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Systems > T4 Test 2 > Flashcards

T4 Test 2 Flashcards

1
Q

This is the least severe form of nerve injury, temporary impairment of condition. With no significant structural change of the cell and no wallerian degeneration.

A

Neuropraxia

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2
Q

What are some causes of neurapraxia?

A

Mild compression injury e.g Saturday night palsy, and other entrapment neuropathy, leading to mechanical deformation of the nerve and or ischemia.

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3
Q

What is the prognosis of neuropraxia?

A

Axonal conduction and function is usually restored completely once cause of compression is identified and addressed

May need an interval of rest

May occasionally leave mild permanent damage 

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4
Q

What is axonotmesus?

A

Loss of axonal structural continuity, no loss of continuity of the Endoneurial sheath with wallerian degeneration.

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5
Q

What are some causes of axonotmesis?

A
  • Can be a result of a more severe impact or stronger/more sustained compressive situation
  • Neuritis, infection (Lyme, disease, toxins, diabetes related ischemia)
  • Can also occur when the nerve is stretched
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6
Q

What is the prognosis of axonotmesis?

A
  • may recover completely, but some degree of permanent damage is likely. affected axons may regenerate
  • requires period of immobilization or modified use
  • treatment according to cause possibly anti-inflammatories
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7
Q

Separation of the axon and damage to connective tissue. The injury may be a complete transection, proximal and distal segments or part of the nerve may remain in continuity. There is Wallerian degeneration. This is…

A

Neurotmesis

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8
Q

What are causes of neurotmesis?

A

Severance injuries, displacing fractures and ruptures/traction injuries. Also amputations crush injuries, industrial accidents, MVAs

Includes damage to endoneurium perineurium, and in the most severe cases the epineurium may lead to neuroma formation

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9
Q

What is the prognosis of neurotmesis?

A
  • In cases involving viable distal segments, complete recovery is hypothetically possible, but unlikely. axons must regenerate
  • Usually partial recovery or permanent complete loss of function
  • Surgical repair, nerve graphs often required
  • Immobilization often for 3 to 6 weeks and rehab required
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10
Q

List the connective tissue layers of the axons from outermost to innermost.

A

Epineurium, Perineurium, Endoneurium

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11
Q

What is wallerian degeneration?

A

The process that occurs when axon/nerve fibre is cut, severely tractioned or crushed. Which occurs in 4 stages (Degeneration, Clearance, Regeneration, Growth & re-myelination)

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12
Q

What is neurolemma?

A

Infiltration by macrophages, mast cells and Schwann cells to clear fragmented, axonal material and debris from the injury site and along the pathway of the axon

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13
Q

The _____ is essential for regeneration of a peripheral nerve. It should remain as a hollow tube after clearance stage to move to the regeneration stage.

A

Endoneurial sheath

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14
Q

GAP repair on average tends to last _____ days

A

10 to 12

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15
Q

Regeneration is said to occur on average at a rate of ____ per day

A

1 mm per day

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16
Q

What is neuroma?

A

Regenerating axons wander into surrounding tissue/scar and form, dense fibrous mass of scar tissue made up of disorganized Schwann cells, capillaries, fibroblast, macrophages, and collagen fibres at the injury site

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17
Q

What is neuritis?

A

Inflammation of a nerve

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18
Q

What is the regeneration frontier?

A

The regeneration frontier is the location of the leading tip of the new axon, It’s newly reconstructed, neurolemma and Myelin sheath during regeneration.

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19
Q

What can be used to locate the regeneration frontier?

A

Tinel’s sign

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20
Q

What is flaccid paralysis?

A

Atonia - full loss of firing

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21
Q

What is flaccid paresis?

A

Hypotonia - partial loss of firing

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22
Q

A partial injury is more likely to present with…

A

Irritable firing phenomenon

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23
Q

What is hyperesthesia?

A

Increased sensitivity to stimulation

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24
Q

What is paresthesia?

A

Spontaneous, abnormal sensations

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25
Q

What is dysesthesia?

A

Unpleasant, painful sensations

26
Q

What is allodynia?

A

Pain caused by stimulus that doesn’t usually provoke pain.

27
Q

What is hyperalgesia?

A

Increased pain response to a stimulus that is normally painful

28
Q

What is hyperpathia?

A

Increased sensory threshold for stimulus, but more intense and prolonged pain once threshold is reached

29
Q

Which nerves carry the majority of the autonomic axons for the entire limb, upper and lower?

A

Median for upper
Tibial/sciatic for lower

30
Q

What muscles are innervated by the axillary nerve?

A

Deltoids
Teres minor
(Long head of triceps brachii)

31
Q

Where is the sensory innervation of the axillary nerve?

A

To the superolateral shoulder over deltoid

(Skin over the shoulder)

32
Q

What are the motor functions of the axillary nerve?

A

Abduction of the arm beyond first 15°

33
Q

What mm are innervated by the musculocutaneous nerve?

A
  • BBC = Biceps, Brachialis, Coracobrachialis
34
Q

What are the motor functions of the musculocutaneous nerve?

A
  • Flexion of the arm at the elbow
  • Supination of the forearm 
35
Q

What is the sensory innovation of the musculocutaneous nerve?

A

The lateral forearm

36
Q

Which upper limb nerve is most commonly affected by diabetic neuropathy?

A

Musculocutaneous nerve

37
Q

Loss of biceps DTR may be from injury to which nerve?

A

Musculocutaneous

38
Q

Which muscles are innovated by the median nerve?

A

Flexor carpi radialis, Palmaris longus, pronator quadratus, pronator Teres, digital flexors

39
Q

What are the motor functions of the median nerve?

A

Thumb flexion and opposition, flexion of digits 2 & 3, wrist flexion and abduction, forearm pronation

40
Q

What is the sensory innervation of the median nerve?

A

Skin over anterolateral surface of hand

41
Q

What is carpal tunnel syndrome?

A

Compression of the median nerve as it passes through the carpal tunnel beneath the transverse carpal ligament.

42
Q

Is forearm pronation a sole or shared action of the median nerve?

A

Sole action

43
Q

Is wrist flexion a shared or sole action of the median nerve?

A

Shared with ulnar

44
Q

Is wrist abduction a shared or sole action of the median nerve?

A

Shared with radial

45
Q

Is thumb opposition a shared or sole action of the median nerve?

A

Shared with ulnar

46
Q

Is thumb abduction a shared or sole action of the median nerve?

A

Shared with radial

47
Q

Which actions of the median nerve are shared with the ulnar nerve?

A

Wrist flexion, thumb flexion, finger flexion of fingers four and five

48
Q

Which actions of the median nerve are shared with the radial nerve?

A

Wrist abduction, thumb flexion

49
Q

Which nerve carries majority of autonomic fibres for the entire arm, forearm and hand

A

The median nerve

50
Q

Which nerve is referred to as the tool utilization nerve?

A

The median nerve

51
Q

Full loss of medium nerve function leads to _____ deformity

A

Ape hand deformity

52
Q

Which mm are innervated by the ulnar nerve?

A

Flexor carpi ulnaris, flexor digitorum profundus, adductor pollicis, small digit mm

53
Q

What are the motor dunctions of the ulnar nerve?

A

Finger adduction and abduction other than thumb, thumb adduction, flexion of digits 4 and 5, wrist flexion, and adduction

54
Q

What is the sensory innervation of the ulnar nerve?

A

Skin over medial surface of the hand through the superficial branch

55
Q

Arcade of Struthers entrapment is entrapment of which nerve?

A

Ulnar nerve

56
Q

Cubital tunnel syndrome can affect which nerve?

A

Ulnar nerve

57
Q

Full loss ulnar nerve function leads to reduce grip strength and ____ presentation

A

Claw hand

58
Q

Compression in the arcade of froshe is a common injury of which nerve?

A

Arcade of froshe

59
Q

True or false: it is possible to get i juries to the radial nerve that are sensory only or motor only

A

True: this is because motor and sensory branches of the radial nerve take different paths in the forearm

60
Q

What mm are supplied by the radial nerve?

A
  • Forearm extensors
  • Triceps, brachioradialis, extensor carpi radialis longus, anconeus

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