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NPTE -- Neuro > Nerve Injury > Flashcards

Flashcards in Nerve Injury Deck (36)
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1

Double crush syndrome

two separate lesions along the same nerve that create more severe symptoms thatn if only one lesion existed

2

Mononeuropathy

Isolated nerve lesion; associated conditions include trauma and entrapment

3

Neuroma

abnormal growth of nerve cells, associated conditions include vasculitis, AIDS, and amyloidosis

4

Peripheral neuropathy

Impairment or dysfunciton of the peripheral nerves, associated conditions include diabetic peripheral nueropathy, trauma, alcoholism

5

Polyneuropathy

diffuse nerve dysfunction that is symmetrical and typically secondary to pathology and not trauma, associated conditions include Guillain Barre syndrome, peripheral neuropathy, use of neurotoxic drugs, and HIV

6

Wallerian Degeneration

Degeneration that occurs distally specifically to the myelin sheath and axon

7

Acute Nerve Injury - Neurapraxia (6)

1. Mildest form, no nerve fiber damage, typically pressure injuries

2. Conduction block with axonal continuity

3. Axon, epi/peri/endoneurium intact

4. Conduciton preserved proximally and distally to the injury

5. Sx: pain, min mm atrophy, numbness/sensory loss, dec proprioception

6. complete, rapid recovery in 4-6 wks

8

Acute Nerve Injury - Axonotmesis

1. More severe, due to traction, compression, cursh injury

2. Reversible injury b/c fibers maintain anatomical relationship to each other

3. Damage to axon

4. Preservation of endo/epineurium, schwann cells

5. Distal wallerian degeneration cna occur

6. recovery varies/is spontaneous, rate of regrowth 1mm/day

9

Neurotmesis

1. Most severe

2. Damage/transectoin to axon, myelin, CT

3. Irreversible, no sontaneous recovery (requires surgery)

4. All motor/sensory distal to the injury is lost

5. Flaccid paralysis, mm wasting

6. If surgically reattached, 1mm/day regrowth, sensory returns before motor

10

Cause of Axillary N Injury (2)

1. humeral neck fx

2. anterior shoulder dislocation

11

Cause of Musculoskeletal N Injury 

1. Clavical fx

12

Cause of Radial N Injury

1. Humeral fx

2. Compression in radial tunnel

13

Cause of Median N Injury (2)

1. Pronator teres entrapment

2. Compression in carpal tunnel

14

Cause of Ulnar N Injury

1. Guyon's canal entrapment

2. Compression of cubital tunnel

15

Cause of Femoral N Injury

1. THA

2. Displaced acetabular fx

3. Anterior femur dislocation

4. Hypterectomy

5. Appendectomy

16

Cause of Sciatic N Injury (3)

1. Blunt force to buttocks

2. THA

3. Accidental injection into nerve

17

Cause of Obturator N Injury

1. Fixation of femoral fx

2. THA

18

Cause of Peroneal N Injury (2)

1. Femoral/Tibial/Fibular Fx

2. Positioning during surgical procedure

19

Cause of Tibial N Injury (2)

1. Tarsal tunnel entrapment

2. Popliteal fossa compression

20

Cause of Sural N Injury

1. Calcaneal/Lateral malleolus fx

21

Anterior Horn Cell Pathology (5)

1. Sensory intact

2. Motor weakness/atrophy

3. Fasciculations

4. Decreased DTR

5. Ex: ALS, poliomyelitis

22

PNS Muscle Pathology (4)

1. Sensory intact

2. Motor weakness, fasciculation rare

3. Normal or decreased DTR

4. Ex: muscular dystrophy

23

Neuromuscular Junction Pathology (4)

1. Sensory intact

2. Motor fatigue greater than actual weakness

3. Normal DTR

4. Ex: myasthenia gravis

24

Peripheral Nerve (Mononeuropathy) Pathology (4)

1. Sensory loss along nerve route

2. Motor weakness/atrophy in peripheral distribution

3. May have fasciculations

4. Ex: trauma

25

Peripheral Polyneuropathy Pathology

1. Sensory impariment in "stocking glove" distribution 

2. Motor weakness/atrophy, weaker distally than proximally

3. May have fasciculations

4. Decreased DTR

5. Ex: diabetic peripheral polyneuropathy, T4 syndrome

26

Spinal Roots/Nerve Pathology

1. Sensory component will have dermatomal deficits

2. Motor weakness in an innervated pattern

3. May have fasciculations

4. Decreased DTR

5. Ex: herniated disc

27

UMN Disease (3)

1. Lesion in descending motor tracts within cerebral motor cortex, internal capsule, brainstem or spinal cord (lateral white column)

2. Sx: weakness, hypertonicity, hyperreflexia, mild atrophy, abnormal reflexes

3. Ex: cerebral palsy, hydrocephalus, ALS, CVA, MS, huntington's, TBI, psuedobulbar palsy, brain tumor

28

LMN Disease (3)

1. Lession in nerves/axons below the level of the brainstem, ventral gray column of spinal cord

2. Sx: flaccidity, weakness, decreased tone, fasciculations, atrophy, decreased/absent reflexed

3. Ex: ALS, Guillian Barre, tumors, trauma, Bell's palsy, CTS, muscular dystrophy, spinal muscular atrophy

29

UMN vs LMN

1. Reflexes

2. Atrophy

3. Fasciulations

4. Tone

1. UMN = hyper, LMN = dec, absent

2. UMN = mild, LMN = present

3. UMN = absent, LMN = present

4. UMN = hyper, LMN = hypo, flaccid

30

Forms of hypokinesia (3)

1. Apraxia

2. Rigidity

3. Bradykinesia