Neuromuscular Diseases Flashcards
(42 cards)
A-Alpha Fibers
-1a (spindle) and 1b (GTO) (sensory)
-fastest
-large motor axons
-Proprioception: muscle stretch (spindle) and tension (GTO)
A-Beta Fibers
-II (sensory)
-touch, pressure, vibration, joint position
A-Gamma Fibers
-II (sensory)
-gamma efferent motor axons
-intrtafusal fibers
-motor and muscle spindles
A-Delta Fibers
-III (sensory)
-sharp pain, light touch and temp
B Fibers
-III (sensory)
-SNS preganglionic motor axons
C Fibers
-IV (sensory)
-slowest
-dull aching pain, temp and sensation
ALS
-amyotrophic lateral sclerosis
-progressive fatal disease: decreases breathing, anterior horn degeneration
-degeneration of Upper and lower motor neurons
-no cognitive loss
-Average life expectancy: 3yrs
-can be sporadic (MC) or inherited
ALS Diagnostics
LMNL: weakness, atrophy
-Brainstem: jaw/face, tounge atrophy
-Cervical: neck, arm, hand, diaphram
-Lumbosacral: back, abdomen, leg/foot
UMNL: spread of reflexes and clonus
-Brainstem: clonic jaw jerk, gag reflex, spaticity
-Cervical: DTRs, hoffmann, spatic tone
-Thoracic: loss of abdominal reflexes
-Lumbosacral: ^^^
ALS Symptoms
Fatigue/SOB
-BIPAP or ventilator
Muscle Stiffness/Weakness
-dyphagia (swallowing)
-breathing
Pseudobulbar Palsy
-laughing/crying disconnect
Mood
Sialorrhea
-lots of saliva
Speech Changes
Pain
-lack of movement
-positional
-cramps/contractures
Nutrition
-maintain muscle
West Nile Virus
-virus from mosquito (july-october)
-80% asym
-20% west nile fever: pain, headache, fever, rash
-<1% Neuroinvasive: aseptic meningitis, meningoencehalitis (brain and meninges, acute flaccid paralysis (B/B)
Acute Flaccid Paralysis
-after viral illness
-acute onset and rapid of asymmetric flaccid weakness
-hypoactive or absent reflexes
-pure motor
-respiratory insufficiency
-B/B dysfuntion separates from Guillain-Barre
Poliomyelitis
-enterovirus (no in US except for vaccination)
-mostly asymptomatic limited to gut
Minor diesease
-flu like
Major disease
-CNS invasion (anterior horn)
-<1%
S/s: muscle atrophy and weakness via anterior horn
Post-Polio Syndrome Diagnostic Criteria
- Hx Paralytic poliomyelitis
- Partial or complete recovery
- Onset of persistent muscle weakness
- Symptoms for >1yr
- Exclude other cases
Post-Polio Syndrome
-Lower motor neuron syndrome
-joint pain w/ cold intolerance
-may have a new neurologic problem unrelated polio
Radiculopathy
-nerve root compression
-bulge compresses root
-L5-S1(MC) & C7/C8
S/s:
-pain, numbness, and tingling in dermatome
-weakness of muscles in myotome
-reduced reflex
Tx:
-improve with time and PT
-most relapse
-surgery if not responding or weakness
Polyradiculopathy
-multiple spinal nerve roots
S/s:
-motor s/s predominate, some sensory loss, pain, loss of DTR
Causes:
-inflammatory diseases, DM, infectious, neoplastic
Plexopathy
-cervical or lumbosacral plexus
S/s:
-painful, restricted to single limb, more widespread than a single nerve
Causes:
-trauma most common, cancer (pancoast tumor), thoracic outlet
Mononeuropathy
-neuropathy of a single peripheral nerve
S/s:
-nerve distribution
Cause:
-compression, entrapment, trauma, rarely ischemia
Ex:
-carpal tunnel
-meralgia parathetica (britany spears)
Polyneuropathy
-peripheral nerves
S/s:
-symmetric, length dependent weakness, sensory loss, Loss of DTRs
-Stocking Glove distribution
-Diabetes (Most Common)
-thyroid disease
-toxic
-infections
Axonal Polyneuropathy
-killing the axon
-grows slowly
S/s:
-Distal>proximal
-Leg>arms
-Muscle wasting
Ex:
-Diabetes
-Toxicity
-Alcohol
Demyelinating Polyneuropathy
-weakness without atrophy
-length dependent
-patchy
-asymmetric
Ex:
-compression/stretch
-Guillain-Barre
-Charcot-Marie-Tooth
Small Fibers Neuropathy
-reduced ability to feel pain and temp
-allodynia
-neuropathic pain
-discoloration of skin
-autonomic dysfunction
Large Fibers Neuropathy
-numbness, tightness, balance
-walking on foam
Autonomic Neuropathy
-involuntary
S/s:
-orthostatic hypotension
-arrhythmias
-constipation, urinary retention, erectile (1st sign)
-abnormal sweating
-gastroparesis
