Brainscape's Knowledge GenomeTM

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


See full index

CMT-uno > Neuropathies > Flashcards

Neuropathies Flashcards

1
Q

Carpal tunnel Syndrome

S/Sx
Nerve affected?

A

Pain, burning, tingling and numbness to fingers in median nerve distribution
Typically increases with activity
Often report shaking the hand to help with symptoms
Weakness with more severe disease

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

Carpal tunnel

PE
Signs

A

Diminished sensation to 1st-3rd fingers and radial half of 4th finger
Poor grip strength; thenar atrophy (late)

+Tinel sign- reproduction of symptoms with nerve percussion

+Phalen sign- reproduction of symptoms with flexing wrist to 90degrees for 60 sec

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

carpal tunnel

Dx

A

Ultrasound may show flattening of nerve

Best test is EMG/NCV (electromyography/ nerve conduction velocity)- will give you a yes/no AND will give severity of disease (mild, moderate, severe)

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

carpal tunnel

Tx

A

Relieve pressure on the nerve
Splint in neutral position
Reduce repetitive activity
PT for modalities and tendon glide exercises
NSAIDs or oral steroids
Steroid injection
Surgical release (endoscopic or open)

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

Carpal tunnel

who is often affected? recovery? people with CT often have high rate of?

A

Often occurs in pregnancy
Odds of full recovery diminish with thenar atrophy
People with these diseases have high rate of CTS:
RA, myxedema, amyloidosis, sarcoidosis, leukemia, acromegaly, and hyperparathyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ulnar neuropathy

General

A

Compression of the ulnar nerve in one of two places
At elbow (cubital tunnel)
At wrist (Guyon’s canal)
Can be from resting arm on things
Can also be from growth in wrist

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

Ulnar neuropathy

S/Sx

A

Pain, tingling or numbness in the ulnar nerve distribution (1/2 4th finger and all of 5th finger)
Sometimes will have weakness and sometimes won’t (depends on location of compression)
Worse with elbow flexion (if compression is at elbow)

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

Ulnar neuropathy

Tx

A

Depends on location, but still need to reduce compression:
Bracing elbow or wrist, especially while sleeping
NSAIDs or oral steroids
Avoid putting pressure on the nerve
Surgical release with relocation of nerve at elbow (ulnar nerve transposition)

When at wrist/ hand, often related to mass/ tumor and requires surgery

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

Radial neuropathy

General

A

Damage to radial nerve with humerus fracture
Compression of radial nerve
Axilla, wrist

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

Radial neuropathy

S/Sx

A

Numbness to back of hand
Weakness with wrist extension and at triceps
All symptoms and physical exam findings depend on location of problem (obviously won’t have weakness of triceps if problem is distal)

Compression at axilla is often from crutches
Saturday night palsy is usually radial nerve (arm over chair or head on hand)

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

Radial neuropathy

PE and Dx

A

same as S/Sx

EMG/NCV

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

Radial neuropathy

Tx

A

Remove compression or stop the thing/ activity causing compression
ALWAYS check radial nerve status with humerus shaft fracture

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

tarsal tunnel syndrome

General

A

Compression of the posterior tibial nerve at the ankle/foot; sometimes due to nerve stretching

Often accompanied by over pronation of the foot (flat feet)- will get into this more in orthopedic lectures

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

Tarsal tunnel sydrome

PE

A

Abnormal sensation to areas mentioned in signs/symptoms
Sometimes very tender over posterior tibial tendons and nerve in the tarsal tunnel
Rarely will have weakness and only in the foot

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

tarsal tunnel

Dx and Tx

A

Same as all other compressive neuropathies but EMG/NCV is less accurate here than in upper extremity

Same as all other compressive neuropathies but EMG/NCV is less accurate here than in upper extremity

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

Meralgia Paresthetica

general

A

Compression of lateral femoral cutaneous nerve

Typically happens in pregnant, obese or diabetic patients

17
Q

Meralgia Paresthetica

S/Sx

A

Numbness to lateral thigh that does not pass the knee joint
Often unilateral

18
Q

Meralgia Paresthetica

PE and Dx

A

Same as signs and symptoms
No loss of motor function

No Dx necessary

19
Q

Polyneuropathies & Mononeuritis Multiplex

A

Weakness, sensory disturbances (often including pain), or both in arms/ legs; diminished or absent DTRs; sometimes has family link; sometimes has a link to toxic exposure or systemic illness

20
Q

Diabetic Neuropathy- Peripheral

general

A

Due to late-stage diabetes mellitus (types I and II)
Damage to axons, worse with long nerves (why legs/ feet are worse)
Causes motor and sensory problems
Eventually develop vascular problems

21
Q

Diabetic neuropathy - peripheral

Early S/Sx

A

Early- sensory: diminished sensation to pain, vibration and temperature
Stocking glove pattern (starts distally and progresses proximally)

22
Q

diabetic neuropathy - peripheral

PE

A

Perform Semmes-Weinstein filament test- if cannot feel 5.07 size, they are at significant risk for injury
May have toe clawing
Calluses and ulcerations on plantar skin over MT heads

23
Q

Diabetic neuropathy - peripheral

Dx

A

X-rays will eventually show joint subluxation (shifting), subtle fractures and then bone destruction
Obviously need to monitor blood glucose levels
Might consider EMG/NCV early to determine tarsal tunnel syndrome vs diabetic neuropathy

24
Q

Diabetic Neuropathy- Peripheral

Charcot arthropathy

A

Prolonged neuropathy in addition to trauma can lead to collapse of arch and destabilization of midfoot joints
Patient ends up with rocker bottom foot deformity
Leads to ulcers on bottom of foot

25
Q

diabetic neuropathy - peripheral

Tx

A

Improve glucose control
Shoe adjustments (diabetic shoes reduce injuries that cause calluses and ulcers)
Ulcers must be treated by wound care specialists
Prevention!! See podiatrist regularly for exams and paring of calluses

Medications:
Low dose nortriptyline and amitriptyline (tricyclic antidepressants) treat the pain and cause drowsiness which helps with sleep
Gabapentin and pregabalin help with pain but have abuse potential
SSRIs give some relief but not as much as tricyclics
Sometimes topicals give some relief (capsaicin and lidocaine creams)

26
Q

Diabetic Neuropathy- Autonomic

general

A

Just like peripheral, damage to autonomic nerves by long term high blood glucose
Can change BP, pulse, GI activity, bladder fxn, ED

27
Q

Diabetic neuropathy - autonomic

S/Sx

A

GI- N&V, feeling of fullness, reflux, constipation or diarrhea, gastroparesis (more in type I)
GU- incomplete emptying of bladder, erectile dysfunction
Circulatory- orthostatic hypotension

28
Q

Diabetic neuropathy - autonomic

Tx

A

Treatments: treat each issue individually as you normally would treat it, nothing special specifically for cases related to neuropathy

29
Q

Charcot-Marie Tooth Disease

general

A

NOT THE SAME AS CHARCOT FOOT

Inherited, motor and sensory
Type 1- mutations in myelin protein genes
Type 2- axonal loss, also genetic

30
Q

Charcot-Marie Tooth Disease

S/Sx

A

Foot deformities, abnormal gait as a child or early adult
Progresses slowly and eventually leads to muscle wasting that starts in the legs
Distal sensory loss
Sometimes will have slight tremor

31
Q

CHarcot-Marie Tooth disease

PE

A

Same as signs and symptoms
Will have diminished or absent DTRs
Claw foot and high arch
Claw fingers

32
Q

Charcot-Marie Tooth Disease

Dx and Tx

A

EMG/NCV

No cure
NSAIDs and acetaminophen for pain
Surgeries for deformities

33
Q

Friederich Ataxia

general

A

Autosomal recessive trinucleotide repeat disease
Obvious cerebellar dysfunction (gait and hand coordination)
Weakness in legs
Sensory disturbance and diminished DTRs

34
Q
A
35
Q

Guillain-Barre Syndrome

general

A

Acute, idiopathic polyneuropathy
Often follows infection, vaccine, or surgery
Probably immune-based but no real known cause

36
Q

Guillain-barre Syndrome

S/Sx

A

Weakness is more of a problem than sensory issues, but they do NOT have loss of sensation or neuropathic pain

Tends to be symmetric
Begins in proximal legs, spreads to arms and sometimes the face

37
Q

Guilain-barre syndrome

PE

A

See signs and symptoms
Can develop autonomic nerve problems like cardiac irregularities, hypo or hypertension, pulmonary dysfunction, impaired sphincter control

38
Q

Guillain-barre syndrome

LP and EMG

A

Lumbar puncture: CSF has high protein count with normal cell ct

EMG/NCV- very odd changes, neurologist will interpret

39
Q

Guillain-barre syndrome

Tx

A

Not much for mild cases
Plasmapheresis- need to do this early and especially with severe cases
Need to be in ICU if trouble breathing
Clot prevention

CMT-uno (54 decks)

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