely neuroma.
Where is the popiteal injection given?
7 cm proximal and approximately 1 cm lateral to the transverse popliteal crease.
Muscle innervated by the medial plantar nerve
LAFF First Lumbrical Abductor hallucis Flexor digitorum brevis Flexor hallucis brevis
Muscles innervated by the lateral plantar nerve?
Abductor digiti minimi Quadratus planti Lumbricles 2-4 (Deep lateral plantar nerve innervates... Adductor hallucis muscle and dorsal interossei 1-3 plantar 1-2)
Superficial lateral plantar nerve hits flexor digit minimi and remaining interosei Dab 4 Pad 3
Name the innersapce neuromas from medial to lateral.
Joplins neuroma Housers neuroma Heuters neuroma Mortons neuroma Iselens neuroma
A sign that describes the splaying of the toes secondary to a mass caused by either a neuroma or local infiltrate
Sullivans sign
Multiple sclerosis
Best diagnosis modality?
Chronic inflammatory disease
Myelin sheath attacked
Progressive disruption between the brain and the body.
Diagnosed best with MRI!
Spinal tap can find IgG self directed antibodies.
Amytrophic lateral sclerosis? (ALS)
A devastating progressive degenerative disease of both UMN and LMN results in muscle weakness and atrophy.
Mental status preserved, men effected most often.
Death within 3-5 years of onset via respiratory failure.
Signs of an upper motor neuron lesion?
No muscle atrophy Clonus Babinski Hyperreflexia Spasticity* Spastic paralysis NO FASCICULATIONS
Signs of a lower motor neuron lesion?
Atrophy of the muscle Hyporeflexia of the deep reflexes Flaccid paralysis Fasciculations Hypotonicity
Guillain barre syndrome?
Acute progressive and self limiting inflammatory demylnating disorder.
Rapid weakness and paralysis that spreads within days.
It is autoimmune disorder with a common percipitating factor such as campylobacter infection, viral infections etc.
Look for symmetrical muscle weakness working from the legs to the arms.
Charcot Marie Tooth Disease (CMT, Peroneal muscle dystrophy)
Damage to the peripheral nervous system
Weakness from distal to proximal most commonly presenting with foot drop first.
May have some sensory deficiencies but most commonly motor.
Loss of the intrinsics of the feet happens first!!
What is the order of muscle loss seen in charcot marie tooth disease?
Plantar intrinsics Tibialis anterior EDL EHL Peroneus Brevis
Key is that peroneus brevis is effected while peroneus longus is spared creating pes cavus deformity*
The legs may end up with the “Inverted Champagne bottle or Stork Leg appearance!!”
