Lect 3 & 4

Question 1

the PNS does not include ______ and______

Answer 1

the enteric nervous syst and CN II

Question 2

what is a mononeuropathy

Answer 2

affects one nerve; often d/t compression, inflam, or ischemia

Question 3

what is mononeuritis multiplex

Answer 3

asym noncontagious multifocal neuropathy; mult nerves affected but no pattern, freq d/t diabetes, vasculitis,autoimmune, infection

Question 4

what is polyneuropathy?

Answer 4

symmetric contagious multifocal neuropathy usually starts distally; d/t DM, metabolic dz, demyelination(guillan barre), or infection(zoster)

Question 5

autonomic neuropathy?

Answer 5

type of polyneuropathy that affects the ANS; same causes as polyneuropathy and is usually co-occuring; ANS sx such as urinary retention, ED, inc/dec HR/BP, sweat disturbances

Question 6

What’s the acronym for periph neuropathy etiologies?

Answer 6

Vascular
Infection/inflamm
Neoplastic
Degen/drugs
Iatrogenic
Congenital
Autoimmune/allergy
Trauma
Endocrine/metabolic

Question 7

what is bell’s palsy, what’s the most important test?

Answer 7

compression of facial nerve (VII); best test is to wrinkle brow (if they cannot wrinkle their brow it’s bells)

Question 8

Stroke pts _______ (can/cannot) wrinkle their brow

Answer 8

CAN

Question 9

median nerve compression of carpal tunnel will not affect….

Answer 9

pinky and medial half of ring finger

Question 10

carpal tunnel results in______ atropy

Answer 10

thenar

Question 11

what is guillain-barre syndrome

Answer 11

ASCENDING paralysis, acute autoimmune polyneuropathy (usually happens post infection)

Question 12

ascending paralysis with absent fever should make you think

Answer 12

guillain-barre syndrome

Question 13

how to treat guillain-barre syndrome (3)

Answer 13

plasmaphoresis
IVIG
breathing support
(80% will recover within a yr)

Question 14

what is myasthenia gravis

Answer 14

serious muscle weakness, autoimmune neuromusc dz causing fluctuating FATIGABILITY

Question 15

what is the main sx of myasthenia gravis?

how do you test it?

Answer 15

muscle fatigability
have pt do sustained contraction (look up) eventually eye will droop, or ask them to count and eventually speech will slow

Question 16

tx for myasthenia gravis? (2)

Answer 16

AchE inhibitors or immunosuppressant

Question 17

UTIs can cause ….

Answer 17

delirium

Question 18

nerve conduction studies determine the speed of _________

Answer 18

motor or sensory nerve electrical conduction

Question 19

nerve conduction studies (NCS) should always be performed….

Answer 19

bilaterally! (need to compare two sides for results to be meaningful)

Question 20

NCS are helpful in dx of _________ and ______

Answer 20

mononeuropathies and mononeuritis multiplex

Question 21

NCS can be done by…

Answer 21

docs AND PAs

Question 22

electromyography(EMG) is ….

Answer 22

records electrical activity of skeletal muscles

Question 23

EMGs are not helpful for _____________ or __________!!!

Answer 23

pain or sensory nerve dysfxn

Question 24

EMGs can be dones by…

Answer 24

DOCs ONLY

Question 25

somatosensory evoked potentials are used for…

Answer 25

NCS to make sure nerve is connected to CNS/functioning during brain surgery

Question 26

what is discography

Answer 26

fluid is injected into disks in rando order and pain is noted (make sure they are operating on correct disk or pt really needs surgery)

Question 27

name the 5 evoked potentials

Answer 27

motor (transcranial electric/magnentic stimulation)
visual
auditory
laser (small fibers)
NCS