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becky: neuro MSK > PNS > Flashcards

PNS Flashcards

1
Q

ALS

A

upper and lower MN signs
degeneration of anterior horn cell
MOTOR ONLY no sensory loss
*fatal: affect swallowing, resp mm

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2
Q

As ALS progresses,

A

weakness, facial/respiratory, paresis–>plegia
NO SENSORY LOSS, NO COG FUNCTION LOSS

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3
Q

HOW DOES ALS usually present?

A
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4
Q

pseudobulbar palsy

A

laugh or cry inappropriately
disconnect btwn emotions and expression
COMMON IN ALS**, MS, strokes

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5
Q

LMN signs in ALS

A

weakness, atrophy, fasciculations
brainstem: jaw, face, palate, tongue, larynx
cervical: neck, arm, hand first
thoracic: diaphragm, back, abdomen
lumbosacral: back, abdomen, leg, foot

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6
Q

how does pain manifest in ALS?

A

cramps, contractures, pressure sores due to lack of mobility

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7
Q

West Nile Virus

A

asymmetric flaccid weakness and hypoactive/absent reflexes
*pure motor

anterior horn cell!!! changes in MRI, B&B affected too!
meningoencephalities
aseptic meningitis

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8
Q

plexopathy presents as

A

very painful at shoulder or hip, weakness in limb, more than one nerve/root distribution

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9
Q

plexopathy is due to

A

trauma
tumor
thoracic outlet syndrome (extra cervical rib)
*diabetes can cause ischemia to plexus (lumbosacral plexus)

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10
Q

mononeuropathy multiplex

A

neuropathy in several different nerves quickly in short period of time

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11
Q

polyneuropathy is

A

length dependent
(feet, then hands when knees get affected, abdomen affected in front)
*stocking/glove distribution

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12
Q

meralgia parasthetica

A

lateral femoral cutaneous nerve (compressed at inguinal ligament), sensory ONLY
***numbness
-Britney Spears
-L2, L3

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13
Q

demyelinating neuropathy

A

weakness without atrophy!
patchy/asymmetric
can be length independent

get better!

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14
Q

causes of demyelinating neuropathy

A
  1. compression/stretch (carpal tunnel, trauma)
  2. GBS and CIDP: inflammatory, get better
  3. multifocal motor neuropathy
  4. diphtheria
  5. Charcot Marie Tooth: gene absent
  6. hereditary neuropathy
  7. MAG neuropathy
  8. leukodystrophies
  9. diabetes
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15
Q

axonal neuropathy

A

most common: diabetes
alcohol (2nd most common)
toxic: vincristine, acrylamide, arsenic
cancer
amyloid
AMAN, AMSAN (axonal GBS)
uremia
collagen vascular diseases

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16
Q

small fiber neuropathy

A

a lot of times is diabetes
pain and temp loss, neuropathic burning pain
discolored skin, less sweat, loss of hair

PAIN, TEMP, AUTONOMIC
not proprioception, not motor
allodynia
emg may be normal!

17
Q

large fiber neuropathy

A

sensory (proprioception) and motor nerves
*numb, walking on foam

18
Q

autonomic neuropathy

A

Orthostatic hypotension
* Arrhythmias
* Severe constipation, urinary retention, erectile dysfunction
* Abnormal sweating
* Early satiety, lightheadedness with meals

19
Q

inflammatory demyelinating polyneuropathies

A

disorders that cause weakness, sensory loss, areflexia
AIDP or GBS are rapid
CIDP are slow

20
Q

AIDP

A

acute inflamm demyelin polyneuropathy
1. tingling/parasthesias
2. severe radicular back pain
3. weakness legs to arms

21
Q

GBS

A

demyelinating

monitor/treat respiratory failure, autonomic dysfunction
rehab early! get better

22
Q

chronic inflammatory demyelinating polyneuropathy

A

mainly motor over sensory
large fiber!
not atrophy (demyelinating)
but areflexic

symmetric weakness of prox and distal

23
Q

diabetic neuropathy does not cause weakness!!! It is probably

A

CIDP in diabetic patient

24
Q

diabetic neuropathies

A

stocking-glove sensory loss
autonomic changes after sensory
does not cause weakness
*can treat PAIN not weakness
neuropathic pain meds can cause sleepiness and dry mouth

25
Q

what is charcot marie tooth disease

A

distal weakness, atrophy
length dependent sensory loss
foot deformities (hammer toes)
absent reflexes/decreased
CHRONIC, slowly prog

hereditary!

26
Q

myasthenia gravis

A

post synaptic autoimmune disorder
*with very brief rest, much better! FATIGABLE!
EYE MUSCLES! asymmetric ptosis, diplopia
-difficulty chewing, dysarthria, dysphagia, nasal speech
-hoarse
-head drop
-limb weakness

27
Q

presynaptic disorder

A

lambert eaton
botulism

28
Q

triggers for MG exacerbation

A

Emotional upset
* Viral illnesses and other systemic illness, fever* Heat
* Hypo or hyperthyroidism
* Surgery
* Menstrual cycle
-MEDS

29
Q

ocular cooling for myasthenia gravis

A

cold makes better conduction across neuromuscular junction
antibodies attack ACh junction…

30
Q

what are negative signs of myopathy?

A
  • Weakness
  • Fatigue
  • Atrophy
  • Exercise
    Intolerance
31
Q

what are positive signs of myopathy?

A

-Myalgia
* Cramps
* Contractures
* Hypertrophy* Stiffness
* Myoglobinuria

32
Q

difference between prox/distal for neuropathy vs. myopathy

A

myopathy: PROXIMAL WEAKNESS
neuropathy: distal

33
Q

what does a myopathy physical exam look like

A

gower’s maneuver (all fours)
getting up from chair, reaching high is HARD due to prox weakness
**sensation usually intact
DTRs normal/slightly reduced

34
Q

inclusion body myositis

A

most freq myopathy in patients over 50 yrs
prox leg and distal arms (finger flexors, quads)
-asymmetric
-dysphagia
-muscle atrophy

35
Q

myotonic dystrophy type I

A

most common ADULT myopathy
frontal temporal balding
can’t smell
myotonia: sustained contracture of muscles (shake hand, can’t release it)
eyelid myotonia
cardiac problems
cataracts

36
Q

facioscapulohumeral dystrophy

A

face and scapula weakness
(triple humps) in shoulder

37
Q

oculopharyngeal muscular dystrophy

A

ptosis, weakness of eye muscles, prob with swallowing

38
Q

emery-dreifuss muscular dystrophy

A

contractures

39
Q

becker and dyshen

A

most common (children)

becky: neuro MSK (14 decks)

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