Peripheral Neuropathy Lecture Powerpoint Flashcards
The only cranial nerve covered in dura mater and technically part of the CNS opposed to the PNS
CN II (optic nerve)
Are spinal nerves part of the PNS?
uhhh
T4 dermatome corresponds to…. T10 corresponds to…
Nipple line, umbilicus line
know the dermatome man
df
Peripheral neuropathy definition
Pathology or abnormality affecting the nerves of the PNS specifically including mono (focal involvement of single nerve) or poyneuropathies (affecting many peripheral nerves and often symmetric)
Carpal tunnel syndrome is an example of a ___ neuropathy
Mono
Diabetic neuropathy is an example of a ___ neuropathy
Poly
Mononeuropathy multipex
Simultaneous or sequential non-symmetrical involvement of varying nerves and is not progression of a single neuropathy (for example peroneal nerve and median nerve compression occurring at the same time) sometimes due to same underlying cause other times randomly co-occurring
Peripheral neuropathy predisposing factors (8)
- Diabetes
- peripheral arterial disease
- HTN
- hypercholesterolemia
- tobacco/alcohol use
- Genetic conditions
- nutritional deficit
- iatrogenic (such as surgery positioning)
Peripheral neuropathy epidemiology
Males equal to females, risk increases with age
PNS disorders symptoms (3)
- weakness
- parasthesia/dysesthesia (burning, numbness, pins and needles)
- autonomic dysfunction
Typical presentation of a patient with chronic peripheral neuropathy description
-my feet are asleep especially at night (brain has nothing else to focus on) and sometimes have shooting tingling pain coming up the legs that has been going on a while in both legs over past few months (subacute)
Cranial neuropathies signs and symptoms are specific to…
….the sensation and motor function (remember pneumonic to know which CN’s do which) of that specific nerve
Some say money matters…
Sensory I Sensory II Motor III Motor IV Sensory V1 Sensory V2 Both V3 Motor VI Both VII Sensory VIII Both IX Both X Motor XI Motor XII
Degenerative disk disease definition
Tear of intervertebral disk that rips the annulus fibrosis allowing the nucleus pulposis to protrude out most often laterally and potentially compress spinal nerve roots that also exit laterally either from sharp trauma or extended deterioration over time
Degenerative disk disease presentation (4)
- Low back pain
- sensory disturbance
- weakness
- unilateral specific location
Neoplastic disease is a common etiology of peripheral neuropathy (T/F)
FALSE
Diabetic amyotrophy definition
Subacute onset, very painful, dermatomal sensory deficit with a protracted course over 2 to 3 months that resembles a disk herniation but imaging is unremarkable typically occurring in prolonged hyperglycemic states
Diabetic amyotrophy treatment (1)
Steroids to decrease inflammation and monitoring blood glucose
Herpes zoster infection (REMEMBER the name of the causative agent)
Shingles, caused by varicella zoster virus that resides in nerve roots and erupts sporadically and is triggered by stress or immunocompromise appearing with dermatomal vesicular rash with severe pain
Post herpetic neuralgia
Pain lingering from herpes zoster infection that lasts for months or years after
Herpes zoster treatment (2)
Antiviral medication and chronic pain management
Brachial plexopathy in infant
Occurs during childbirth when a shoulder gets caught on the pubic symphisis of the mother while the baby’s head is pulled
Cervical or brachial plexopathy etiologies (3)
- trauma
- malignancies
- idiopathic