Peripheral Nerve Lesions

Question 1

Double Crush Syndrome

Answer 1

Existence of two separate lesions along the same nerve that. Creat more severe symptoms than if only one lesion existed

Question 2

Mononeuropathy

Answer 2

An isolated nerve lesion; associated conditions include trauma and entrapment

Question 3

Neuroma

Answer 3

Abnormal growth of nerve cells; associated conditions included vasculitis, AIDS, and amyloidosis

Question 4

Peripheral neuropathy

Answer 4

Impairment or dysfunction of the peripheral nerves; associated conditions include diabetic peripheral neuropathy, trauma, alcoholism

Question 5

Polyneuropathy

Answer 5

Diffuse nerve dysfunction that is symmetrical and typically sencodnar to pathology and not trauma; associated conditions include Guillain-Barré syndrome, peripheral neuropathy use of neurotoxin drugs and HIV

Question 6

Wallerian degenration

Answer 6

Degeneration that occurs distally specifically to the myelin sheath and axon

Question 7

What are the classification of acture Nerve injures?

Answer 7

1. Neurapraxia
2. Axonotmetsis
3. Neurotmesis

Question 8

Describe Neurapraxia

Answer 8

1. Mildest form of injury
2. Conduction block usually due to Myeline dysfunction
3. Axonal continuity preserved
4. Axons, epineurium, perineurium and endoneurium intact
5. Nerve conduction is preserved proximal and distal to the lesion
6. Nerve fibers are not damaged, no evidence of nerve degeneration is noted
7. Sxs include pain, minimal muscle atrophy, numbness or greater loss of motor and sensory function, dismissed proprioception
8. Recovery is rapid and complete and will occur within 4-6 weeks
9. Pressure injuries are most common

Question 9

Describe Axonotmesis

Answer 9

1. More severe grade of injury to a peripheral nerve
2. Reversible injury to damaged fibers since they maintain an anatomical relationship to each other
3. Damage occurs to the axons with preservation of the endoneurium (neural connective tissue sheath), epineurium, Schwann cells, and supporting structures
4. Distal Wallerian degeneration can occur
5. The nerve can regenerate distal to the site of the lesion at a rate of one millimeter per day
6. Recovery is spontaneous and varies from spotty to no recovery; surgery may be required for repairs
7. Traction, compression and crush injures are the most common

Question 10

Describe Neurotmesis

Answer 10

1. The Mose severe grade of injury to a peripheral nerve
2. Axon, myeline, connective tissue components are all damaged or transected
3. Irreversible injury; no possibility of regeneration
4. Flaccid paralysis and wasting of muscles occur; total loss of sesnation to area supplied by the nerve
5. All motto and sensory loss distal to the lesion becomes permanently impaired
6. No spontaneous recovery; with surgical reattachment potential regeneration axons may grow at one millimeter per day with Proximal recovery first; sensory recovery occur sooner than motor fibers
7. Complete transaction of the nerve trunk

Question 11

What is the common etiology associated with the axillary nerve lesion?

Answer 11

Fracture of the neck of the humerus; anterior dislocation of the shoulder

Question 12

What is the common etiology of the Musculocutaneous nerve lesion?

Answer 12

Fracture of the clavicle

Question 13

What is the common etiology associated with a radial nerve lesion?

Answer 13

Compression of the nerve in the radial tunnel; Fx of the humerus

Question 14

What is the common etiology associated with median nerve lesion?

Answer 14

Compression in the carpal tunnel, pronator teres entrapment

Question 15

what is the common etiology associated with an ulnar nerve lesion?

Answer 15

Compression in the cubital tunnel,, entrapment in Guyon’s canal

Question 16

T or F; In the LE many Nerve injures for women are secondary to labor, deliver or surgical procedures around the pelvis

Answer 16

True

Question 17

What is the common two logo associated with a femoral nerve lesion?

Answer 17

Total hip arthroplasty (THA), displaced acetabular Fx, anterior dislocation of the femur, hysterectomy, apendectomy

Question 18

What is the common etiology assocatied with a sciatic lesion?

Answer 18

Blunt force trauma to the buttocks, total hip arthroplasty, accidental injection to the nerve

Question 19

What is the common etiology associated with an obturator lesion?

Answer 19

Fixation of a femur Fracture, total hip arthroplasty

Question 20

What is a common etiology associated with a peroneal nerve lesion?

Answer 20

Femur, tibia or fibula Fx, positoning during surgical procedures

Question 21

What is a common etiology associated with a tibial nerve lesion?

Answer 21

Tarsal tunnel entrapment, popliteal fossa compression

Question 22

What is a common etiology associated with Sural nerve lesion?

Answer 22

Rx of the calcaneus or lateral malleolus

Question 23

Characteristics of an anterior horn cell pathology?

Answer 23

1. Sensory component intact
2. Motor weakness and atrophy
3. Fasciculation
4. Decreased DTR

Example: ALS (amyotrophic lateral sclerosis); poliomyelitis

Question 24

Characteristics of a muscle pathology?

Answer 24

1. Sensory component intact
2. Motor weakness; fasciculations are rare
3. Normal or decreased DTRs

Example: muscular dystrophy

Question 25

Characteristics of a Peripheral Nerve (Mononeuropathy) pathology?

Answer 25

1. Sensory loss along the nerve route
2. Motor weakness and atrophy in a peripheral distribution; may have fasciculations

Example: trauma

Question 26

Characteristics of a peripheral polyneuropathy pathology?

Answer 26

1. Sensory Impairments; “stocking glove” distribution
2. Motor weakness and atrophy; weaker distally than proximally; may have fasciculations
3. Decreased DTRs

Example: Diabetic peripheral polyneuropathy

Question 27

Characteristics of Spinal Roots and Nerves Pathologies?

Answer 27

1. Sensory component will have corresponding dermatomes deficits
2. Motor weakness in an innervated pattern; may have fasciculations
3. Decreased DTRs

Example: Herniated disk