Disorders of the Peripheral Nervous System Flashcards Preview

Neuro 1 > Disorders of the Peripheral Nervous System > Flashcards

Flashcards in Disorders of the Peripheral Nervous System Deck (36)
Loading flashcards...
1
Q

NCV

A

Nerve conduction velocity

Amplitude - number of conducting fibers reduced in axonal loss

Conduction velocity - reflects myelin sheath…decreased in demyelinating process

2
Q

EMG good for

A

Myopathyic vs. neurologic causes

3
Q

Babinski sign in UMN vs. LMN

A

May be present in UMN…not in LMN

4
Q

PNS sensory presentation in general

A

Worse at night
Negative
Positive
Stocking-glove pattern

5
Q

ALS type of dz and what to look for generally

A

Acquired, chronic, motor neuron disease

UMN and LMN signs and symtoms

6
Q

Diagnosis of ALS

A

Weakness
No sensory loss of sphincter distrubance
Progressive course
No cause other than genetic

7
Q

ALS symptoms and signs

A

Mixed UMN and LMN in limbs

Cognitive decline in some cases

Weakness and wasting of muscles

8
Q

Risk factors and pop of ALS…what degenerates

A

SMoking
30-60
CN motor nuclei, anterior horn cells, corticospinal tracts

9
Q

ALS clinical findings

A

UMN and LMN
If bulbar - trouble chewing, swallowng, breathing (worse prognosis)
Drooping of palate and fasciculating tongue
Cog change
Motor weakness in limbs or stifness

10
Q

ALS labs

A

EMG - chronic partial denervation..sponatneous activity in resting muscle

11
Q

Tx of ALS

A

Riluzole reduces glutamate release

Supportive

12
Q

Course of ALS

A

Progressive
Fatal in 3-5 years from pulmonary infection
Worse if bulbar

13
Q

Spinal nerve disorders (herniated disc related radiculopathies)

A

Pain in a dermatomal region

Weakness of muslce in myotome

14
Q

Causes of spinal nerve dz

A

Herniated disc
Osteo or rehumatoid arthritis
Cancers

15
Q

Signs and symptoms of nerve root disorders

A

All LMN signs
Diminished reflexes
Shock-like pains may radiate down

16
Q

Grading of reflexes

A
0 - none 
1 - dimished 
2 - normal
3 - brisker but not necessarily dz 
4 - very bad with clonus
17
Q
Anke reflexx
Knee reflex
Brachioradilais
Biceps
Triceps
A
Sacral 1 
Lumbar 2-4 
Cervical 5-6
Cervical 5-6
Cervical 6-7
18
Q

Guillain Barre is also

A

Acute inflammatory demylinating polyneuropathy

19
Q

Guillan barre histo and clinically

A

Weakness in distal that rapidly advances to proximal (ascending paralysis)…areflexia…can progress to resp failure

Demyelination of spinal nerve roots and peripheral nerves

20
Q

Pathogen of G-B

A

GI realted often

Acute-onset immune mediated demyelinating neuropathy

21
Q

G-B tx and prognosis

A

Plasmapheresis and IV Ig
Supportive

May spend weeks in ICU but can survive

22
Q

Diabetes

A

Most common cause of peripheraly nerupathy

23
Q

Patterns of diabtetes

A

Ascending distal symmetric sensorimotor polyneuropathy

Auto dysfunction

24
Q

Pathology of diabetic symmetric sensorimotor polyneurpathy

A

Axonal neuropathy

25
Q

Clinical features of diabetes

A

Numbness with stocking-glove distribtuion
Parethesias or dysethesias

Hyporeflexia that may progress to weakness

Charcot foot or skin ulcers

26
Q

Varicella Zoster

A

Latent infection within neurons of sensory ganglion

Follows a dermatome

Peripheral axonal degeneration

27
Q

Most common dermatomes of zoster

A

Trigeminal or throacic

28
Q
Carpal tunnel
Cubital tunnel
Saturday night
Tarsal tunnel
Meralgia paresthetica
A
Median nerve
Ulnar nerve
Radial nerve
Posterior tibial nerve
Lateral femoal cutaneous
29
Q

Carpal tunnel syndrome risk factors and presnetation

A

Thumb and first two digits numb…thenar atrophy…weakness in opposition

Diabetes or excessive wrist motions

30
Q

Ulnar nerve palsy

A

Cubital tunnel syndrome
Guyon’s canal or ulnar groove

Decreased 4th and 5th sensation with claw hand (hand of benediction) and weakness of finger abduciton

31
Q

Radial nerve palways

A

Extension of wrist and fingers - drop hand

Decreased back of hand sensation

32
Q

Lateral femoral cutaneous neuropathy

A

Trapped under inguinal ligament

Pure sensory over lateral thigh

Eliminate the cause

Tight belt, pregnant

33
Q

Peroneal neuropathy

A

Pain in laterla lower leg and foot drop

34
Q

Posterior tibial nerve neuroapthy

A

Pain in medial ankle and plantar surface…weakned toe flexors

35
Q

CMT type of dz

A

Herediatry motor and sensory neuropahty

36
Q

CMT symtpoms and findings

A

Hypertrophic neuropathy with onion bulb formation from schwann cell hyperplasia

Distal muscle atrophy with sensory loss and pes cavus