Peripheral Neuropathies

Question 1

What is acute inflammatory polyradiculopathy resulting in demyelination of the peripheral nerves and motor fibers

Answer 1

Gullian-Barre Syndrome

Question 2

What 2 nervous systems can be affected by peripheral nervous system pathology

Answer 2

somatic and autonomic

Question 3

Which neuropathy involves the following? (sensory or autonomic nerves)

loss of autonomic function in the same region as the somatosensory loss

Answer 3

Sensory nerves

Question 4

What is any pathologic change invovling peripheral nerves affected axons or myelin

Answer 4

Peripheral neuropathy

Question 5

Where do lesions of somatic sensory nervous system occur?

Answer 5

• dorsal root ganglia
• spinal nerve root
• somatic sensory nerve fibers

Question 6

Loss of cutaneous sensation follows a peripheral nerve distribution pattern if what is damaged?

Answer 6

Peripheral nerve fibers

Question 7

Loss of cutaneous sensation follows a dermatome distribution pattern if what is injured?

Answer 7

Spinal Nerve Root

Question 8

What is absence of sensivity to sensory stimuli?

Answer 8

Anesthesia

Question 9

What is increased sensivity to sensory sitmuli

Answer 9

Hyperesthesia

Question 10

What is decreased sensivity to sensory stimuli

Answer 10

hypoesthesia

Question 11

What is abnormal sensation such as numbness, prickling, or tingling, pins and needs, burning

Answer 11

Paraesthesia

Question 12

What is impairments in position and movement awareness presenting as uncoordinated and inaccurate movments and balance issues

Answer 12

Proprioceptive abnormalites

Question 13

What is impaired during proprioceptive abnormalities

Answer 13

planning, coordination, and execution of movement

Question 14

What is uncoordinated, awkward voluntary movements as a result of the loss of proprioception

Answer 14

Sensory Ataxia

Question 15

What type of neuropathic pain is this?

Normally painless stimuli from touching the skin is experience as pain or an unpleasant sensation

Answer 15

dysestheia

Question 16

What type of neuropathic pain is this?

Percieivng innocuous stimuli as painful

Answer 16

Hyperalgesia

Question 17

Motor abnormalities can affect what due to peripheral neuropathy?

Answer 17

• spinal nerve root
• somatic motor nerve fibers
• motor end plate

Question 18

What is random, spontaneous, brief contractions of single muscle fibers

Answer 18

Fibriliation

Question 19

What does the altered membrane in fibriliation cause?

Answer 19

involuntary contractions

Question 20

The muscle membrane undergoes denervation to ____ to _____

Answer 20

hypersensivity, acteylcholine

Question 21

What is interrupting lower motor neuron signals to muscle decrease or prevents muscle contraction

Answer 21

Foot drop

Question 22

What is parital loss of capacity for voluntary movement

Answer 22

Paresis

Question 23

What is complete loss of capactiy for voluntary movement

Answer 23

Paralysis

Question 24

What is muscle atrophy due to nervous system damage?

Answer 24

Neurogenic atrophy

Question 25

What is muscle atrophy due to lack of use?

Answer 25

Disuse atrophy

Question 26

Severe muscle atrophy is caused by what?

Answer 26

Complete denervation

Question 27

Muscle atrophy occurs rapidly due to chnages in ____

Answer 27

pattern of protein production in muscles

Question 28

What is abnormally low muscular resistance to passive stretch

Answer 28

hypotonia

Question 29

What is complete denervation of somatic motor fibers; total lack of muscle tone?

Answer 29

flaccidty

Question 30

What is reduced or loss of deep tendon reflexes

Answer 30

impaired reflexes

Question 31

# Which nerve damage is this? autonomic abnormalities which include lack of seating and loss of sympathetic control of smooth muscle fibers in the arterial walls

Answer 31

single nerve damage

Question 32

# Which nerve damage is this? autonomic abnormalites include impotence and difficulty regulating blood pressure, heart rate, sweating and bowel and bladder functions

Answer 32

multiple nerves

Question 33

# Which visceral fiber abnormality is this? abnormal transmission into the CNS relayed from visceral, glands, or smooth muscles affected baroreceptors signalling aterial pressure, receptors within organs, signaling irritants, distentin or hypoxia

Answer 33

Sensory visceral fibers

Question 34

# Which visceral fiber abnormality is this? alterations in involuntary motor functions, HR breathing and gut motitly

Answer 34

Visceral Motor fibers

Question 35

Why does trophic change occur?

Answer 35

the damaged nerve root is not able to provide nutritional factors with denervated tissues

Question 36

What happens when axon is severed?

Answer 36

Distal segment undergoes Wallerian degeneration

Question 37

# What are the following steps of? 1. axon terminal degenerates 2. myelin breaks down and forms debris 3. cell body undergoes metabolic changes 4. presynaptic terminals retract from the dying cell body 5. postsynaptic cells degenerate

Answer 37

Wallerian Degeneration

Question 38

What involves the destruction of myelin surrounding the sensory and motor fibers impeding conduction of action potentials?

Answer 38

Peripheral neuropathies

Question 39

What allows leakage of electrical current across the membrane, decreasing the ampltitude and velocity of the singal as the action potential travels down the axon

Answer 39

Demyelination

Question 40

Which cells in PNS guide axonal regrowth to their target cells and produce nerve growth factor?

Answer 40

Schwann cells

Question 41

# What type of sprouting is this? involves denervated neuron attracting side sprouts from nearby undamaged axons

Answer 41

Collaterral sprouting

Question 42

# What type of sprouting is this? involves the injured axon sending out side sprouts to form new synpases with undamaged neurons

Answer 42

Regenerative sprouting

Question 43

What is the recovery rate of axonal injury

Answer 43

1-3 in per month 1-3 mm per day

Question 44

What occurs if the wrong muscle target cells are innervated by sprouts resulting iin unintended movement?

Answer 44

Synkinesis

Question 45

What is the peripheral neuropathy that involves single nerve and causes focal dysfunction

Answer 45

mononeuropathy

Question 46

what is the peripheral neuropathy that involves several nerves and result in multifocal dysfunction; random asymmetirc presenation signs

Answer 46

multiple mononeuropathy

Question 47

What is the peripheral neuropathy that involves many nerves; symmetric involvement of sensory, motor, and autonomic axons often progressing distal to proximal

Answer 47

polyneuropathy

Question 48

What is loss of myelin limited to site of injury; large and small diameter fibers; no axon damage; complete recovery

Answer 48

Traumatic myelinopathy

Question 49

What is axon damage, myelin is intact; Wallerian degeneration distal to lesion; no axon damage; complete recovery

Answer 49

Traumatic Axonpathy

Question 50

What are nerves are physically divided due to excessive stretch or laceration; complete interruption of axons and myelin with degeneration; poor regeneration; inappropirate reinnervation and neuroma formatoin

Answer 50

Severance

Question 51

What is a traumatic myelinopathy caused by the mechanical construction of the median nerve within the anatomical canal

Answer 51

Carpal tunnel syndrome

Question 52

What is the pathogy of carpal tunnel syndrome?

Answer 52

compression of median nerve in carpal tunnel

Question 53

# What is this an etiology of? - gripping vibrating tools, extended time with wrist strongly flexed or extended, frequent repetitve use of flexor muscles; associated with genetic facotrs, pregnancy, and endocrine and rhematic disease

Answer 53

Carpal tunnel

Question 54

# What are these symptoms caused by? - numbness, tignling, burning sensation in median nerve distribution - initially pain and numbness are notes at night - symptoms persist throughout the day and sensation is decreased or lost in the lateral 3.5 digits and adjacent palm - symptoms evoked by compression of median nerve or by stretching nerve - pain can radiate into forearm and shoulder due to spreading neuroinflammation from lesion site to dorsal horn in spinal cord

Answer 54

Carpal tunnel syndrome

Question 55

# What are these motor symptoms of? paresis and atrophy of thenar muscles

Answer 55

carpal tunnel syndrom

Question 56

# What are these autononic symptoms of? unusally severe lack of sweating in median nerve distribution

Answer 56

carpal tunnel syndrome

Question 57

When does the Gullain-Barre syndrome occur?

Answer 57

1-2 weeks after mild respiratory or gastrointenstinal infection and rapidy worsens

Question 58

# What is this a patholgy of? demyelination, axonal degradation

Answer 58

Gullain-Barre syndrome

Question 59

# What is this an etiology of? immune system produces antibody that cross-reacts with proteins contained within the myelin sheath, but sometimes the segmental demyelination is so extreme the axons degnerate

Answer 59

Gullain-Barre syndrome

Question 60

# What are these sensory symptoms of? - weakness is greater than sensory loss - pain - hypersensivity to touch - abnormal sensation (tingling, burning)

Answer 60

Gullain-Barre syndrome

Question 61

# What are these motor symptoms of? - paresis or paralysis - may include respiratory muscles - motor CN may be affected

Answer 61

Gullain-Barre syndrome

Question 62

# What are the autonomic symptoms of? - changes in bowel, bladder, cardiac and respiratory function - blood pressure fluctuation, irregular cardiac rhythms, incontinence

Answer 62

Gullain-Barre syndrome

Question 63

# What are these a pathlogy of? - demyelination and axon damage - abnormablities in ion channesl impair nerve conduction - loss of myelinated and unmyelinated axons - all sizes of sensory axons are damaged - nerves affected distally vs. proximally

Answer 63

Diabetic polyneuropathy

Question 64

# What are these etiology of? - chronic metabolic disturbances affected nerve cells and Schwann cells - chornic hyperglycemia leads to abnormalities in microcirculation, creating enodthelia capillary changes and local ischemia that affect the nerve and damage Schwann cless

Answer 64

Diabetic polyneuropathy

Question 65

# What are these sensory symptoms for? - sensation affected most - stocking-glove distribution - distal extremity more invovled than proximal - impaired vibration sense - numbeness, pain, paratheseais, dysethesias - lack of pain sensation - balance, gait, coordination problems

Answer 65

Diabetic polyneuropathy

Question 66

# What are these motor symptoms of? - ankle reflexes decreased - muscle weakness and atrophy occur distally - muscle weakness causes abnormal stresses on joints - difficulty walking on heels but can walk on toes

Answer 66

Diabetic polyneuropathy

Question 67

# What are these autonomic symptoms of? - cardiovascular, gastrointestinal, genitourinary, sweating - orthostatic hypotension - impaired sweating - bowel, bladder, digestive, genital, pupil, and lacrimal dysfunction - loss of autonomic regeneration of blood flow increases bone reabsorbtion

Answer 67

Diabetic polyneuropathy

Question 68

This is disruption in signalling between efferent nerve terminals and muscle cells in what disorder type?

Answer 68

Motor endplate disorders

Question 69

What is an autoimmune disease that damages acteylcholine receptors at the neuromuscular junction?

Answer 69

Myasthenia gravis

Question 70

# What has this pathology? - ACh is released into synpase - unable to bind to ACh receptors on muscle fiber due to antibodies on receptor blocking entry - antibody - muscle fiber not triggered resulting in weakness

Answer 70

Myasthenia gravis

Question 71

# What has this etiology? - autoimmune disorder - decreased number of muscle membrane ACh receptors due to antibodies attacking and destroying nicotinic receptors on muscle cells

Answer 71

Myasthenia gravis

Question 72

# What has this sensory symptom? - normal sensory

Answer 72

Myasthenia gravis

Question 73

# What has these motor symptoms? - fluctuating muscle weakness - weakness increases with muscle age - affected muscles control eye movement and eyelid muscles, facial expression, etc. - proximal limb weakness causes difficulity reaching overhead, climbing stairs, etc.

Answer 73

Myasthenia gravis

Question 74

# What autoimmune symptoms does this have? normal autoimmune

Answer 74

Myasthenia gravis