Periferic Nerve Disease

Question 1

Neuropathy?

Answer 1

Damage to peripheral nerves

Question 2

Polyneuropathy?

Answer 2

It is a widespread disease of peripheral nerves all together due to the same cause and pathophysiological processes.

Question 3

Mononeuropathy?

Answer 3

A single nerve is affected.

Question 4

In which disorder does segmental demyelination occur?

Answer 4

Gullian barre syndrome

Question 5

What are the classical features of radiculopathies**?

Answer 5

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.

Question 6

What is segmental demyelination?

Answer 6

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.

Question 7

What is the Thestructurethatsurroundstheperipheralnervefromtheoutside and lines the fascicles?

Answer 7

Epineurium

Question 8

At which levls does lumbosacral radiculopathies does it occur in?

Answer 8

commonly occurs at the L4-L5 or L5-S1 levels.

Question 9

What is lumbosacral radiopathies?

Answer 9

A decrease in the patellar reflex may occur in L3 radiculopathy

Question 10

Patients with L5 radiculopathy may present with…?

Answer 10

.. foot drop and sensory symptoms on the anterolateral aspect of the lower leg extending to the dorsum of the foot and big toe.

Question 11

What is the most common upper extremity entrapment neuropathy?

Answer 11

Carpal tunnel syndrome

Question 12

Which fingers are affected in carpall tunnel syndrome?

Answer 12

First 3 and a half; thumb, pointer finger and middle finger

Question 13

When does a pt experience shaking-‘flick’ phenomenon (done to release tension)?

Answer 13

Carpal tunnel syndrome

Question 14

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.

Answer 14

Tinel sign

Question 15

What is the second most common entrapment neuropathy of the upper extremity after carpal tunnel syndrome.?

Answer 15

Cubital Tunnel Syndrome after carpal tunnel syndrome

Question 16

What is observed in the hypothenar eminence in ulnar neuropathy?

Answer 16

Atrophy

Question 17

When is CLAW HAND observed?

Answer 17

Ulnar neuropathy

Question 18

What is froment sign?

Answer 18

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.

Question 19

When does froment sign occur?

Answer 19

In ulnar neuropathy

Question 20

When does wrist drop occur?

Answer 20

Radial neruopathy

Question 21

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.

Answer 21

spiral groove

extensor

Question 22

Where do you only see weakness in the finger extensor muscles?

Answer 22

Posterior interosseous neuropathy in radial neruopathy

Question 23

Moat common cause of peroneal neuropathy?

Answer 23

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.

Question 24

What else can cause drop foot?**

Answer 24

• 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

Question 25

Clinical feature of peroneal neuropathy?

Answer 25

Drop foot

Question 26

What is the most common entrapment neuropathy in tibial neuropathy?

Answer 26

Tarsal tunnel syndrome

Question 27

Where does interdigital neuroma(Morton’s neuroma) occur?

Answer 27

Tibial neuropathy

Question 28

Symptom of polyneuropathy described as sensory defect in the distal extremity?

Answer 28

Stocking-glove distribution

Question 29

**What is the cerebrospinal fluid finding that suggest guillain barre syndrome?

Answer 29

Cerebrospinal fluid:
• Protein level increased. There is no cell increase. = Albuminocytological dissociation

Question 30

The duplication of which protein is imp in Charcot-Marie-Tooth Disease (CMT)?

Answer 30

Peripheral myelin protein 22

Question 31

neuromuscular respiratory failure and dysphagia are a result of ..?

Answer 31

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

Question 32

Which neurons are defected in hereditary spastic paraplagia?

Answer 32

Upper motor neurons are defected

Question 33

Which gene mutation is involved in Hereditary Spastic Paraplegia (HSP)

Answer 33

Spastin gene

Question 34

What are the upper/lower motor neuron diseases??

Question 35

ALS is imp

Question 36

*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?

Answer 36

The damage in the lower motor neuron

Question 37

dermatome lvl of nipples?

Answer 37

t4

Question 38

*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?

Answer 38

Median nerve

Question 39

*which nerve is affected in Cubital Tunnel syndrome?

Answer 39

ulnar nerve

Question 40

is Amyotrophic lateral sclerosis (ALS) disease curable?

Answer 40

no , there are only ameliorating options; s.a. *Riluzole: It aims to prevent excitoxicity,
*Edaravone: It acts by reducing oxidative stress,

Question 41

*what are some facts about Amyotrophic lateral sclerosis ALS?

Answer 41

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.

Question 42

give examples of positive phenomena in sensory nerve damage?

Answer 42

loss of joint and position sense, hypoesthesia,
hypoalgesia

Question 43

give examples of negative phenomena in sensory nerve damage?

Answer 43

paresthesia, dysesthesia, pain, allodynia,
hyperalgesia

Question 44

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.

Answer 44

1)Paresthesia:

2)Hypoesthesia, anesthesia:

3)Hypoalgesia, analgesia:

Question 45

1-Hypersensitivity to tactile stimuli.

2-Hypersensitivity to painful stimuli.

Answer 45

1-Hyperesthesia:

2-Hyperalgesia:

Question 46

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.

Answer 46

1-Dysesthesia:

2-Allodynia:

3-Phantom limb pain:

Question 47

WHAT ARE THE CLINICAL FINDINGS When autonomic nerves are damaged?

Answer 47

• 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

Question 48

which rami joins the plexus structures and forms the peripheral nerves?

Answer 48

anterior/ventral rami

Question 49

which rami has sensory and motor functions and innervates the paraspinal region?

Answer 49

posterior/dorsal rami

Question 50

what is the lvl of dermatome for perineum?

Answer 50

S2,3,4

Question 51

dermatome lvl of the umbilicus?

Answer 51

T10