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Neurology > Radiculo, plexo, neuropathy > Flashcards

Radiculo, plexo, neuropathy Flashcards

1
Q

Which nerve roots do not carry sensory nerve fibers?

A

C1 and Co1

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2
Q

What is the sensory domain?

A

The skin region innervated by the sensory nerve fibers contained within a nerve root

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3
Q

What is the muscle domain?

A

The muscles innervated by the motor nerve fibers contained within a nerve root

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4
Q

Two most common causes of radiculopathies?

A

Disk herniation and degeneration

Lumbosacral radiculopathies

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5
Q

Clinical features of radiculopathies?

A 
Pain is the historical hallmark
Sharp; stabbing; hot; electric
Often radiating
Often aggravated by maneuvers that stretch the root
  -Neck extension
  -Neck rotation
  -Spurling's maneuver
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6
Q

Other radiculopathic features?

A 
Weakness and atrophy
 -Motor nerve fibers
 -Myotomal distribution
Paresthesias and sensory loss
 -Sensory nerve fibers
 -Dermatomal distribution
 -Muscle stretch reflexes (diminished or absent)
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7
Q

Frequent causes of radiculopathies?

A

Disc herniation (50 yrs)

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8
Q

Types of spondylosis?

A 
Cervical
 -myeloradiculopathy (spinal cord stenosis)
Lumbosacral 
 -Neurogenic claudication
   >>Ambulation --> LE pain and weakness
 -Cauda equina syndrome
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9
Q

Elements of brachial plexus plexopathies?

A 
Anterieor primary rami
Trunks
Divisions
Cords
Terminal nerves
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10
Q

Most common compression of the median nerve causes?

A

Carpel Tunnel Syndrome

  • Compressed at the wrist
  • Numbness in the first 3.5 digits with pain
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11
Q

What happens if the median nerve is compressed at the arm?

A

Weakness of the hand (thenar muscles) and wrist flexion

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12
Q

Where is the ulnar nerve frequently compressed? Causing?

A

Elbow

Weakness and atrophy of the hypothenar and interosseous muscle with numbness in the 5th and half of the 4th digit

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13
Q

What does a nerve conduction test show in ulnar nerve compression?

A

Slowing of the ulnar nerve at the elbow

Might show denervation in the affected muscles

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14
Q

Saturday night palsy?

A

Compression of the radial nerve causing wrist drop

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15
Q

If you see foot drop, what nerve is compressed?

A

Peroneal Nerve

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16
Q

Classification of demyelinating neuropathy?

A

Weakness - distal & proximal
Areflexia
Decreased vibration & position sense with little deficit of pain & temperature sensations
Very slow NCV, conduction block with normal amplitude of nerve action potential
Prolonged distal latencies, F responses & H reflexes

17
Q

Classification of axonal neuropathy?

A 
Mostly distal weakness
Distal areflexia
Glove and stocking sensory deficits
Nerve conduction is almost normal with reduced action potential amplitude
Signs of denervation on EMG
18
Q

Classification of Wallerian degeneration?

A

Severe acute damage to myelin and axons

19
Q

If a disease is demylinating what is it associated with? If it is more axonal?

A

Autoimmune

Toxins

20
Q

Characteristics of Charcot-Marie-Tooth Disease?

A 
AD
Demylinating (mostly) , Rarely axonal
High arched feet
Hammer toes
Check NCV in relatives
21
Q

Genes related to Type 1 Charcot-Marie-Tooth Disease?

A

Deletions on the genes that express myelin protein PMP 22(1A) or protein 0 P0(1B)

22
Q

Types of diabetic neuropathies?

A 
Mononeuropathy
Mononeuritis multiplex
Diffuse polyneuropathy
Truncal neuropathy
Diabetic amyotrophy
23
Q

Characteristics of Diabetic mononeuropathy?

A

Limb or cranial neuropathy

24
Q

Types of diabetic diffuse polyneuropathies?

A

Mixed
Sensory - Motor
Sensory
Autonomic

25
Q

Origin of diabetic diffuse sensory motor neuropathy?

A

Metabolic

  • Accumulation of sorbitol
  • Deficiency of myoinositol
26
Q

Presentation of diabetic diffuse sensory motor neuropathy?

A

Burning of feet, then numbness and weakness

27
Q

How does diabetic diffuse sensory motor neuropathy improve?

A

Good control of diabetes

28
Q

Are diabetics are more predisposed to entrapment neuropathies?

A

Yes

29
Q

Tx of diabetic polyneuropathy?

A 
Good control of diabetes 
Nerve growth factor
Sorbitol antagonist
Myoinositol & vitamin supplementation
Be aware of other conditions
30
Q

What is Guillain-Barre Syndrome?

A

An acute automimmune ascending paralysis accompanied by arreflexia and normal or mildly abnormal sensation with albuminocytological disassociation in the spinal fluid

31
Q

Characteristics of Guillain-Barre syndrome?

A

Progressive (symmetrical) paralysis over a period of one to three weeks
Acute inflammatory radiculoneuropathy
Ascending paralysis, facial weakness, respiratory insufficiency
Paresthesia but little evidence of sensory deficiy
Areflexia, normal or almost normal sensation

Neurology (25 decks)

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