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PHTH 7212 Pathophysiology > LE Neuropathies- Shappy > Flashcards

LE Neuropathies- Shappy Flashcards

(51 cards)

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1
Q

Parts of the PNS

A

Motor

Sensory

Autonomic

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2
Q

Neurapraxia

A

caused by mild ischemia

-segmental demylination blocking condition

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3
Q

Axonotmesis

A

Prolonged compression and necrosis

  • axon damage connective tissue intact
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4
Q

Neurotmesis

A

Complete severance of axon and distruption of connective tissue

  • gun shot, stab (can be surgical) or avulsion, amputations
  • muscle fibers atrophy due to loss of trophic stubstances
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5
Q

Causes of PN injury

A

compression/ trauma, heredity, infections, toxins, metabolic, etc

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6
Q

Demylination

A

typically segmental

-damage to the mylin sheath around the nerve loosing the velocity of conduction

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7
Q

Degeneration (of PN)

A

typically more severe injury

  • Anterograde or Wallerian degerneration (dead at the distal end)
  • ex. foot dangling off the bed and having a nerve compression If the nerve is severed then Wallerian degeneration. If the axon stays intact, not Wallerian
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8
Q

Regeneration

A

Slow process, axonal sprouting

can get lost and not find correct endoneurial tube

if there is connective tissue, more likely of the target tissues have the connection to have the regrowth

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9
Q

Reinnervation

A

Can occur when adjacent neuron innervates muscle fibers of injured neuron, collateral sprouting

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10
Q

Mononeuropathy

A

single PN injured

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11
Q

Polyneuropathy

A

several PN injured

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12
Q

Radiculoneuropathy

(or Radiculopathy)

A

Nerve root injury

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13
Q

Polyradiculitis

A

infection creating inflammation of several nerve roots

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14
Q

Myopathy

A

Motor endplate injury

synpse issue

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15
Q

Signs and Symptoms of Peripheral Dysfunction

(Sensory)

A

tingling, numbness, burning, etc

  • peripheral distribution
  • nerve root (distal first, stocking glove distribution)
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16
Q

Signs and Symptoms of Peripheral Dysfunction

(Motor)

A

weakness, hypotonia, flaccid

  • paresis or paralysis- peripheral distrubution
  • weakness-myotome distributions of that spinal nerve
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17
Q

Signs and Symptoms of Peripheral Dysfunction

(automonic)

A

Vascular, sweating, hair, skin

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18
Q

Charcot-Marie-Tooth (CMT) Disease

A

Hereditary motor and sensory neuropathy or peroneal muscular atrophy; Charcot foot- the foot’s intrinsic muscles are wasting which creates a high arch and clawed toes

  • distal limb muscle wasting and weakness
  • skeletal deformities
  • distal sensory loss
  • DTR abnormalities
  • balance issues which makes them walk farther appart have a large base of support
  • looks like they are walking on glass
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19
Q

Charcot Foot

A

Chromosomal defect; high arch and toes curls

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20
Q

CMT Pathology

A

mutation in the proteins

-Schwaan cell demyelination along with hypertrophic onion bulb formation

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21
Q

onion bulb

(like seen in CMT)

Study These Flashcards
A

palpable enlarged peripheral nerves due to Schwann cells and precesses attempting to remyelinate damaged nerves

22
Q

Clinical Presentation of CMT

Study These Flashcards
A

Pes Cavus and hammer toes

Weakness in DF and EVER, foot drop, and steppage gait

Wasting of intrinsic muscles (because the foot is holding in one position)

Loss of proprioception and cutaneous sensation (tingling and burning sensations present); having balance problems

23
Q

CMT Diagnosis

Study These Flashcards
A

EMG studies

  • decresed NCV- both motor and sensory
  • axonal degeneration or demyelination on nerve biopsy
24
Q

CMT Treatment

Study These Flashcards
A

Can not fix the cause, only treat the symptoms

  • footdrop- bracing, remebering skin care due to the insensate feet
  • gait training
  • ROM exercises (can try, but this is something that the patient will need to learn to do everyday in order to get to neurtal)
  • strengthening has questionable effects
  • overall conditioning
  • balance training- work on ways to compensate
25
Morton's Neroma
Interdigital perineural fibroma -usually between 3rd and 4th toes and is unilateral found in runners, high heels, no cushion in your shoes, etc (squeezing the toes)
26
Morton's Neuroma Pathology
thickenign of endoneurium and perineurium, demylinaiton, decreased blood supply
27
Causes of Morton's Neuroma
Poor foot mechanics - Excessive pronation - Poor intermetatarsal mobility Extrinsic factors - High heel shoes - Narrow toe box - Thin sole shoes - Jogging and shear forces
28
Morton's Neuroma Clinical Presentation
burning, tingling, sharp pain, numbness -radiating into toes or foot
29
Morton's Neuroma Diagnosis
MRI Provocation Test - palpation of the involved area (bone versus between the bones) - matarsal sqeeze test (won't tell you if its the bone or the neuroma)
30
Morton's Neuroma Treatment
Surgical (cut the ligament to open up the space Non-surgical -injections, shoe modification, orthotics, activity modification, NSAIDS, moving the metatarsals to open up the space
31
Nerve Entrapments
Iliacus Syndrome Saphenous Neuropathy Obturator Neuropathy Proximal Tbial Neuropathy Common Peroneal Neuropathy Superficial Peroneal Neuropathy Deep Peroneal Neuropathy Posterior Tibial Nerve Compression (Tarsal Tunnel Syndrome) Metabolic Neuropathies Alcoholic Neuropathy Chonic Renal Failure Anemia Infections/Inflammations
32
Iliacus Syndrome
Femoral Nerve (L2,3,4) entrapment between inguinal ligament and iliopsoas - muscle weakness - sensation- dermatomal to anterior thight, lower leg and foot
33
Saphenous Neuropathy
Saphenous nerve is a branch of femoral and only sensory loss just distal to the ingunal ligament
34
Obturator Neuropathy
medial thigh muscle weakness fascial tighness, groin injury with inflammation, tumor, etc (space occupying lesion)
35
Proximal Tibial Neuropathy
L4,5,S1,2; off of sciatic nerve Posterior lower leg muscle weakness and sensory loss (heel) Popliteal fossa hematoma, baker's cyst
36
Common Peroneal Neuropathy
(L4,5,S1) lateral anterior compartment innervation of lower leg trauma-contusion, cast, etc -pain, foot drop, sensation (everion, DF) icing the knee too close to the fibular head- nerve runs close to the surface near here
37
Superficial Peroneal Neuropathy
Lateral compartment motor and sensation dorsolateral foot and ankle
38
Deep Peroneal Neuropathy
anterior tarsal tunnel impingement (extensor retinaculum) toe extensors and sensation dorsomedial
39
Posterior Tibial Nerve Compression
Tarsal Tunnel Syndrome - space occupying lesions, foot mechanics, trauma, etc - burning, tingling, numbness, tap test or Tinel's sign - Plantar muscle weakness distal to impingement posterior/ inferior to the medial mallelous -TOM, DICK, and HARRY Tendons: posterior tibialis, flexor digitorum longus, flexor hallus longus posterior tibial nerve (medial and lateral plantar nerve- toe flexion)
40
Metabolic Neopathies
Diabetic Polyneuropathy or Mononeuopathy Alcoholic Neuopathy Chronic Neuropathy Anemia
41
Diabetic Polyneuopathy or Mononeuropathy
nerve and schwann cell damage: sodium-potassium and ATP deficiencies, microcirculation issues (thickening) and ischemia loss of nerve axons both myelinated and unmyelinated
42
Alcoholic Neuropathy
direct toxic effect of alcohol or deficiencies in thiamine and other B vitamins for malnutrion
43
Chronic Renal Failure
Uremic toxins- demyelination of PNS
44
Anemia
B12 deficiency with Pernicious anemia
45
Infections/ Inflammtions causing Neuropathies
Guilain-Barre Syndrome Post-Polio Syndrome Herpes Zoster- Shingles
46
Guillain-Barre Syndrome
immune-mediated-bacteria and viral infection
47
Post-Polio Syndrome
Neuromusclar atrophy over decades
48
Herpes Zoster-Shingles
Dormant chickenpox virus
49
How to treat Phantom Limb
Mirrors, Tens at most distal end (using electricity), using heat/cold, taping, massage Treating the nerve
50
Which is more likely to have regeneration: axonotmesis or neurotmesis?
axonotmesis
51
Baker's Cyst
back in the popital fossa fairly mobile, not always painful can test to see if it's infected friction causes fluid build up near the gastro and hamstrings in the posterior aspect of the knee; taking the fluid out will not cure; need to fix the problem (stretching)

PHTH 7212 Pathophysiology (12 decks)

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