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SS - Exam 1 > Monoparesis > Flashcards

Monoparesis Flashcards

1
Q

Monoparesis

A

Disease that affects a single limb
Diffuse diseases - neuropathy, NMJ & muscular disease
Cranial neuropathy

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2
Q

Neuropathy

A

Disorder of neurons - cell body, axon, Schwann cells

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3
Q

Myopathy

A

Disorder of muscle fibers

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4
Q

Junctionopathy

A

Dysfunction of the neuromuscular junction

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5
Q

Motor unit definition

A

Lower motor neuron
- cell body in ventral horn of SC
- axon & supporting structures
Neuromuscular junction
Muscle fibers
- all the myofibers that the neuron innervates

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6
Q

Mononeuropathy

A

Focal/single peripheral nerve dysfunction
- radial neuropathy, sciatic neuropathy

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7
Q

Multiple mononeuropathy

A

Multiple nerves of one limb affected, but no other limbs affected
- brachial plexus avulsion

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8
Q

Polyneuropathy

A

Diffuse peripheral nerve dysfunction
Secondary to diabetes mellitus

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9
Q

Paresis

A

Decreased voluntary movement
(Mono paresis is decreased voluntary movement of a single limb)

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10
Q

Plagiarism

A

Absent voluntary movement (paralyzed)
Monoplegia is complete paralysis of a single limb

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11
Q

Weakness

A

Loss of strength

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12
Q

What causes monoparesis

A

Motor unit dysfunction
- LMN cell body
- axons of LMN
- NMJ
- muscle
Sensory dysfunction
Autonomic nerves/ganglia

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13
Q

Possible neurological exam findings

A

Decreased movement of affected limb
Weakness in limb
Decreased sensory function
Normal & decreased reflexes
Atrophy of affected limb
Pain
Nerve root signature - lameness due to nerve root injury
Horner’s syndrome
Abnormal cutaneous trunci reflex

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14
Q

Neurological disease

A

Decreased voluntary movement
Reflexes often reduced
Atrophy generally severe, occurs rapidly
Horner’s syndrome

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15
Q

Orthopedic disease

A

Generally consistent in each stride
Orthopedic exam reveals abnormalities
Normal neurologic exam

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16
Q

Autonomous zones

A

Area that is innervated by only one nerve
Also for sensory testing of that nerve
Not all nerves have autonomous zones
Testing by 2 step pinch

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17
Q

Important nerves of brachial plexus

A

Suprascapular
Musculocutaneous
Radial
Median & ulnar
Lateral thoracic
Sympathetic nerves to head & neck

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18
Q

Suprascapular
Spinal cord segments
Muscles innervated
Reflex affected
Muscle function loss
Cutaneous sensation
Signs of dysfunction

A

Spinal cord segments - C6-7
Muscles innervated - supraspinatus/ infraspinatus
Reflex affected - NA
Muscle function loss - shoulder extension
Cutaneous sensation - shoulder
Signs of dysfunction - little/limited gait abnormality ± shoulder abduction

19
Q

Musculocutaneous

A

Spinal cord segments - C6-8
Muscles innervated - biceps brachii, brachialis
Reflex affected - biceps; withdrawal (flexor)
Muscle function loss - elbow flexion
Cutaneous sensation - medial antebrachium/first digit
Signs of dysfunction - limited gait abnormalities, weak elbow flexion

20
Q

Radial

A

Spinal cord segments - C7-T2
Muscles innervated - triceps, extensor carpi radialis, digit extensors
Reflex affected - triceps, extensor carpi radialis
Muscle function loss - elbow extension, carpus ext, digit ext
Cutaneous sensation - cranial antebrachium & foot
Signs of dysfunction - loss of weight bearing, knuckling

21
Q

Median & ulnar

A

Spinal cord segments - C8-T2
Muscles innervated - superficial & DDF, carpal flexor
Reflex affected - withdrawals
Muscle function loss - carpus flexion, digit flexion
Cutaneous sensation - caudal antebrachium, foot, 5th digit
Signs of dysfunction - little gait abnormalities, mild carpus hyperextension

22
Q

Lateral thoracic

A

Spinal cord segments - T1-3
Muscles innervated - dilator of pupil
Reflex affected - pupillary light
Muscle function loss - pupil dilation
Cutaneous sensation - NA
Signs of dysfunction - miosis,

23
Q

Important nerves of lumbosacral plexus

A

Obturator
Femoral
Sciatic
Peroneal
Tibial

24
Q

Obturator

A

Spinal cord segments - L4-6
Muscles innervated - Pectineus, Gracilis
Reflex affected - NA
Muscle function loss - hip adduction
Cutaneous sensation - NA
Signs of dysfunction - limited gait abnormality

25
Q

Femoral

A

Spinal cord segments - L4-6
Muscles innervated - quadriceps group, psoas group
Reflex affected - patellar
Muscle function loss - stifle ext, hip flexion
Cutaneous sensation - medial surface of limb & first digit
Signs of dysfunction - loss of weight bearing

26
Q

Sciatic

A

Spinal cord segments - L6-S2
Muscles innervated - biceps femoris, semiM, semiT, cranial tibial, gastrocnemius
Reflex affected - withdrawal, cranial tibial, gastrocnemius
Muscle function loss - hip ext, stifle flex, hock flex & ext, digit flex & ext
Cutaneous sensation - entire limb, except medial & 1st digit
Signs of dysfunction - knuckling of paws & WB

27
Q

Peroneal

A

Spinal cord segments - L6-S2
Muscles innervated - cranial tibial
Reflex affected - cranial tibial
Muscle function loss - hock flex, digit ext
Cutaneous sensation - craniolateral surface of limb, distal to stifle
Signs of dysfunction - hyperextended hock, knuckled paw

28
Q

Tibial

A

Spinal cord segments - L6-S2
Muscles innervated - gastrocnemius
Reflex affected - gastrocnemius
Muscle function loss - hock ext, digit flexion
Cutaneous sensation - caudal surface of limb, distal to stifle
Signs of dysfunction - dropped hock

29
Q

Testing for neuromuscular disease

A

Signalment, history, exam/neuro exam
CBC, chemistry (CK), urinalysis
Thoracic radiographs, abdominal ultrasound

30
Q

Advanced testing for neuromuscular disease

A

Electrodiagnosis
Muscle/nerve biopsy
Advanced imaging - CT/MRI
Cerebrospinal fluid sampling

31
Q

Nerve trauma

A

Focal - affecting single nerve
- sciatic
- radial
Brachial plexus injury/avulsion

32
Q

Focal trauma

A

Sciatic - injection site, fractures to limbs, iatrogenic
Radial - fractures

33
Q

Brachial plexus injury

A

Common in dogs & cats
Usually secondary to motor vehicle accidents/falls
Peracute onset - trauma
Pathophys
- traction injury - avulsion
- ventral nerve root more susceptible than dorsal

34
Q

Pathophysiology of nerve injruy

A

Neuropraxia
Axonotmesis
Neurotmesis

35
Q

Neuropraxia

A

Transient interruption of nerve function, can last for days to months

36
Q

Axonotmesis

A

Separation of axon from cell body w degeneration of axon. Leads to Wallerian degeneration. Supporting structures remain intact (endoneurium, Schwann cells). Regeneration usually occurs but slowly

37
Q

Neurotmesis

A

Complete severing of axon, supporting structures. During regrowth, risk of a neuroma. Surgery rarely helpful. Recovery not likely.

38
Q

Localization and severity of localization

A

Exam, electro diagnostic like EMG
Best clinical guideline is whether Nociception (pain sensation) is present
Lack of pain sensation is poor prognostic indicator

39
Q

Nerve injury treatment & prognosis

A

Usually no specific treatment
Occasionally with isolated nerve injury, surgery can be attempted, limb amputation may be recommended
Intact nerves = better chance of functional recovery
Severed nerves = grave prognosis

40
Q

Neoplasms

A

Nerve sheath tumors
Lymphoma

41
Q

Peripheral nerve sheath tumors (PNST)

A

Signalment
History - chronic, slowly progressive loss of limb function, muscle atrophy, pain, palpable mass
Neoplasia - schwannoma, neurofibroma, malignant NST

42
Q

Diagnosing NST

A

Good exam palpation
Systemic work up
Radiographs
Ultrasound
CT/MRI
Electro diagnostics

43
Q

NST treatment and prognosis

A

Pain management, surgery (location dependent) radiation, chemotherapy
Guarded to poor
Locally invasive rather than metastatic

SS - Exam 1 (33 decks)

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