Brainscape's Knowledge GenomeTM

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


See full index

Neurology finals > Neuropathies > Flashcards

Neuropathies Flashcards

1
Q

What is a mononeuropathy

A

Lesions of individual peripheral or cranial nerves

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

From which nerve roots is the median nerve formed of?

A

C6-T1

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

What is the function of the median nerve

A

Precision grip

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

Which muscles are innervated by the median nerve

A

Lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

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

What syndrome results from compression of the median nerve at the wrist?

A

Carpal tunnel syndrome

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

Describe the symptoms of carpal tunnel syndrome

A

Aching pain in the hand and arm especially at night and paraesthesia in the thumb, index and middle fingers
Relieved by dangling hand over the edge of the bed and shaking it
May be sensory loss and weakness of abductor pollicis brevis and wasting of the thenar eminence
Light touch and 2 point discrimination and sweating may be impaired

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

What causes carpal tunnel

A

Swelling or compression of the tunnel - myxoedema, prolonged flexion (colles splint), acromegaly, myeloma, local tumours, rheumatoid arthritis, amyloidosis, pregnancy, sarcoidosis

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

What tests are requested in carpal tunnel

A

Neurophysiology - confirms the site of the lesion and severity
Phalens test - Maximal wrist flexion for 1 minute
Tinnels test - tapping over the nerve on the wrist can induce tingling

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

How is carpal tunnel syndrome treated?

A

Splinting
Steroid injections
Decompression surgery

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

What is tarsal tunnel syndrome

A

Unilateral sole pain, following tibial nerve compression

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

Which nerve roots form the ulnar nerve

A

C7-T1

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

What is the ulnar nerve vulnerable to?

A

Elbow trauma

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

What are the signs of ulnar nerve damage

A

Weakness/wasting of medial wrist flexors, interossei and medial 2 lumbricals (claw hand - more marked wrist lesions with digitorium profundus intact). Hypothenar eminence wasting, weak 5gth digit abduction and 4th, 5th DIP joint flexion, sensory loss over medial 1 and half fingers and ulnar side of the hand

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

Where does compression of the ulnar nerve most commonly happen?

A

The epicondylar groove or at the point where the nerve passes between the two heads of flexor carpi ulnaris.
May also less commonly occur at the Guyon’s canal (between pisiform and hamate bones)

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

How are ulnar nerve mononeuropathies treated?

A

Rest and avoid pressure on the nerve
Elbow splinting at night time to prevent flexion >60
Splint for the hand may prevent permanent clawing
For chronic neuropathy or if splinting fails, a variety of surgical procedures have been tried. Decompression in situ or medial epicondylectomies are effective in 50% but many will recur

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

What is the function of the radial nerve?

A

Opens the fist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which nerve roots form the radial nerve?

A

C5-T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How may the radial nerve become compressed?

A

Compression against the Humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you test for radial nerve compression?

A

Wrist and finger drop with elbow flexed and arm pronated

Sensory loss is variable - the dorsal aspect of the root of the thumb - anatomical snuffbox is more reliably affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which muscles are involved in radial nerve compression?

A 
Brachioradialis 
Extensors
Abductor pollicis longus 
Supinator
Triceps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the function of the phrenic nerve

A

Supplies the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which nerve roots form the phrenic nerve

A

C3,4,5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do lesions of the phrenic nerve cause?

A

Orthopnoea with a raised hemidiaphragm on CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What causes lesions of the phrenic nerve?

A 
Lung cancer
TB
Paraneoplastic syndrome
Myeloma
Thyoma 
Cervical spondylosis/trauma
Thoracic surgery 
Infections - HZV, HIV, Lyme disease
Muscular dystrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe brachial plexus compression symptoms

A

Pain/paraesthesia and weakness in the affected arm in a variable distribution

26
Q

What causes brachial plexus compression?

A 
Trauma
Radiotherapy
Prolonged wearing of a heavy rucksack 
Cervical rib
Thoracic outlet compression
Neuralgic amyotrophy
27
Q

Which nerve roots form the lateral cutaneous nerve of the thigh?

A

L2-3

28
Q

What does compression of the lateral cutaneous nerve of the thigh cause?

A

Meralgia paraesthetica

29
Q

Describe the symptoms of meralgia paraesthetica

A

Anterolateral burning thigh pain

30
Q

Where is the compression of the lateral cutaneous nerve of the thigh

A

Entrapment

31
Q

Which nerve roots form the sciatic nerve

A

L4-S3

32
Q

What causes sciatic nerve mononeuropathy

A

Pelvic tumours

Fractures to the pelvis or femur

33
Q

What symptoms do lesions of the sciatic nerve cause

A

Lesions affect the hamstrings and all the muscles below the knee (foot drop) with loss of sensation below the knee laterally

34
Q

Which nerve roots form the common peroneal nerve

A

L4-S1

35
Q

Where does the common peroneal nerve originate

A

From the sciatic nerve just above the knee

36
Q

Where is the common peroneal nerve often damaged

A

Often damaged as it winds round the fibular head

37
Q

What are the signs of common peroneal nerve damage

A

Foot drop
Weak ankle dorsiflexion/eversion
Sensory loss over dorsal foot

38
Q

Where does the tibial nerve originate?

A

From sciatic nerve just above knee

39
Q

Which nerve roots form the tibial nerve?

A

L4-S3

40
Q

What do lesions of the tibial nerve cause?

A

Inability to stand on tiptoes (plantarflexion of the foot), invert the foot or flex the toes with sensory loss over the sole

41
Q

What is mononeuritis multiplex

A

Involvement of 2 or more peripheral nerves

42
Q

What causes mononeuritis multiplex

A 
DM
Connective tissue disease 
Vasculitis 
Sarcoidosis
Amyloidosis
Leprosy
43
Q

Which investigation is used to define the anatomic site of lesions in mononeuritis multiplex?

A

EMG

44
Q

What are polyneuropathies

A

Motor and/or sensory disorder of multiple peripheral or cranial nerves
Usually symmetrical, widespread and often worse distally

45
Q

How are polyneuropathies classified?

A

Chronicity
Function
Pathology

46
Q

How are polyneuropathies diagnosed?

A

History - time course, nature of symptoms, preceding/associated events, travel, alcohol and drug use, STIs and FH

47
Q

Which conditions result in palpable nerve thickening

A

Leprosy

Charcot marie tooth

48
Q

What investigations are done in polyneuropathies

A 
FBC
ESR
U&Es
LFT
TSH
B12
Electrophoresis 
ANA
ANCA
CXR
urinalysis 
LP and specific genetic tests for inherited neuropathies 
Lead level
Antiganglioside antibodies 
Nerve conduction studies distinguish demyelinating from axonal causes
49
Q

Describe sensory neuropathy

A

Numbness, pins and needles, paraesthesia, affects glove and stocking distribution, difficulty handling small objects. Signs of trauma, joint deformation
Diabetic and alcoholic neuropathies are typically painful

50
Q

Which disorders is sensory neuropathy common in

A

DM
CKD
Leprosy

51
Q

Which disorders is motor neuropathy common in

A

Guillian barre syndrome
Lead poisoning
Charcot Marie Tooth disease

52
Q

Describe the symptoms of a motor neuropathy

A

Progressive, weak or clumsy hands, difficulty in walking (falls and stumbling), difficulty breathing (decreased vital capacity)

53
Q

What are the signs of a motor neuropathy

A

LMN lesion
Wasting and weakness more marked in the distal muscles of hands and feet (foot or wrist drop)
Reflexes are reduced or absent

54
Q

Describe the symptoms of cranial nerve polyneuropathy

A

Swallowing/speaking difficulty

Diplopia

55
Q

How are polyneuropathies treated?

A

Involve physio and OT
Foot care and shoe choice are important in sensory neuropathies to minimize trauma
Splinting joints helps prevent contractures in prolonged paralysis
In Guillian barre - IVIG helps
Vasculitis causes - steroids and immunosuppressants
Neuropathic - amitriptyline, duloxetine, gabapentin or pregabalin

56
Q

What is autonomic neuropathy

A

Sympathetic and parasympathetic neuropathies may be isolated or part of a generalised sensorimotor peripheral neuropathy

57
Q

What causes autonomic neuropathy

A 
DM
Amyloidosis
Guillian Barre 
Sjogrens 
HIV
Leprosy
SLE
Toxic 
Genetic
Paraneoplastic
58
Q

List some signs of sympathetic autonomic neuropathy

A

Postural hypotension
Decreased sweating
Ejaculatory failure
Horner syndrome

59
Q

List the signs of parasympathetic autonomic neuropathy

A 
Constipation 
Nocturnal diarrhoea 
Urine retention 
Erectile dysfunction 
Holmes Adie pupil
60
Q

List some autonomic function tests

A

BP - Postural drop of >20/10mmHg is abnormal
ECG - A variation of <10bpm with respiration is abnormal
Cystometry - Bladder pressure studies
Pupils - Instil 0.1% adrenaline dilates if post-ganglionic sympathetic denervation, 2.5% cocaine dilates if normal, 2.5% methacholine constricts if parasympathetic
Paraneoplastic antibodies - AntiHU, antiYO, antiRI, antiamphysin, anti CV2, antiMA2

61
Q

What does primary autonomic failure occur with?

A

Alone or as part of multisystem atrophy or with parkinsons disease

Neurology finals (32 decks)

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