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quiz #1 Flashcards

1
Q

flaccidity

A

motor loss

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2
Q

paresis

A

weakness

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3
Q

anesthesia

A

sensory loss

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4
Q

paresthesia

A

sensory impairment

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5
Q

dysthesia

A

pain

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6
Q

what provides a protective barrier around fascicles which make up the nerve

A

epineurium

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7
Q

groups of fibres that are contained within the mechanically strong epineurium

A

fascicles

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8
Q

what surrounds individual fibres

A

endoneurium

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9
Q

what conveys sensory stimuli from the skin & deeper structures to the CNS

A

afferent fibers / sensory neurons

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10
Q

cell bodies found in brainstem & spinal cord - their axons innervate skeletal mm cells, referred to as motor end organs

A

somatic efferent fibers / motor neurons

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11
Q

combination of sensory & motor neurons

A

mixed nerve

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12
Q

what influences vasomotor function, sweating & skin, hair & nail health as well as neuropathic pain usually travel with these nerves or along the walls of arteries

A

autonomic fibers

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13
Q

peripheral nerve lesions

A

compression
trauma
systemic disorders
systemic edematous conditions

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14
Q

classifications of nerve injuries

A

neuropraxia (1st degree)
axonotmesis (2nd degree)
neurotmesis (3-5 degrees)

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15
Q

nerve lesions may be ____ or _____

A

complete: all fibres within nerve are affected

partial: only some fibres are affected

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16
Q

healing process - lesions may be ____ or ____

A

regenerating: repairing itself

permanent: nerve is unable to regrow

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17
Q

-1st degree
-compression of nerve causing local conduction block with no structural damage to axon or to tissue distal to lesion
-conduction block caused by local demyelination of nerve fibres
-recovery occurs as damaged area is repaired, may require weeks or months
-type of injury involves loss of motor function but sensory & autonomic fibres unaffected
-prognosis = good

A

neuropraxia

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18
Q

-2nd degree
-prolonged, severe compression of nerve
-causes lesion at site of compression, followed by degeneration of axons distal to injury
-endoneurial tube remains intact
-sensory, motor & autonomic losses occur
-regeneration of axons to peripheral end organs results in functional recovery
-prognosis = good since endoneurial tube provides appropriate pathway through which axons can regenerate to correct end organ

A

axonotmesis

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19
Q

-3rd-5th degree
-injury to nerve as result of severance of part or all of nerve trunk, including endoneurial tube
-category of injury results in degeneration of nerve
-axons may have difficulty regenerating to distal end organs because of scar tissue at lesion site from local edema & bleeding
-same losses occur as with axonotmesis
-prognosis = poor; no clear pathway to orient regenerating axons
-surgical repair usually required to ensure some functional recovery

A

neurotmesis

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20
Q

peripheral nerve pain can be due to…

A

-neuritis
-neuralgia
-causalgia
-reflex sympathetic dystrophy (RSD)
-neuromas

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21
Q

inflammation of a nerve, axon unaffected, constant dull pain

A

neuritis

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22
Q

nerve pain, sudden, paroxysmal (excruciating), “lightning like” & often throbbing

A

neuralgia

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23
Q

also known as tic douloureux or painful tic, affects trigeminal nerve; cranial nerve V (CNV)

A

trigeminal neuralgia

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24
Q

affects intercostal nerve that travels between internal & innermost intercostal mm

A

intercostal neuralgia

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25
severe pain syndrome, sudden, intense, persitent, burning
causalgia
26
P syndrome, abnormal sympathetic reflex, arterial spasm
RSD (reflex sympathetic dystrophy) / complex regional pain syndrome
27
abnormal nerve healing, tumour cells, may or may not be symptomatic
neuromas
28
when an injury occurs, axon of nerve will regenerate distal to lesion site & myelin surrounding nerve distal to lesion will likely degenerate - this is known as...
Wallerian degeneration
29
traction injury of the lower brachial plexus (C8-T1), results in combination of median & ulnar nerve lesions -children: poor positioning at birth
Klumpke's paralysis
30
symptoms of Klumpke's paralysis
-"claw hand" -atrophy & functional losses primarily affect mm of hand -severe edema, vasomotor & trophic changes in hand -sensory losses affect C8 & T1 dermatomes
31
additional complication to Klumpke's paralysis
Horner's syndrome -manifests on affected side
32
symptoms of Horner's syndrome
-constriction of pupil (miosis) -drooping of eyelid (ptosis) -loss of sweating to face & neck (anhydrosis) -recession of eyeball into orbit (enophthalmos)
33
traction injury, involves upper brachial plexus (C5-C6) -children: birth trauma can cause this paralysis -adult: shoulder trauma
Erb's palsy
34
symptoms of Erb's palsy
-"waiters tip", shoulder ADD & int.R, elbow ext, forearm pronated, wrist & fingers flexed -mm wasting & motor dysfunction affect all mm above elbow, especially shoulder ABD, ext. rotators, extensors, as well as forearm supinators & pronators -sensory loss involves C5 & C6 dermatomes -tissue edema & dystrophy NOT significant
35
nerve injury which results in damage to all the fibres within the nerve
complete lesion
36
neurological condition involving lesion of facial nerve (CNVII) that causes weakness or paralysis of mm on same side of face
Bell's palsy
37
Bell's palsy - facial nerve leaves brain stem & then separates into what two divisions?
one motor division & one mixed sensory and autonomic division
38
causes of Bell's palsy
-compression from edema (pregnancy, middle ear infection, diabetes, hypertension, hypothyroidism, leprosy or tumor) -conditions affecting parotid gland (mumps or cancer) -compression from inflammation secondary to trauma (blow or stab wound, forceps used during birth) -exposure to chill or draft
39
symptom picture of Bell's palsy
-rapid onset of unilateral weakness ranging from mild to severe -flaccid paralysis of mm of facial expression -headaches -may be unable to open/ close eye -loss of blinking reflex -inability to flare nostrils, raise corners of mouth, whistle or pucker -difficulty eating, articulating sounds & holding lower lip to glass to prevent dribbling -loss of control of lacrimation & usually decreased salivation -loss of taste to anterior 2/3 of tongue -pain not usually primary symptom
40
observations for Bell's palsy
-facial expressions distorted -head may be positioned down & away in order to hide affected side -tearing may be seen -eye patch -flaccidity -edema
41
testing for Bell's palsy
-AROM of facial expressions -close affected eye -strength testing of orbicularis oculi mm positive
42
CI's for Bell's palsy
-concern about eye infection if eye cannot close & tearing diminished -pressure during massage is modified on flaccid tissue -long dragging strokes & fascial techniques CI’d on affected side
43
which way should your pressure of strokes be when treating Bell's palsy?
strokes is from midline on face laterally towards the lesion site
44
path of median nerve
-medial & lateral cords of brachial plexus (C5-T1) -down radial aspect of arm from axilla to cubital fossa -runs between heads of pronator teres mm -penetrates deeper, then in forearm -reaches carpal tunnel -branches into hand in thenar area
45
mm innervated by the median nerve
-pronator teres -flexor carpi radialis -flexor digitorum profundus (lateral half) -palmaris longus -pronator quadratus -abductor pollicis brevis -flexor pollicis longus -flexor pollicis brevis -opponens pollicis -1st & 2nd lumbricals
46
causes of lesions of the median nerve
fractures dislocations compression trauma
47
presentation of a complete median nerve lesion
"ape hand" or "oath hand"
48
path of the radial nerve
-posterior cord of brachial plexus (C5-T1) -below clavicle to posterior axillary wall -between long & medial heads of triceps -to spiral groove of humerus, deep to lateral head of triceps -winds around humerus to lateral side, travels to anterior arm (superficial) -between brachialis & brachioradialis, passing extensor carpi radialis longus & extensor carpi radialis brevis -crosses elbow joint to supinator -to thenar eminance
49
the radial nerve divides into what two branches?
-posterior motor branch -superficial branch
50
mm innervated by the radial nerve
-triceps -anconeus -brachioradialis -extensor carpi radialis longus -extensor carpi radialis brevis -supinator -extensor digitorum -extensor carpi ulnaris -extensor digiti minimi -extensor pollicis longus -extensor pollicis brevis -abductor pollicis longus -extensor indicis
51
causes of lesions of the radial nerve
fractures dislocations post-surgical complications compression supinator syndrome
52
presentation of a complete radial nerve lesion
"wrist drop"
53
path of the ulnar nerve
-medial cord of brachial plexus (C8-T1) -along posterior wall of axilla, under pectoralis to mid-upper arm (insertion of coracobrachialis) -travels along medial triceps (superficial) -at elbow, goes posterior to medial epicondyle of humerus & medial to olecranon process -ulnar collateral ligament supports nerve -follows between & deep to head of flexor carpi ulnaris mm (can be site of compression) -continues to wrist, travels over flexor retinaculum between pisiform & hook of hamate & beneath volar carpal ligament Guyon’s canal (site of compression) -to hypothenar eminence
54
the ulnar nerve divides into what two branches?
-superficial branch -deep branch
55
mm innervated by the ulnar nerve
-flexor carpi ulnaris -flexor digitorum profundus (medial half) -hypothenar mm -abductor digiti minimi -flexor digiti minimi -opponens digiti minimi -3rd & 4th lumbricals -palmar & dorsal interossei -adductor pollicis -flexor pollicis brevis (deep head)
56
causes of lesions of the ulnar nerve
fractures dislocations post-surgical complicatons prolonged compression repetitive action direct trauma pathology
57
presentation of a complete ulnar nerve lesion
"claw hand" 4th & 5th digit flexed
58
what special test would be positive with an ulnar nerve lesion?
Froment’s sign *client attempts to maintain firm grip on object held between thumb & index finger
59
ULTT 1 tests which nerve?
median nerve, anterior interosseous nerve
60
ULTT 2 tests which nerve?
median nerve, musculocutaneous nerve, axillary nerve
61
ULTT 3 tests which nerve?
radial nerve
62
ULTT 4 tests which nerve?
ulnar nerve
63
cubital tunnel syndrome affects which nerve?
ulnar nerve
64
signs & symptoms of ulnar nerve impingement affecting the wrist (tunnel of Guyon)
-claw hand deformity -Bishop's / popes hand deformity
65
a rapidly progressing inflammatory disease that results in demyelination of peripheral nerves
Guillian-Barre syndrome
66
signs & symptoms of Guillian-Barre syndrome
begins in weakness in legs & ascends to trunk, down arms & up to face (within 24-72hrs) -numbness & tingling of feet & hands -visions & speech may be impaired
67
symptoms of trigeminal neuralgia
-unilateral pain, transient, follows any parts of CN V -occasional mild twinges to episodes of extreme sharp pain -pain lasts few seconds to several hours

NEURO TX (8 decks)

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