Spinal Nerves and Plexes (4B) EXAM 2 Material

Question 1

Dysfunction of Peripheral Nerves: Sensory Changes

Answer 1

Decreased, lost and/or abnormal sensations

Question 2

Parasthesia

Answer 2

Painless abnormal sensation in the absence of nocioceptor (pain receptor) stimulation.

Question 3

Dysesthesia

Answer 3

Unpleasant abnormal sensation, evoked or spontanious.

Question 4

Types of Dyesthesia

Answer 4

Allodynia

Hyperalgesoa

Question 5

Allodynia

Answer 5

A type of dyesthesia

Pain from stimulus that normally wouldn’t cause pain. (ex: Sunburnt and putting shirt on).

Question 6

Hyperalgesia

Answer 6

A type of dyesthesia

Excessive sensitivity to typically mild painful stimuli. (ex: Trigeminal Neuralgia)

Question 7

Dysfunction of Peripheral Nerves: Motor Changes

Answer 7

Paresis / Paralysis, muscle atrophy progresses rapidly.

Question 8

Dysfunction of Peripheral Nerves: Autonomic Changes

Answer 8

Difficulty regulating basic body functions.

Question 9

If one nerve is damaged in the PNS (Autonomic Changes) what is the result:

Answer 9

Changes only seen if the nerve is completely severed…lack of sweating would occur.

Question 10

If many nerves are damaged in the PNS (Autonomic Changes) What is the result:

Answer 10

Difficulty regulating blood pressure, heart rate, sweating

Question 11

Dysfunction of Peripheral Nerves: Trophic Changes

Answer 11

(Trophic means skin)

1. Skin becomes shiny; nails brittle; subcutaneous tissue thickens
2. Ulceration of tissues
3. Poor healing of wounds and infections.

Question 12

Skin becoming shiny; brittle nails; subcutaneous tissue thickening is a sign of what kind of peripheral nerve dysfunction?

Answer 12

Trophic Change

Question 13

Disease of dysfunction of one of more peripheral nerves

Answer 13

Neuropathy

Question 14

Single peripheral nerve disease or dysfunction

Answer 14

Mononeuropathy

Question 15

Which type of neuropathy has focal dysfunction?

Answer 15

Mononeuropathy

Question 16

Which type of neuropathy damage can be to the axon, myelin sheath or both?

Answer 16

Mononeuropathy

Question 17

Which type of neuropathy usually results from trauma?

Answer 17

Mononeuropathy

Question 18

Neuropathies: Several individual nerves; multifocal dysfunction that presents as asymmetircal involvement of individual nerves:

Answer 18

Multiple mononeuropathies

Question 19

Mononeuropathy: Class I - Neuropraxia

Answer 19

Impingement or compression of nerve –> loss of myelin limited to the site of injury, NO damage to axon
ex: Carpal tunnel syndrome

Question 20

What is the prognosis of neuropraxia? (Mononeuropathy Class I)

Answer 20

Recovery tends to be complete

Question 21

Mononeuropathy: Class II - Axontmesis

Answer 21

Axon is cut with myelin and connective tissues in tact

Ex: A hard crush of the nerve, due to dislocation or closed fractures

Question 22

What is the prognosis of axontmesis? (Mononeuropathy

Class II)

Answer 22

Recovery is generally good

Question 23

Mononeuropathy: Class III - Neurotmesis

Answer 23

Entire nerve is cut - both axons and membranes

ex: Excessive stretch

Question 24

What is a result of neurotmesis?

Answer 24

Loss of sensation and muscle paralysis in area supported by the nerve affected.

Question 25

What is the prognosis of neurotmesis (Mononeuropathy Class III)

Answer 25

Recovery is similar to axontmesis but the nerve conduction distal to the injury may never return due to poor regeneration.

Question 26

Class Levels of Mononeuropathy:

And regeneration potential

Answer 26

Class I: Neuropraxia (Good)
Class II: Axontmesis (Good)
Class III: Neurotmesis (Variable)

Question 27

Polyneuropathy

Answer 27

Damage to many nerves

Question 28

Etiology of Polyneuropathy:

Answer 28

Toxic, Metabolic or autoimmune

Question 29

Example of a Polyneuropathy:

Answer 29

Guillian Barre (demyelination of PNS nerves)

Question 30

How does polyneuropathy typical present itself?

Answer 30

Distally and symmetrically

Hallmark is symmetrical involvement of sensory, motor and autonomic fibers, often progressing from distal to proximal

Question 31

Polyneuropathy typically progresses from proximal to distal, or distal to proximal?

Answer 31

Distal to proximal

Question 32

Where do symptoms often begin in polyneuropathy?

Answer 32

Feet, then appear in hands

Question 33

Trophic changes of Polyneuropathy:

Answer 33

Poor healing, ulceration of skin, neurogenic joint damage, lack of sensation

Question 34

Diabetic Polyneuropathy:

Answer 34

Axons and myelin are damaged

Question 35

Usually WHAT is most affected in Diabetic Polyneuropathy?

Answer 35

Sensation

“Glove/Stocking” distribution

Question 36

Proper diabetic foot care is important in what neuropathic disorder?

Answer 36

Diabetic Polyneuropathy

Question 37

Motor problems in Diabetic Polyneuropathy:

Answer 37

Balance and coordination issues, weakness

Question 38

What autonomic functions are susceptible to diabetic polyneuropathy?

Answer 38

Usually all autonomic functions are susceptible.

Cardiovascular, Gastrointestinal, Genitourinary and sweating dysfunction are common.

Question 39

Retrograde Degeneration

Answer 39

Degeneration of proximal axon

Question 40

Degeneration of distal axon

Answer 40

Orthograde (Wallerian)

Question 41

Is axonal growth and regeneration in PNS possible?

Answer 41

yes, proximal stumps begin to sprout

Question 42

Is regeneration slow or fast?

Answer 42

Slow (1-2 mm/day)

Question 43

Rule of thumb with PNS regeneration

Answer 43

The more distal the lesion, the better the prognosis