Peripheral Neuropathies

Question 1

Subtypes of neuropathy (3)

Answer 1

1. axonal
2. demyelinating
3. wallerian degeneration

Question 2

motor cell body is located in the

Answer 2

spinal cord

Question 3

sensory cell body is located in the

Answer 3

dorsal root ganglion

Question 4

does the cell body maintains the axon by both manufacturing structural elements and Ntt

Answer 4

yea

Question 5

includes all neural structures outside the pial membrane of the spinal cord and brainstem.

Answer 5

PNS

Question 6

extend into the posterior columns and dorsal horns of the spinal cord.

Answer 6

Dorsal roots (sensory afferents)

Question 7

Peripheral axons of the dorsal root ganglia are the

Answer 7

sensory nerve fibers.

Question 8

fibers for touch and pressure and spindle afferents.

Answer 8

Larger, heavily myelinated

Question 9

fibers for sharp and lancinating pain and temperature.

Answer 9

maller, thinly myelinated

Question 10

fibers for dull, burning, poorly localized pain.

Answer 10

Small unmyelinated

Question 11

Type I : ____________,CV 80-120m/sec

Answer 11

myelinated

Question 12

Type II: _________ CV 30-75 m/sec

Answer 12

thinly myelinated

Question 13

Type III and IV: ___________ CVs 0.5-30 m/sec

Answer 13

unmyelinated with

Question 14

The efferent roots consist of emerging axons of the

Answer 14

anterior horn cells, lateral horn cells and motor nuclei of the brainstem.

Question 15

Large myelinated fibers terminate on

Answer 15

muscle.

Question 16

Small unmyelinated fibers terminate on

Answer 16

sympathetic and parasympathetic ganglia.

Question 17

transport away from cell body

Answer 17

anterograde

Question 18

transport towards cell body

Answer 18

retrograde

Question 19

does axonal transport requires energy? is it dependent of electrical activity?

Answer 19

It does require energy but it is independent of electrical activity

Question 20

what do drugs like vincristine and viblastine do to axonal transport?

Answer 20

disrupt neurotubule organization resulting in neuropathy

Question 21

kinesin

Answer 21

anterograde

Question 22

dynesin

Answer 22

retrograde

Question 23

what determines the rate of recovery from nerve injury as it is needed to transport structural components?

Answer 23

slow transport

Question 24

what type of transport carries signal of nerve injury which induces chromatolysis?

Answer 24

retrograde

Question 25

how do some neurotropic viruses like polio, herpes and rabies enter the nerve body?

Answer 25

enter through peripheral nerve endings and ascend to the nerve body by retrograde transport

Question 26

Dying forward

Answer 26

wallerian degeneration

Question 27

dying back

Answer 27

axonal degeneration

Question 28

degeneration from the point of axonal injury peripherally.

Answer 28

wallerian degeneration

Question 29

: metabolic derangement results in the most distal parts of the axon to degenerate in a proximal direction.

Answer 29

axonal degeneration

Question 30

what is the important thing about nerve conduction studies?

Answer 30

can help distinguish between lesions by measuring action potential evoked by sensory nerve or motor

Question 31

Low amplitude CMAPS and absent SNAPs on NCSs

Answer 31

axonal neuropathy

Question 32

how does axonal neuropathy usually progress? how is the distribution? what is lost?

Answer 32

• it is usually slow and chronic
• stocking glove distribution
• loss of reflexes distally and muscle wasting

Question 33

how does axonal neuropathy occurs?

deficiency and genetic

Answer 33

• deficiency in thiamine, pyridoxine, vitamin E

Genetic: HSMN II

Question 34

Guillan-Barre syndrome

what are some of the clues both in the clinical setting and nerve conduction?

Answer 34

it is a primarily motor syndrome that is rapidly progressive.

clinical setting: areflexia nad ataxia

NCS: conduction block

Question 35

how do you treat Guillan-Barre syndrome?

Answer 35

immune modulating

Question 36

what is the most susceptible element of the nerve

Answer 36

myelin

Question 37

demyelinating polyneuropathy autoimmune

Answer 37

Guillain-Barre syndrome, CIDP, multiple forms associated with certain antibodies.

Question 38

Demyelinating polyneuropathy Genetic

Answer 38

Charcot-Marie-Tooth Type I, metachromatic leukodystrophy.

Question 39

individuals nerve are picked off one by one and is seen especially in polyarteritis nodosa

Answer 39

ischemic mononeuritis multiplex

Question 40

how do you treat ischemic mononeuritis multiplex (vasculitis)

Answer 40

steroids and cyclophosphamide

Question 41

Disruption of ____________ transport means that organelles cannot be transmitted to the distal axons and cannot renew membrane and neurotransmitters systems.

Answer 41

anterograde

Question 42

_________ transport sends signal to the cell body to increase metabolic activity and produce growth factors for axonal regeneration.

Answer 42

Retrograde

Question 43

axonotmesis

Answer 43

After injury axonal sprouting occurs and if the Schwann cell sheathes are not disrupted will regenerate to their original targets as in type 2 nerve injury

Question 44

neurotmesis

Answer 44

If the Schwann cells are disrupted as in penetration injuries or in cases of intense connective tissue reaction the reinnervation cannot occur

Question 45

Traumatic Nerve Injury: Seddon’s Classification class 1

Answer 45

Neurapraxia

Question 46

Traumatic Nerve Injury: Seddon’s Classification class 2

Answer 46

Axonotmesis

Question 47

Traumatic Nerve Injury: Seddon’s Classification class 3

Answer 47

Neurotmesis

Question 48

More of a compression with focal demyelination, no denervation, relatively quick recovery

Answer 48

neurapraxia

Question 49

axonal damage but intact nerve sheath for sprouting to occur through. Slower and sometimes incomplete recovery.

Answer 49

axonotmesis

Question 50

scarred or disrupted nerve sheath, No recovery.

Answer 50

neurotmesis