39 - Radiculopathy Flashcards
(36 cards)
How many pairs of spinal nerves are there?
31 (8 cervical, 12 thoracic, 5 lumbar/sacral, 1 cocygeal)
What level does the spinal cord end?
ends at L1/L2 so do LP at L3/L4
What is the flow of structures after a neuron leaves the spinal cord?
rootlets > roots > MSN > anterior/posterior rami
Where are the roots and trunks of the brachial plexus with respect to teh clavicle?
supraclavitcular
Where are divisions of brachial plexus with respect to the clavicle?
divisions are retroclavicular
Where are cords and branches of the brachial plexus wrt clavicle?
infraclavicular
What are two most common etiologies of radiculopathies?
disk herniations and degenerations
Cervical: = herniated nucleus pulposus (C7>C6) OR spondylosis of C5+C6.
Lumbosacral = HNP at L5/S1
Patient hurts back and has radiculopathy affecting leg. Mother tells him to stay in bed and rest. You say?
momma don’t know shit. quit being a bitch. Avoid bed rest and be as routine as possible.
What is Spurling’s Maneuver?
??
What pattern of motor or sensory loss will you have with radiculopathies?
motor loss along myotomes
sensory loss along dermatomes
What will happen to muscle stretch reflexes in LMN disease?
decreased
What nerve levels are responsible for the anal wink? ;)
S2-S4
What is EDX testing? What is it good for?
asseses sensory nerves + muscle mfibers + myelination status + location + severity.
confirms clinical diagnosis from history and physical.
Not much good by itself though
What is a plexopathy?
LMN lesion in plexus of LMN and peripheral nerves
Ex: median N, ulnar N, radial n entrapment syndromes.
Patient complains of numbness and weakness of thumb, pointer finger, and half of the ring finger. What nerve?
Median nerve loss. Carpal tunnel
Patient has wrist drop. Where is lesion?
radial n. (axillary entrapment)
patient has foot drop. Where is lesion
fibular head (peroneal nerve)
Student has been studying at a desk for 22 hours nonstop with his elbows supporting weight. Where is he at risk for developing weakness/numbness?
medial elbow entrapment can compress the ulnar N., causing medial 1.5 digits and hypothenar/interosseous atrophy.
What is Charcot Marie Tooth Disease?
AD demyelinating disease AKA hereditary motor and sensory neuropathy type 1.
What is CMT disease type 1a?
deletion of myelin protein PMP on ch. 17
What is CMT disease type 1?
defect of protein 0 ch.1
What is PMP 22? What will a deficeincy of it cause?
a peripheral myelin protein involved in compaction of myelin on peripheral nerves.
Defects or deficiencies of it cause peripheral demyelinating neuropathies.
What is classic presentation of CMTD?
distal muscle weakness, atrophy of leg BELOW KNEES, orthopedic foot problems (HAMMER TOE/ARCH FEET)
What is diabetic nephropathy?
neuropathy secondary to hypoglycemia associated with DM. Can present as a mononeuroapthy, complex, polyneuropathy, truncal or diabetic amyotrophy.
