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MSK 2 Final DF > sachen peripheral neuropathy > Flashcards

sachen peripheral neuropathy Flashcards

1
Q

emg measures myelinated or unmyelinated fibers?

A

myelinated

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2
Q

which of the types are the larger myelinated ones and what is their function

A

alpha- proprioception and somatic motor

beta- touch and pressure

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3
Q

delta fiber is what

A

smaller unmyelinated

pain cold and touch

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4
Q

what is wallerian degeneration

A

nerve isd severed and distal pionts to it deteriotes

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5
Q

what type of pathological process is guillen barre

A

segmental demyelination

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6
Q

most common radiculopathy in cervical and lumbar

A

c6 and C7

L5 and S1

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7
Q

C5 radiculopathy

pain
weakness
DTR loss

A

P: scapula shoulder

W: shoulder abduction

D: biceps

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8
Q

C6 radiculopathy

pain
weakness
DTR loss

A

P: scapular, shoulder, prox arm

W: shoulder abduction and elbow flexion

D: biceps and brachioradialis

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9
Q

C7 radiculopathy

pain

weakness
DTR loss

A

P: scapula
shoulder/arm
elbow/forearm

W: elbow ext, wrist ext, finger ext

D: triceps

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10
Q

C8 radiculopathy

pain
weakness
dtr loss

A

P: scapula shoudler/arm medial forearm

W: finger abd and finger flexion

D: finer flexors

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11
Q

L4 pain, sensory, weakness, DTR loss

A

antlat thigh, knee, medial calf

sensory: medial calf
weakness: hip flexion and knee extension

DTR: patella

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12
Q

L5: pain, sensory, weakness, dtr loss

A

pain: dorsal thigh and lat calf
sensory: lat calf and dorsum foot
weakness: hamstrings, foot dorsiflexion, inversion, eversion

dtr loss = none

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13
Q

S1: pain, sensory, weakness, dtr loss

A

pain: post thigh and post calf
sesory: postlat calf and lat foot
weakness: hamstrings and foot plantarflex
dtr loss is achilles

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14
Q

dermatome

C6
C7
C8
T1
T4
T10
A 
c6: thumb and index
C7: middle
C8: fourth and fifth finger
T1: medial forearm
T4 is nipple
T10 is umbilicus
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15
Q

dermatome
L1
L4
L5

A

L1: inguinal
L4: medial calf
L5: lateral calf

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16
Q

single nerve affected
specific pattern of sensory loss
weakness only in specific muscles

A

mononeuropathy

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17
Q

diffuse, symmetrial disease- motor sensory or both
stocking/glove sensory loss
distal weakness, possiblhy atrophy
hypo or arreflexia

A

polyneuropathy

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18
Q

focal involvement of two or more nerves

may occur in some systemic disorders

A

mononeuropathy multiplex

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19
Q

loss of sensation

A

negative

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20
Q

paresthesias and pain

A

positive sensory

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21
Q

parestesias secondary to what

A

large myelinated fiber disease: pins and needles

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22
Q

pain secondary to

A

small unmyelinated fiber disease

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23
Q

hyperpathia

A

pain threshold elevated but pain excessively felt

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24
Q

hyperalgesia

A

lowered threshold to pain

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25
Q

decreased vibration, joint position sense, areflexia, ataxia, hypotonia

A

negative large fiber

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26
Q

tingling, pins and needles, numbness

A

large fiber positive

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27
Q

hypotension, decreased sweat, impotence, urinary retention, constipation

A

autonomic negative

28
Q

hyperhidrosis, urinary frequency, diarrhea

A

autonomic positive

29
Q

brachial plexopathy

A 
CABG
idiopathic
radiation injury
neoplastic
trauma
ischemia
30
Q

parsonage turner inflammation/idiopathic

A

sever pain around shoulder, in few days get atrophy in deltoid and biceps weakness
autoimmune and treat with steroids

31
Q

radiation injury causes what injury in BP

A

upper trunk, lateral cord, painless

32
Q

neoplastic brachial plexopathy

A

breast, lung cancer

-medial cord, painful

33
Q

median nerve sites of compression and clinical features

A

1) wrist (carpal tunnel)- sensory loss and thenar atrophy
2) anterior interosseous (abnormal pinch sign, normal sensation, nerve conduction study normal)

3) elbow (pronator teres syndrome) tenderness of pronator teres, sensory loss

34
Q

ulnar nerve entrapment sites and clinical feture

A

1) elbow btwn medial epicondyle and olecranon
2) cubital tunnel syndrome (btwn tendinous arch of FCU) = claw of 4th and 5th finger

2) wrist-guyon’s canal- hypothenar atrophy, variable sensory loss

35
Q

radial nerve entrapmetnt site and clinical feature

A

1) axilla (crutch palsy) wrist drop, tricep involved, sensory loss
2) spiral groove, wrist drop “saturday night palsy”
3) supinator- posterior interosseous, paresis of finger extensors, radial wrist deviation
4) wrist- superficial sensory branch- paresthesias in dorsum of hand (handcuff palsy)

36
Q

median mononeuropathy trapped btwn what

A

2 heads of palmaris longus muscle

or ligament of struthers

37
Q

needle EMG in anterior interosseous syndrome

A

abnormalities in FPL, FDP, PQ

38
Q

ulnar mononeuropathy: EMG may show abnormalities in what

A 
1st dorsal interosseous
abductor digiti minimi
adductor policis
flexor carpi ulnaris
flexor digitorum profundus
39
Q

froemnt sign when you must flex at at phalangeal joint to grip something

A

ulnar neuropathy

40
Q

spiral groove saturday night palsy (radial nerve)

A

weakness of wrist and finger extension

may have sensory loss dorsal thumb web

41
Q

L5 vs peroneal nerve entrapment

A

someone with footdrop

L5 does inversion and peroneal does not so if can still invert foot then peroneal nerve

42
Q

sciatic nerve roots and site compression

A 
L4-S2
sciatic notch
hip
piriformis m
popliteal fossa
43
Q

peroneal mononeuropathy at fibular head

where does the amplitute and CV drop and by how much

A

above the knee by 50% or so

44
Q

needle EMG for peroneal mononeuroptahy at fibular head: what is the abnormality in

A

tibialis ant, EHL, EDB

45
Q

clinical features of peroneal mononeuropathy at fibular head

A

weakness of foot dorsiflexion and eversion
weakness of toe extension
sensory loss dorsum of foot

46
Q

symmetric, motor, sensory, autonomic, or combo loss

progressive

A

peripheral neuropathy

47
Q

autonomic involvement periopheral neuropathy

A

pupillary irregularities, sweating abnormalities, impotence, hypo/hypertension

48
Q

stocking glove distribution

A

peripheral neuropathy

49
Q

etiology of peripheral neurpathy

A

metabolic/endocrine

infectious like lyme disease and HIV

immune mediate like GBS and paraproteinemic (monoclonal gammopathy)- associated with cancer, MM is big one

deficiency of B vitamins

Toxins

Drug induced

vasculitic

paraneoplastic

50
Q

CMT type 1

A 
AD with variable penetrance
demyelinative neuropathy 
10-20 yrs old
difficult walk or running first
distal symmetric atrophy (legs>arms)
arrefelxia
mild sensory loss
pes cavus, hammer toes, scoliosis high arches
51
Q

CMT type II

A 
axonal degenration
AD
adult onset
distal symmetric atrophy
arreflexia
mild sensory loss
52
Q

CMT type II and EMG

A

normal or nearly normal motor nerve conduction bc of axonal loss not demyl

53
Q

viral syndrome with guillanin barre

A 
EBV
mycoplasma pneumonia
campylobacter jejuni
HIV
hodkin's disease
54
Q

GBS clinical features

A 
ascending symmeteric weakness
hypo or absent dtr
no/minimal sensory symptoms or signs
possible respiratory failure, autonomic involvement
improvement over weeks
55
Q

treatment for GBS

A

supportive

direct treatment with plasma exchange or IVIg

56
Q

miller fisher syndrome and GBS

A

5% of GBS cases
-ophthalmoplegia, ataxia, arreflexia
facial wekness, dysarthria, dysphagia
GQ1b and GT1a antibodies

57
Q

chronic inflammatory demyelinating polyneuropathy CIDP

A

similar to GBS but slower to eveolve and more persistent
15% have monoclonal antibody (IgM or IgG)
treat with IVIg, steroids, plasma exchange, immunosupp agents

58
Q

mutlifocal motor neuropathy

clinical, lab, treat

A

slowly progressive distal weakness of hands>feet
no sensory signs, no UMN signs
elevated serum GM-1 ab
treatment: IVIg

59
Q

cranial neuropathy in DM

A

CN II, VI, VII

60
Q

inherited demyelinating peripheral neuropathy

A

HSMN 1 and III
refsum’s dis
leukodystrophies

61
Q

acquired axonal peripheral neuropathy

A

DM, etOH, uremia, metals, chemo, MM

62
Q

Hu antibody

A

carcinomatous sensory neuroapthy

63
Q

aANCA

A

systemic vasculitis

64
Q

anti MAG

A

MGUS neurop

65
Q

anti GM1

A

multifocal motor neurop

66
Q

anti GQ1b

A

miller fisher syndrome

MSK 2 Final DF (10 decks)

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