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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
decreased vibration, joint position sense, areflexia, ataxia, hypotonia
negative large fiber
26
tingling, pins and needles, numbness
large fiber positive
27
hypotension, decreased sweat, impotence, urinary retention, constipation
autonomic negative
28
hyperhidrosis, urinary frequency, diarrhea
autonomic positive
29
brachial plexopathy
``` CABG idiopathic radiation injury neoplastic trauma ischemia ```
30
parsonage turner inflammation/idiopathic
sever pain around shoulder, in few days get atrophy in deltoid and biceps weakness autoimmune and treat with steroids
31
radiation injury causes what injury in BP
upper trunk, lateral cord, painless
32
neoplastic brachial plexopathy
breast, lung cancer | -medial cord, painful
33
median nerve sites of compression and clinical features
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
ulnar nerve entrapment sites and clinical feture
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
radial nerve entrapmetnt site and clinical feature
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
median mononeuropathy trapped btwn what
2 heads of palmaris longus muscle | or ligament of struthers
37
needle EMG in anterior interosseous syndrome
abnormalities in FPL, FDP, PQ
38
ulnar mononeuropathy: EMG may show abnormalities in what
``` 1st dorsal interosseous abductor digiti minimi adductor policis flexor carpi ulnaris flexor digitorum profundus ```
39
froemnt sign when you must flex at at phalangeal joint to grip something
ulnar neuropathy
40
spiral groove saturday night palsy (radial nerve)
weakness of wrist and finger extension | may have sensory loss dorsal thumb web
41
L5 vs peroneal nerve entrapment
someone with footdrop | L5 does inversion and peroneal does not so if can still invert foot then peroneal nerve
42
sciatic nerve roots and site compression
``` L4-S2 sciatic notch hip piriformis m popliteal fossa ```
43
peroneal mononeuropathy at fibular head | where does the amplitute and CV drop and by how much
above the knee by 50% or so
44
needle EMG for peroneal mononeuroptahy at fibular head: what is the abnormality in
tibialis ant, EHL, EDB
45
clinical features of peroneal mononeuropathy at fibular head
weakness of foot dorsiflexion and eversion weakness of toe extension sensory loss dorsum of foot
46
symmetric, motor, sensory, autonomic, or combo loss | progressive
peripheral neuropathy
47
autonomic involvement periopheral neuropathy
pupillary irregularities, sweating abnormalities, impotence, hypo/hypertension
48
stocking glove distribution
peripheral neuropathy
49
etiology of peripheral neurpathy
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
CMT type 1
``` 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
CMT type II
``` axonal degenration AD adult onset distal symmetric atrophy arreflexia mild sensory loss ```
52
CMT type II and EMG
normal or nearly normal motor nerve conduction bc of axonal loss not demyl
53
viral syndrome with guillanin barre
``` EBV mycoplasma pneumonia campylobacter jejuni HIV hodkin's disease ```
54
GBS clinical features
``` ascending symmeteric weakness hypo or absent dtr no/minimal sensory symptoms or signs possible respiratory failure, autonomic involvement improvement over weeks ```
55
treatment for GBS
supportive | direct treatment with plasma exchange or IVIg
56
miller fisher syndrome and GBS
5% of GBS cases -ophthalmoplegia, ataxia, arreflexia facial wekness, dysarthria, dysphagia GQ1b and GT1a antibodies
57
chronic inflammatory demyelinating polyneuropathy CIDP
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
mutlifocal motor neuropathy | clinical, lab, treat
slowly progressive distal weakness of hands>feet no sensory signs, no UMN signs elevated serum GM-1 ab treatment: IVIg
59
cranial neuropathy in DM
CN II, VI, VII
60
inherited demyelinating peripheral neuropathy
HSMN 1 and III refsum's dis leukodystrophies
61
acquired axonal peripheral neuropathy
DM, etOH, uremia, metals, chemo, MM
62
Hu antibody
carcinomatous sensory neuroapthy
63
aANCA
systemic vasculitis
64
anti MAG
MGUS neurop
65
anti GM1
multifocal motor neurop
66
anti GQ1b
miller fisher syndrome

MSK 2 Final DF (10 decks)

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