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05. OS Midterm/CPA 2 > Neuropathy Basics > Flashcards

Neuropathy Basics Flashcards

1
Q

What is a neuropathy?

A

Functional or pathological changes in the peripheral nervous system

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2
Q

What is compression neuropathy?

A

Process where a nerve becomes entrapped as it passes through a narrow tunnel or passage Can occur at any site along the nerve

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3
Q

Biomechanical causes of compression neuropathy

A

Space occupying lesion - Herniated disc or cyst

Degenerative causes - foraminal stenosis

Post-traumatic causes - Fracture and hematoma

Mechanical causes - Muscle spasm and pinching

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4
Q

Systemic causes of compression neuropathy

A
  • Pregnancy
  • Hypothyroidism
  • Diabetes
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5
Q

Structure of an Axon

A
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7
Q

Pathogenic Changes to Axon

A

Ischemia

Thickening of epineurium

Myelin thinning distortion

Microtubule Closure

Axonal degeneration

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8
Q

Nerve Damage: 1st Degree

A

Neuropraxia

Focal damage of myelin fibers arounf axons

Connective tissue sheath remains intact

Recovery: Days to weeks - less severe

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9
Q

Nerve Damage: 2nd Degree

A

Axonotmesis

Some disruption/injury to the axon itself

Myelin sheath remains intact

Recovery: Is possible but takes months

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10
Q

Nerve Damage: 3rd Degree

A

Neurotmesis

Disruption of axon and endoneurium

Recovery: Cannot occur as intraneural fibrosis occurs

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11
Q

Nerve Damage: 4th Degree

A

Neurotmesis

Disruption og axon, endoneurium, and perineurium (nerve fasciculi)

Large area of intraneural scarring at the injury site - Stops any nerve regeneration distal to the injury

Surgery required to restore neural continuity

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12
Q

Nerve Damage: 5th Degree

A

Neurotmesis

Whole nerve from the axon to the epineurium is damaged

Perineural hemorrhage and scarring occurs

Surgery required to restore neural continuity

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13
Q

Radiculopathy

A

Presents in neck andradiateds down a specific pattern on arm

Numbness, weakness, decreased reflexes related to cervical levels

Positive Spurling’s test

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14
Q

Causes of Radiculopathy

A

Impingement of nerve at the level of the cervical spine due to a disc disease, disc herniation, degenerative arthritis

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15
Q

Radiculopathy testing

A

Spurling’s Test

MRI of Cervical Spine and maybe upper extremity

EMG (cheaper than MRI)

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16
Q

Radiculopathy - C Spine: Contralaterial Traction, Supine

A
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17
Q

Plexopathy

A

Disorder effecting a network of nerves, blood or lympatic vessels

Think thoracic outlet syndrome

19
Q

Lumbosacral Radiculopathy Patterns for L3-S1

A
20
Q

Plexopathy Patient Presentation

A

Patient complains of intermittent numbness and tingling, not consistent with one nerve root

Complains of pain in shoulder or neck region

Generalized intermittent weakness in extremities

21
Q

Tenderpoints associated with Lumbosacral Radiculopathy

A
22
Q

Lumbosacral Radiculopathy

A

L5-S1 most common segment affected

Commonly due to herniated disc

Leads to pain down one leg

24
Q

Red Flag Symptoms for Lumbosacral Radiculopathy

A

Weight loss

Fever

Chills

Loss of bowel or bladder control

26
Q

Definition of Bulging Disc

A

Compressed evenly without signifcant damage to the cartilage rings

Usually caused secondary to cervical disc disease

27
Q

Protrusion Heriated Disc

A

Some tearing of the cartilage ring

Only a few cartilage rings are torn in the anulus fibrosis

No leakage of central material (nucleus pulposus)

28
Q

Extrusion Herniated disc

A

Cartilage rings have torn in a small area

Nucleus pulposus is able to flow out of the disc space

29
Q

Direction of disc rupture

A

Most commonly ruptures posterior-laterally which compresses the nerve root as it exits the intervertebral foramen which commonly causes a radiculopathy

30
Q

Herniated discs and compression of nerve roots through the C/T/L spine

A

C-Spine - compresses nerve root below

eg. Disc between C4-C5 compresses nerve root of C5

T&L-Spine - compresses nerve root above

eg. Disc between L3-L4 compresses nerve root L3

31
Q

General Treatment for radiculopathy caused by herniated discs

A

Modify activity, use NSAIDS, splinting &/or injections

OMT, PT, pain management

Should be pursued if persists 3-6 months (except for cubital tunnel syndrome

Surgical release is considered when non-operative management fails

Cubital tunnel syndrome - operative decompression is considered in call cases tor prevent nerve damage

32
Q

Cheiralgia Paresthetica/Wartenberg’s syndrome/Handcuff neuropathy

A

Compression of the superficial radial nerve

Numbness, tingling, burning in SRN (superficial branch of radial N) distruction

Caused by compression, edmea, surgical injury

05. OS Midterm/CPA 2 (12 decks)

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