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31 Cards in this Set

  • Front
  • Back
L4 radiculopathy Most commonly caused by ...
disc herniation
What are schwann cells
Form Myelin in PNS, Affect neuromuscul transmission
What are astrocytes
form blood brain barrier
what are oligodendroglia
form myelin in CNS
What are microglia
immune cells of the centreal nervous system (CNS)
What are ependymal cells
line canals
Where are the Na+ and K+ concentrations higher in or out of the cell
K+ higher inside cell
Na+ higher outside the cell
What is the resting membrane potential
-70mV
What events occur during an action potential
1. Depolarization - cell goes form inside negative to inside positve -Na channel opens - Na diffusely floods in - 70 mV to + 58 mv
2. repolarization - Na channels close & K hannels ope [inside of cells retrun to being negative
3. hyperpolarization - "undrshoot " of restin potentia (-75 mV)
4. refractory period - time before another Action potential ccan take place
L5 radiculopathy
Most common radiculopathy
Foot dorsiflexion weakness
anterolateral leg and dorsum of the foot.
weakness of foot eversion (mediated by the L5/peroneal-innervated peroneus muscles) AND
inversion weakness (mediated by the L5/tibial-innervated tibialis posterior)
Diff dx:
foot drop from peroneal neuropathy
lumbosacral plexopathy hip abductors (gluteus medius and minimus)
S1 radiculopathy
caused commonly by intervertebral disk herniation

weakness of foot plantar flexion
knee flexion, and hip extension
Sensory symptoms typically involve the lateral foot and sole

DIFF DX
Sciatic neuropathy and lower lumbosacral plexopathy
Lumbosacral polyradiculopathy and cauda equina syndromes
MULTIPLE CONTIGUOUS ROOTS

prominent bowel and bladder dysfunction,saddle anesthesia
Lumbar nerve roots…leg weakness… paraplegia
What are the different kinds of neuropathy?
* Polyneuropathy
 *Mononeuropathy
 *Multiple mononeuropathies (mononeuropathy multiplex)

*Neuronopathy
Somatic neuropathy
GLOVE AND STOCKING SENSORY LOSS
LOSS OF ANKLE REFLEXES
WEAKNESS DIFFUSE
Mechanism of diabetic peripheral neuropathy
IMPAIRED VASA NERVORA
ACCUMULATION OF POLYOLS –
↑↑ALDACTOSE REDUCTASE
(SCHWANN CELLS, DRG, ENDOTHELIAL CELLS)
↑ SORBITOL IN PERIPHERAL NERVE
IN AXON
REDUCED MYO-INOSITOL
DYSFUNCTION NA/K ATPase
subtypes of diabetic peripheral neuropathy
sensory,
mixed sensory, motor, autonomic
charateristic patterns of DPN
Distal symmetric sensory polyneuropathy
Distal symmetric sensory motor polyneuropathy
Radiculoplexus neuropathy
Neurogenic pain
pain resulting from noninflammatory dysfunction of the peripheral nervous system or CNS.
Neuropathic pain
Neuropathic pain associated with peripheral nervous system injury.
What is neuralgia
pain in the distribution of a single peripheral nerve.
What is a neuroma
A mass containing fibrous tissue, blood vessels, clusters of unmyelinated axons, and Schwann cells, known as a
1st line drugs for neuropathic pain
GABAPENTIN
TRICYCLIC ANTIDEPRESSANTS
NORTRYPTILLINE
AMITRYPTILLINE
TRAMADOL
Capsaicin cream
Lidocaine patch
Isosorbide dinitrate spray
What is restless leg syndrome?
painful burning that occurs only at rest or during sleep relieved by moving the legs.
Secondary restless leg syndrome is cause by...
Pregnancy
iron-deficiency anemia
peripheral neuropathy
periodic leg movements of sleep
What are the symptoms of parkinsons
Triad:
tremor
bradykinesia
rigidity
Also: response to dopamine
cause of secondary parkinsons
Toxins:
manganese dust
carbon disulfide
carbon monoxide poisoning
MPTP
What cause parkinsons
loss of dopamin producing cells in substantia nigra
treatment of parkinsons
ANTICHOLINERGIC DRUGS
Trihexyphenidyl

DOPAMINE AGONISTS
Bromocriptine, pergolide, lisuride, and cabergoline
LEVODOPA
How do you diagnose restless leg syndrome
URGE MOVE LEGS WITH DISCOMFORT
URGE MOVE LEGS WHILE AT REST
URGE TO MOVE OR DISCOMFORT IS
RELIEVED BY MOVING LEGS
4. SX’S WORSE IN EVENING
L1 root level
location of :
weakness
sensory loss
pain
weakness : none
sensory loss: inguinal region
pain: inguinal region
L2 root level
weakness : Iliopsoas
sensory loss: Anterolateral thigh
pain: Groin, anterior thigh