Periferic Nerve Disease Flashcards
Neuropathy?
Damage to peripheral nerves
Polyneuropathy?
It is a widespread disease of peripheral nerves all together due to the same cause and pathophysiological processes.
Mononeuropathy?
A single nerve is affected.
In which disorder does segmental demyelination occur?
Gullian barre syndrome
What are the classical features of radiculopathies**?
Radicular pain,
• Loss of sensation in the involved dermatome,
• Weakness in the involved myotome,
• Decreased or absent deep tendon reflexes transmitted by the affected root.
What is segmental demyelination?
In myelinated nerve fibers, there is no damage to the peripheral nerve axon, but there is damage to the surrounding Schwann cell and/or myelin sheath.
What is the Thestructurethatsurroundstheperipheralnervefromtheoutside and lines the fascicles?
Epineurium
At which levls does lumbosacral radiculopathies does it occur in?
commonly occurs at the L4-L5 or L5-S1 levels.
What is lumbosacral radiopathies?
A decrease in the patellar reflex may occur in L3 radiculopathy
Patients with L5 radiculopathy may present with…?
.. foot drop and sensory symptoms on the anterolateral aspect of the lower leg extending to the dorsum of the foot and big toe.
What is the most common upper extremity entrapment neuropathy?
Carpal tunnel syndrome
Which fingers are affected in carpall tunnel syndrome?
First 3 and a half; thumb, pointer finger and middle finger
When does a pt experience shaking-‘flick’ phenomenon (done to release tension)?
Carpal tunnel syndrome
Which sign that happens in carpal tunnel syndrome is described as An electric sensation that spreads to the fingers when the median nerve is percussed at the wrist level.
Tinel sign
What is the second most common entrapment neuropathy of the upper extremity after carpal tunnel syndrome.?
Cubital Tunnel Syndrome after carpal tunnel syndrome
What is observed in the hypothenar eminence in ulnar neuropathy?
Atrophy
When is CLAW HAND observed?
Ulnar neuropathy
What is froment sign?
It is the use of the long flexors of the 1st and 2nd fingers, which are innervated by the median nerve, to compensate for the intrinsic ulnar hand (adductor pollicis) weakness that occurs when the patient tries to hold the paper/object.
When does froment sign occur?
In ulnar neuropathy
When does wrist drop occur?
Radial neruopathy
Dropped hands and fingers are observed when compressed at the level of the ……., and hypoesthesia may be observed on the …….. surface of the forearm and hand.
spiral groove
extensor
Where do you only see weakness in the finger extensor muscles?
Posterior interosseous neuropathy in radial neruopathy
Moat common cause of peroneal neuropathy?
Compression; Long bed rest due to chronic diseases, crossing legs, sitting cross-legged, position during anesthesia, weight loss and the decrease in supporting fat tissue may cause compression.
What else can cause drop foot?**
• Sciatic nerve injury
• L5 radiculopathy
• Lumbosacral plexopathy
• Polyneuropathies
• Motor neuron diseases
• Upper motor neuron damage due to cerebral lesions
• Hereditary neuropathy with liability to pressure palsies
Clinical feature of peroneal neuropathy?
Drop foot
What is the most common entrapment neuropathy in tibial neuropathy?
Tarsal tunnel syndrome
Where does interdigital neuroma(Morton’s neuroma) occur?
Tibial neuropathy
Symptom of polyneuropathy described as sensory defect in the distal extremity?
Stocking-glove distribution
**What is the cerebrospinal fluid finding that suggest guillain barre syndrome?
Cerebrospinal fluid:
• Protein level increased. There is no cell increase. = Albuminocytological dissociation
The duplication of which protein is imp in Charcot-Marie-Tooth Disease (CMT)?
Peripheral myelin protein 22
neuromuscular respiratory failure and dysphagia are a result of ..?
AMYOTROPHIC LATERAL SCLEROSIS (ALS)
Which neurons are defected in hereditary spastic paraplagia?
Upper motor neurons are defected
Which gene mutation is involved in Hereditary Spastic Paraplegia (HSP)
Spastin gene
What are the upper/lower motor neuron diseases??
ALS is imp
*a pt comes to you with muscle weakness, atrophy, cramps, fasciculation and myokymia, and deep tendon reflexes are reduced or lost. Which motor neurons are affected?
The damage in the lower motor neuron
dermatome lvl of nipples?
t4
*A patient comes with pain in the right hand, Burning or tingling in the fingers, especially the thumb and the index and middle fingers. It appears that the patient has carpal tunnel syndrome, which nerve is affected?
Median nerve
*which nerve is affected in Cubital Tunnel syndrome?
ulnar nerve
is Amyotrophic lateral sclerosis (ALS) disease curable?
no , there are only ameliorating options; s.a. *Riluzole: It aims to prevent excitoxicity,
*Edaravone: It acts by reducing oxidative stress,
*what are some facts about Amyotrophic lateral sclerosis ALS?
A) ALS has no cure
B) ALS affects males more than females.
C) It is commonly seen after the 5th decade of life.
D) ALS generally selectively affects the motor neurone cells, sparing other types of cells.
E) ALS is an idiopathic disease.
give examples of positive phenomena in sensory nerve damage?
loss of joint and position sense, hypoesthesia,
hypoalgesia
give examples of negative phenomena in sensory nerve damage?
paresthesia, dysesthesia, pain, allodynia,
hyperalgesia
1-Subjective sensations such as pricking, tingling, burning, and felting.
2-It refers to the decrease or loss of the sense of touch.
3-It means reduction or loss of pain sensation.
1)Paresthesia:
2)Hypoesthesia, anesthesia:
3)Hypoalgesia, analgesia:
1-Hypersensitivity to tactile stimuli.
2-Hypersensitivity to painful stimuli.
1-Hyperesthesia:
2-Hyperalgesia:
1-An unpleasant sensation that occurs with or without stimuli.
2-It is a condition in which a stimulus that normally does not cause pain causes pain.
3-A very disturbing painful sensation felt at the site of the amputated limb after
arm or leg amputations.
1-Dysesthesia:
2-Allodynia:
3-Phantom limb pain:
WHAT ARE THE CLINICAL FINDINGS When autonomic nerves are damaged?
- dry eyes, impaired pupil light response, ptosis
- orthostotaic hypotension, paroxysmal hypertension, tachycardia, bradycardia
*anhidrosis/hyperhidrosis
*diarrhea/constipation, urinary retention/urinary incontinence - erection/ejaculation disorder, and decreased vaginal lubrication
which rami joins the plexus structures and forms the peripheral nerves?
anterior/ventral rami
which rami has sensory and motor functions and innervates the paraspinal region?
posterior/dorsal rami
what is the lvl of dermatome for perineum?
S2,3,4
dermatome lvl of the umbilicus?
T10
