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NMSP Exam II > Peripheral neuropathies (Hon) > Flashcards

Peripheral neuropathies (Hon) Flashcards

1
Q

Dermatome

A

SKIN are supplied by a single spinal root

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2
Q

Myotome

A

MUSCLE group supplied by a single spinal root

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3
Q

Sclerotome

A

Area of BONE supplied by a single spinal root

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4
Q

Radiculopathy definition

A

nerve root dysfunction

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5
Q

What are the most common levels involved in radiculopathy?

A

Cervical
C5-6 = C6 nerve compression
**C6-7 = C7 nerve compression

Lumbar
L4-5 = L5 nerve compression
L5-S1 = S1 nerve compression

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6
Q

Which nerve root is compressed if a patient is experiencing symptoms across the C6 and C7 dermatomes?

A

C7

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7
Q

Which nerve root is compressed if a patient is experiencing symptoms across the L5 and S1 dermatomes?

A

S1

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8
Q

the C5 spinal nerve root innervates which DTR?

A

biceps

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9
Q

the C7 spinal nerve root innervates which DTR?

A

triceps

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10
Q

the L4 spinal nerve root innervates which DTR?

A

patella

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11
Q

the S1 spinal nerve root innervates which DTR?

A

achilles

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12
Q

Suprascapular nerve

A

comes off early on the brachial plexus; pure C5 to the supraspinatus and infraspinatus muscles

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13
Q

Parsonage-Turner Syndrome

A

a brachial plexopathy syndrome of unknown etiology; patient will present with severe pain in the shoulder and days later have weakness and atrophy of muscles of the shoulder girdle (pain subsides); spontaneous recovery in 6-18 months but steroids are helpful

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14
Q

diffuse, symmetrical disease involving motor, sensory or both neurons

A

definition of peripheral neuropathy (polyneuropathy)

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15
Q

Mononeuropathy

A

a type of peripheral neuropathy where there is only a single nerve affected; there is a specific pattern of sensory loss and weakness only in specific muscle(s)

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16
Q

Polyneuropathy

A

a type of peripheral neuropathy where there is diffuse symmetrical motor, sensory or both deficit; there is a stocking/glove sensory loss; distal weakness and possible atrophy; with decreased reflexes

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17
Q

Dysesthesia

A

pain upon gentle touch

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18
Q

Hyperalgesia

A

lowered threshold of pain

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19
Q

Hyperpathia

A

pain threshold is elevated, but pain is excessively felt

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20
Q

paresthesias

A

pins and needles sensation

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21
Q

What are the typical lower motor neuron symptoms?

A

distal weakness, cramps, fasciculations (twitches), atrophy, decreased DTRs and hypotonia

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22
Q

What are the typical symptoms of sensory large fiber lesion?

A

positive: tingling, pins and needles and numbness

Negative: decreased vibration, decreased joint position sense, areflexia, ataxia and hypotonia

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23
Q

What are the typical symptoms of sensory small fiber lesion?

A

positive: burning and jabbing sensation

negative: decreased pain (pin prick) and temp

24
Q

Compression of the median nerve presents with what major clinical features?

A

sensory loss, thenar atrophy with an abnormal pinch sign

25
Q

Compression of the ulnar nerve presents with what major clinical features?

A

clawing of 4th and 5th fingers, hypothenar atrophy and variable sensory loss

26
Q

Compression of the radial nerve presents with that major clinical features?

A

wrist drop, triceps involved and sensory loss

27
Q

Carpal tunnel syndrome

A

compression of the median nerve at the wrist; presents with sensory loss, thenar atrophy with an abnormal pinch sign

28
Q

Cubital tunnel syndrome

A

compression of the ulnar nerve at the elbow; presents with clawing of 4th and 5th fingers, hypothenar atrophy and variable sensory loss

29
Q

Saturday night palsy

A

compression of the radial nerve at the spiral groove; commonly due to abnormal sleep postures; presents with wrist drop, triceps involved and sensory loss

30
Q
A

the median nerve sensory distribution; medial palmar surface of lower forearm and palm, thenar eminence, thumb and adjacent two fingers

31
Q

Pronator Syndrome

A

median nerve mononeuropathy; diffuse/dull ache at the proximal forearm; pain is exacerbated in the forced forearm pronation; absence of nocturnal awakening because of pain or numbness

32
Q

Anterior Interosseous Syndrome

A

a median nerve mononeuropathy; inability to make the “ok” sign with your hand

33
Q

What test would you suspect to be positive in a patient with an ulnar neuropathy?

A

Froment sign; inability to bend at PIP joint to hold a piece of paper

34
Q
A

Anterior Interosseous Syndrome; a median nerve mononeuropathy; inability to make the “ok” sign with your hand

35
Q
A

a positive Froment sign seen in Ulnar neuropathy; inability to bend at PIP joint to hold a piece of paper

36
Q

Peroneal nerve compression has what major clinical features?

A

foot drop, weak evertors, sensory loss in dorsum of foot

37
Q

What is the most common cause of acquired peripheral neuropathy?

A

diabetes mellitus

38
Q
A

wrist drop seen in compression of the radial nerve at the spiral groove; commonly due to abnormal sleep postures

39
Q
A

stocking-glove distribution seen in peripheral neuropathy; legs usually affected first and more severely than the arms

40
Q

What vitamin deficiency can cause a polyneuropathy?

A

Vitamin B12 deficiency seen in subacute combined degeneration

41
Q
A

spinal cord in B12 deficiency seen in subacute combined degeneration; a peripheral neuropathy

42
Q

Romberg Maneuver test what?

A

proprioception

43
Q

What do suspect to find on a skin biopsy in a patient with a small fiber polyneuropathy?

A

decreased epidermal nerve fiber density

44
Q

Which cranial nerves are most at risk in a patient with diabetes mellitus?

A

**CN III
and CN VI and CN VII

45
Q

What is the most common hereditary polyneuropathy?

A

Charcot-Marie-Tooth 1A (CMT 1A) aka Hereditary Motor & Sensory Neuropathies 1 (HMSN 1)

46
Q

Charcot-Marie-Tooth 1A (CMT 1A) aka Hereditary Motor & Sensory Neuropathies 1 (HMSN 1)

A

most common hereditary polyneuropathy; demyelinating; AD and onset is typically 1st or 2nd decade; presents with difficulty walking or running (legs>arms); EMG shows slowing of motor nerve conduction velocities

47
Q

What would the EMG show in a patient with CMT 1A/HMSN 1?

A

slowing of motor nerve conduction velocities; demyelinating

48
Q
A

Charcot-Marie-Tooth 1A (CMT 1A) aka Hereditary Motor & Sensory Neuropathies 1 (HMSN 1) foot; high arched foot and hammer toes

49
Q

Acute inflammatory demyelinating polyneuropathy (AIDP) aka Guillain-Barré syndrome (GBS)

A

an acquired demyelinating polyneuropathy; typically follows an illness, surgery or immunization or *** viral syndrome with EBV, mycoplasma pneumonia or campylobacter jejuni; patient will present with ascending motor paralysis; possible respiratory failure in these patients

50
Q

A viral syndrome of which organisms are typically seen before Guillain-Barré syndrome (GBS)?

A

EBV, mycoplasma pneumonia or campylobacter jejuni

51
Q

What are key laboratory findings in Guillain-Barré syndrome (GBS)?

A

CSF - albumin-cytologic dissociation (increased protein to normal cell count and normal glucose)
NCV’s - slow conduction velocity and focal conduction block with prolonged F-waves

52
Q

What is the typical treatment for Guillain-Barré syndrome (GBS)?

A

Direct treatment with plasma exchange or IVIg (not steroids)

53
Q

Miller-Fisher Syndrome

A

a variant of Guillain-Barré syndrome (GBS); will find GQ1b/GT1a antibodies; patient will present with ophthalmoplegia, ataxia, arreflexia, facial weakness, dysarthria and dysphagia

54
Q

In which pathology would you find GQ1b/GT1a antibodies in a patients serum?

A

Miller-Fisher Syndrome; a variant of Guillain-Barré syndrome (GBS)

55
Q

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

A

an acquired demyelinating polyneuropathy similar to GBS but slower and more persistent >2 months; patient will have a history of progressive and relapsing with the typical treatment; 15% of cases will have IgM or IgG present

NMSP Exam II (12 decks)

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