Sachen Flashcards
(49 cards)
What radiculopathy?
scapular pain, “tight band around elbow feeling”, 3rd digit numb, absent triceps jerk
C7 nerve root compression (C6-C7) - most common cervical radiculopathy
Hand sensory mnemonic
C6 = "six shooter" C7 = middle finger C8 = ring/pinky finger
What radiculopathy?
dorsal thigh and lateral calf pain, lateral calf numb, weak hip E and loss of all foot movements EXCEPT can still plantarflex
L5 nerve root compression (L4-L5) - most common lumbar radiculopathy
What radiculopathy?
post thigh/post calf pain. Postlat calf and lat food numb. Weakness of hip E and foot plantarflexion.
S1 nerve root compression (L5-S1) - most common lumbar radiculopathy
Triceps reflex
C7
Biceps reflex
C5/C6
Finger flex reflex
C8
Patellar reflex
L4
Achilles reflex
S1
what is mononeuropathy multiplex?
multiple mononeuropathies - focal involvement of two or more nerves.
CNS (UMN) v. PNS (LMN)
- Paresis
- Tone (flaccid/spastic)
- Bulk (atrophic or normal)
- Fasciculations (Y/N)
- DTRs (hyper/hypo)
- Plantar reflex
- Paresis: patterns v. distal
- Tone: spastic v. flaccid
- Bulk: normal v. atrophic
- Fasciculations: no v. sometimes
- DTRs: hypERactive v. hypoactive
- Plantar reflex: Babinski v. absent
What type of neuropathy is this:
symmetric, LMN sx stocking/glove sensory loss distal numb/weak (foot/hand) instead of calf
polyneuropathy
What type of fiber results in this sensory peripheral neuropathy:
- Negative: ↓vibration, ↓proprioception, ataxia, ↓2pt. discrim.
- Positive: Tingling, pins and needles
large myelinated fiber sensory
What type of fiber results in this sensory peripheral neuropathy:
- Negative: ↓p/t impairment
- Positive: burning/jabbing
small unmyelinated fiber sensory
Do nerve roots and peripheral nerves:
-split digits (Y/N)
● Nerve roots DO NOT split digits: Pure C8 root lesion → 4th + 5th finger sensory defects
● Peripheral nerves SPLIT digits: Median N lesion (Carpal tunnel involving lgmts of palmaris longis + pronator teres) → 1st - 3rd finger + lateral 1⁄2 of ring finger defects
Froment sign = what nerve and what mm?
adductor pollicus weakness; ulnar nerve palsy
Saturday night palsy -midshaft humerus fracture, axilla compression.
What nerve? What clinical signs?
WRIST DROP due to paresis of extensor muscles of wrist, finger, thumb.
Radial nerve compression in the spiral groove
Fibular head/neck compression from sitting cross legged - what nerve and what clinical features?
PERONEAL N ENTRAPMENT - Motor weakness of dorsiflexion, eversion, toe extension. Sensory loss dorsum of foot.
What nerve causes: lateral thigh pain, foot drop, absent ankle jerk
sciatic compression (i.e. injection in buttocks in wrong location)
What Hereditary Polyneuropathy and what type of dysfunction/etiology?
● weakness in walking/running is 1st symptom (1st-2nd decade). “Doc, I can’t keep up during sports”
● INVERTED CHAMPAGNE BOTTLE LEGS (severe distal SYMMETRIC ATROPHY; LEGS>arms), HAMMER TOES (chronic), pes cavus, skeletal deformities
Charcot-Marie-Tooth 1 Neuropathies (hereditary motor sensory neuropathies)
DEMYELINATING
What Hereditary Polyneuropathy and what type of dysfunction/etiology?
● onset: adulthood; AD
● Distal symmetric atrophy (legs>arms)
Charcot-Marie-Tooth 1 Neuropathies (hereditary motor sensory neuropathies)
neuronal/axon LOSS
Difference between HMSN1 and HMSN2 EMG
- HMSN 1 EMG: slow motor N. conduction (demyelination)
- HMSN 2 EMG: EMG: almost nml motor N. conduction velocities (axonal loss)
Low back/leg pain is first sign, then ascending symmetric motor paralysis (nominimal sensory); self resolving (after 6w).
Acute Inflammatory Demyelinating Polyneuropathy (GBS)
Etiology/triggering event in Acute Inflammatory Demyelinating Polyneuropathy
prior infection with Campylobacter JEJUNI, Mycoplasma pneumonia, EBV
