Neuro pathologies general

Question 0

Blood vessel supply to nerve

Answer 0

Vasanervorum

No lymphatic vessel to drain extra fluid contributes to longer recovery of nerve damage

Question 1

Compression syndromes of peripheral nerves

Answer 1

Result in a local conduction block in a peripheral nerve but no structural damage to the axon or to tissue distal to the lesion
Symptoms: numbness, tingling, pain weakness due to impaired oxygenation (ischemia) of nerve, impaired local neural conduction

Question 2

Single peripheral nerve is affected

Answer 2

Mononeuropathy

Question 3

Several peripheral nerves are involved

Answer 3

Polyneuropathy

Question 4

Involvement of the nerve root as it emerges from the spinal cord

Answer 4

Radiculoneuropathy

Question 5

Involvement of several nerve roots and occurs when infections create an inflammatory response

Answer 5

Polyradiculitis

Question 6

Brachial plexus injuries

Answer 6

Erb-Duchenne palsy - weiter’s tip position
Klumpke’s paralysis
Homer’s syndrome
Radial nerve - Crutch palsy, saturday night palsy, posterosseous syndrom, cheiralgia paresthetica
Median nerve - Ligament of Struthers, pronator Teres Syndrome, Anterior interosseous syndrome, Carpal Tunnel syndrome
Ulner Nerve - Tardy ulnar palsy, Thoracic outlet syndrome (Cervical rib, Anterior scalene syndrome, interscalene triangle, costoclavicular, pectoralis minor syndrome)

Question 7

Lumbar plexus injuries

Answer 7

Injury to femoral nerve
Injury to obturator nerve
Meralgia paresthetica

Question 8

Sacral plexus

Answer 8

Tarsal Tunnel syndrome

Sciatic nerve lesions

Question 9

Neuritis

Answer 9

Inflammation of the nerve
Mainly sheath and connective tissue are affected (usually the axon is not)
Constant dull pain

Question 10

what causes Neuritis

Answer 10

Secondary to pathology (DM, Leprosy, TB)
Trauma to nerve
Chronic exposure (to a toxin like lead, rugs or alcohol)

Question 11

Neuralgia

Answer 11

Nerve pain intense zapping pain, electric
Recurrent attacks of sudden excruciating pain along distribution of the nerve
No associated pathology
has a trigger zone - are that causes an attack when stimulated
usually its an area of skin supplied by the nerve
Movement of the area increases pain

Question 12

Which nerve does Neuralgica commonly affect?

Answer 12

Trigeminal and intercostal nerves

Question 13

Intercostal neuralgia

Answer 13

affects intercostal nerves that ravel between the internal and innermost intercostal muscles

Question 14

What causes intercostal neuralgia

Answer 14

Diabetes

Post herpes zoster

Question 15

Herpes zoster (shingles)

Answer 15

Start with Varicella zoster virus (chicken pox)
when reactivated, the virus causes a generalized inflammatory response starting in the sensory ganglion and spreading along the nerves causing demyelination and degeneration
inflammation produces pain and tingling in the involved dermatome with a rash and then vesicles that burst and encrust.
Most commonly Trigeminal and thoracic nerves are affected.

Question 16

What is traction injury of superior roots of the brachial plexus (C5-C6)?

Answer 16

Erb-Duchenne palsy
Forceful pulling away of head from shoulder
Sensory loss C5 and C6 dermatome)

Question 17

What is the common sign of Erb-Duchenne palsy?

Answer 17

Waiter’s tip position

arm is adducted, medial rotation, forearm pronated, elbow extended,wrist and fingers flexed

Question 18

What is injury when the arm pulled away from neck?

Answer 18

Klumpke’s paralysis
Traction injury of lower brachial plexus
Poor positioning at birth (breech) or pulled by forces
sensory loss affecting C8 + T1 dermatome
Can get Horner’s syndrome (smaller pupil, drooping eyes)

Question 19

what is the sign of Klumpke’s paralysis

Answer 19

Claw hand - thumb on same plane as palm (whole hand…both median and ulnar)

Question 20

Horner’s syndrome

Answer 20

Miosis: constriction of pupil
Ptosis: drooping of eyelid
Anhydrosis: loss of sweating to face and neck
Enophthalmos: recession of eyeball into orbit

Question 21

Neurapraxia

Answer 21

1st degree nerve injury, mild focal compression. Segmental demylination, reversible in hours to months.

Question 22

Axonotmesis

Answer 22

Second degree nerve injury, prolonged severe compression. Wallerian degeneration (degeneration of the axon, distal to injury). more than 6 months to recover, sensory, motor, and autonomic loss

Question 23

Neurotmesis

Answer 23

Third degree nerve injury
Damaged endoneurium
Wallerian degeneration, hard to regenerate. Surgical intervention to suture.

Question 24

1st degree nerve injury

Answer 24

Neurapraxia, segmental demyelination

Question 25

2nd degree nerve injury

Answer 25

Axonotmesis, wallerian degeneration, endonerium is intact

Question 26

3rd degree nerve injury

Answer 26

Neurotmesis, damaged endonerium, wallerian degeneration