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NEURO TX > quiz #1 > Flashcards

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
Q

severe pain syndrome, sudden, intense, persitent, burning

A

causalgia

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26
Q

P syndrome, abnormal sympathetic reflex, arterial spasm

A

RSD(reflex sympathetic dystrophy) / complex regional pain syndrome

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27
Q

abnormal nerve healing, tumour cells, may or may not be symptomatic

A

neuromas

28
Q

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…

A

Wallerian degeneration

29
Q

traction injury of the lower brachial plexus (C8-T1), results in combination of median & ulnar nerve lesions
-children: poor positioning at birth

A

Klumpke’s paralysis

30
Q

symptoms of Klumpke’s paralysis

A

-“claw hand”
-atrophy & functional losses primarily affect mm of hand
-severe edema, vasomotor & trophic changes in hand
-sensory losses affect C8 & T1 dermatomes

31
Q

additional complication to Klumpke’s paralysis

A

Horner’s syndrome
-manifests on affected side

32
Q

symptoms of Horner’s syndrome

A

-constriction of pupil (miosis)
-drooping of eyelid (ptosis)
-loss of sweating to face & neck (anhydrosis)
-recession of eyeball into orbit (enophthalmos)

33
Q

traction injury, involves upper brachial plexus (C5-C6)
-children: birth trauma can cause this paralysis
-adult: shoulder trauma

A

Erb’s palsy

34
Q

symptoms of Erb’s palsy

A

-“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
Q

nerve injury which results in damage to all the fibres within the nerve

A

complete lesion

36
Q

neurological condition involving lesion of facial nerve (CNVII) that causes weakness or paralysis of mm on same side of face

A

Bell’s palsy

37
Q

Bell’s palsy - facial nerve leaves brain stem & then separates into what two divisions?

A

one motor division & one mixed sensory and autonomic division

38
Q

causes of Bell’s palsy

A

-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
Q

symptom picture of Bell’s palsy

A

-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
Q

observations for Bell’s palsy

A

-facial expressions distorted
-head may be positioned down & away in order to hide affected side
-tearing may be seen
-eye patch
-flaccidity
-edema

41
Q

testing for Bell’s palsy

A

-AROM of facial expressions
-close affected eye
-strength testing of orbicularis oculi mm positive

42
Q

CI’s for Bell’s palsy

A

-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
Q

which way should your pressure of strokes be when treating Bell’s palsy?

A

strokes is from midline on face laterally towards the lesion site

44
Q

path of median nerve

A

-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
Q

mm innervated by the median nerve

A

-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
Q

causes of lesions of the median nerve

A

fractures
dislocations
compression
trauma

47
Q

presentation of a complete median nerve lesion

A

“ape hand” or “oath hand”

48
Q

path of the radial nerve

A

-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
Q

the radial nerve divides into what two branches?

A

-posterior motor branch
-superficial branch

50
Q

mm innervated by the radial nerve

A

-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
Q

causes of lesions of the radial nerve

A

fractures
dislocations
post-surgical complications
compression
supinator syndrome

52
Q

presentation of a complete radial nerve lesion

A

“wrist drop”

53
Q

path of the ulnar nerve

A

-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
Q

the ulnar nerve divides into what two branches?

A

-superficial branch
-deep branch

55
Q

mm innervated by the ulnar nerve

A

-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
Q

causes of lesions of the ulnar nerve

A

fractures
dislocations
post-surgical complicatons
prolonged compression
repetitive action
direct trauma
pathology

57
Q

presentation of a complete ulnar nerve lesion

A

“claw hand”
4th & 5th digit flexed

58
Q

what special test would be positive with an ulnar nerve lesion?

A

Froment’s sign
*client attempts to maintain firm grip on object held between thumb & index finger

59
Q

ULTT 1 tests which nerve?

A

median nerve, anterior interosseous nerve

60
Q

ULTT 2 tests which nerve?

A

median nerve, musculocutaneous nerve, axillary nerve

61
Q

ULTT 3 tests which nerve?

A

radial nerve

62
Q

ULTT 4 tests which nerve?

A

ulnar nerve

63
Q

cubital tunnel syndrome affects which nerve?

A

ulnar nerve

64
Q

signs & symptoms of ulnar nerve impingement affecting the wrist (tunnel of Guyon)

A

-claw hand deformity
-Bishop’s / popes hand deformity

65
Q

a rapidly progressing inflammatory disease that results in demyelination of peripheral nerves

A

Guillian-Barre syndrome

66
Q

signs & symptoms of Guillian-Barre syndrome

A

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
Q

symptoms of trigeminal neuralgia

A

-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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