09 04 TBL lecture Flashcards Preview

Neurology 1- M2 > 09 04 TBL lecture > Flashcards

Flashcards in 09 04 TBL lecture Deck (14):
1

Neuropathy

general term for nerve disorder

-axon/myelin
-large/small diameter
-affect both sensory and motor fibers in nerve
-damage can be permanent or reversible.

2

Radiculopathy

neuropathy affecting the spinal nerve roots

3

Symptoms of diabetic neuropathy?

compromise of microvascular blood supply of peripheral nerves.

-Distal symmetrical polyneuropathy
-glove and stocking pattern of sensory loss

Onset is sudden and sensorimotor deficits in the nerve distribution may be accompanied by painful paresthesia

4

Complex regional pain syndrome

Type 1.
Reflex sympathetic dystrophy
-follows an injury w/o specific nerve damage

Type 2.
Causalgia
-Follows damage to a specific nerve.

Intense local burning pain accompanied by edema, sweating, and changes in skin blood supply.

5

Treatment for neuropathy

-anticonvulsants
-serotonin-norepinephrine re-uptake inhibitors
-tricyclic anti-depressants

6

Guillain- Barre

1. what it is?
2. Onset?
3. Diagnosis?
4. Treatment?

Acute inflammatory demyelinating polyneuropathy

Onset: 1-2 weeks after viral infection
-progressive weakness (areflexia), tingling paresthesias of hand and feet, motor invovlemtn typically much more severe than sensory involvement.

Diagnosis:
-CSF with high protein concentration w/o elevated white blood count
- EMG/nerve conduction = demyelination

Treatment:
-supportive care and immune therapy
-plasmapheresis or intravenous immunoglobulin therapy

7

symptoms of radiculopathy?

burning, tingling pain that radiates/shoots down a limb in the dermatome of the affected root.

-may be loss of reflexes and motor strength

8

straight-leg rouse test

mechanical nerve root compression in the lumbar-scaral region
- traction on nerve root
-test is + if it reproduces the patient's typical radicular pain and paresthesias

If a response occurs in less than a 10 degree angle or more than a 60 degree angle, pain is probably not caused by root compression

9

crossed straight-leg rousing test

elevate asymptomatic leg
- causes typical symptoms in symptomatic leg.

Specificity = 90% -- little false positives.

10

Cervical disc herniations usually move to what position?

herniation occurs laterally

11

Lumbar disc herniations usually happen where? And which nerve do they affect

posteriolateral disc herniations
- affect lower spinal root

Lateral disc herniation
- affect higher spinal root

Central disc herniations (usually occurs at lower levels of caudal equina)--> impinge on nerve roots lower that level of herniation OR compress the spinal cord if it occurs above L1.

12

What muscles are you testing when looking at :

C5

C6

C7

deltoid, infraspinatus, biceps

wrist extensors, biceps

triceps

13

What muscles are you testing when looking at :

L4

L5

S1

Iliopsoas, quadricpes

Foot dorsiflexion, big toe extension, foot eversion, inversion

foot plantar flexion ( Achilles tendon)

14

How can spinal stenosis occur?

inflammation of ligamentum flavum
-affect below level of lesion