Peripheral Nerve Disorders Flashcards
mononeuropathy
weakness, numbness, pain, paresthesia confined to the distribution of the one involved nerve
common causes of mononeuropathy
entrapment, trauma, prolonged limb immobility
neuropraxia
mild
local myelin damage, axon remains intact
axonotmesis
continuity of axon lost
may include damage to epineurium, perineurium, endoneurium
loss of continuity leads to wallerian degeneration
neurotmesis
complete transection of nerve
surgery necessary
regenerative sprouting
damage to one axon and death of the postsynaptic neuron
connects to adjacent postsynaptic neuron
collateral sprouting
death of one presynaptic neuron
branches off and connects to another
multiple mononeuropathy
involves two or more individual nerves in different parts of the body
producing a randon, asymmetrical presentation of signs
vasculitis
dangerous cause of multiple mononeuropathy
fever, fatigue, weight loss, muscle/joint pain
polyneuropathy
symmetrical involvement of sensory, motor and autonomic
polyneuropathy presents how
distal to proximal
feet to legs to fingertips to hands
affects longest peripheral nerves in extremities
causes of polyneuropathy?
diabetes ***
autoimmune disease
kidney disease
HIV/liver infxn
low B12 vit
poor circulation in LEs
underactive thyroid
trauma
tumor
alcoholism
early in the disease of polyneuropathy, what are some sensory symptoms you will see
loss of temp
pain - hypo or hyper
early in the disease of polyneuropathy, what are some motor involvement symptoms you will see
weakness
cramping
fasciculations
muscle loss
early in the disease of polyneuropathy, what are some autonomic involvement symptoms you will see
impaired breathing
GI
dysarthria
as the polyneuropathy progresses, what are some sensory involvement symptoms you will see
loss of vibration
loss of light touch discrimination
loss of proprioception/kinesthesia
as the polyneuropathy progresses, what are some motor involvement symptoms you will see
bone degeneration
loss of ankle reflexes
trophic changes
as the polyneuropathy progresses, what are some autonomic involvement symptoms you will see
temp dysregulation - decrease sweating
loss of bowel/bladder control, erectile dysfunction
loss of BP - OH
diabetic polyneuropathy
blood vessel and nerve damage due to high blood glucose levels and triglycerides
prognosis of diabetic polyneuropathy
can be prevented
progress slowly, recovery slow
depends on management
treating diabetes may halt progression
polyneuropathy intervention strategies
aerobic conditioning
balance training
resistance training
pt education
recommendation for aerobic conditioning when treating polyneuropathy
150 minutes/wk
50-70% HRmax
mRPE 5-7, RPE 14-16
what is important to remember about balance training when treating polyneuropathy
CANNOT improve sensory loss
must strengthen other balance systems to compensate
