Musculoskeletal: 14. Wang : Neuromuscular Disorders And Electrodiagnostics

Front 1

what should be in your differential diagnosis if you see Limb pain, numbness of extremities and weakness of extremities? (general)

Back 1

Neuromuscular disorders

Front 2

what is resting potential of a nerve

Back 2

-70 to -90 mV, maintained by Na+–K+ ATP-pumps.

Front 3

pt has achieness in muscles, pain in the hip and shoulder girdle, CPK is elevated. Patient is on medicine for high cholesterol. What do they likely have?

Back 3

statin-induced myopathy

Front 4

electrodiagnostic studies can give what kind of information

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Back 4

Diagnostic AND prognostic

Front 5

what are the 2 parts of an EMG?

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Back 5

nerve conduction study

Needle EMG (motor unit potentials)

Front 6

how do you look to study a brachial nerve plexopathy? (what nerves do you test)

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Back 6

medial and lateral antibrachial cutaneous nerves are tested

Front 7

involves electrically stimulating peripheral nerves using surface electrodes to measure the following in sensory nerve action potentials (SNAP) and compound motor action potentials (CMAP)

what is this?

Back 7

Nerve conduction study (NCS)

Front 8

in a Nerve conduction study (NCS)

the time it takes an action potential to initiate after receiving a stimulus that causes depolarization

Back 8

Latency

Front 9

in a Nerve conduction study (NCS)

the speed at which an action potential travels down an axon

Back 9

Conduction velocity

Front 10

in a Nerve conduction study (NCS)

: the maximum voltage that an action potential carries during its propagation

Back 10

Amplitude

Front 11

in a Nerve conduction study (NCS)

the time between initiation and completion of an action potential

Back 11

Duration

Front 12

involves passively detecting peripheral nerve electrical activity using a needle electrode to evaluate the patient

what is this

Back 12

Electromyography (EMG)

Front 13

patient has Weakness or numbness that does not follow a single radicular or peripheral nerve distribution , what should you order?

Back 13

EMG

Front 14

patient has Unexplained numbness or weakness what should you order?

Back 14

EMG

Front 15

what should you order if you see a patient with history of leg pain and physical exam positive for numbness and weakness who has a lumbar MRI that is negative for nerve root impingment

Back 15

EMG

Front 16

what should you order if you see a patient with a history of neck pain and radiation therapy for breast cancer who has numbness along multiple dermatomes and also has a positive Tinel sign at the wrist – differential diagnosis includes cervical radiculopathy, brachial plexopathy, median neuropathy at the wrist

Back 16

EMG

Front 17

if a patient has a nerve injury, how long do you have to wait to test with an EMG?


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Back 17

3 weeks

Front 18

a prognostic test for certain conditions, such as carpal tunnel syndrome, to determine the need for surgical intervention describes?

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Back 18

EMG

Front 19

if you EMG is normal, but the physical exam is abnormal, what should you evaluate? using what?

Back 19

the central nervous system (e.g. stroke, spinal cord injury, brain or spinal cord tumor, spinal stenosis) via MRI or referral to Neurology.

Front 20

if your EMG Is abnormal and you have a focal area of nerve injury what should be the next 2 things you do?

Back 20

imaging studies may need to be ordered to confirm the diagnosis

referral for treatment (e.g. interventional spine specialist for spinal nerve root block or neurosurgeon for surgical decompression) is required

Front 21

if you have an abnormal EMG and A non-focal peripheral neuropathy or myopathy, what should you do?

Back 21

send to a neuromuscular specialist

Front 22

patient has nerve traction or compression from lateral fall on head, obstectrical injury, sports-related ("stinger") what does this person have?

Back 22

Erb's Palsy: C5-C6 nerve roots or upper trunk gets stretched

Front 23

patient presents with an arm that becomes adducted, internally rotated, extended, pronated, with the wrist flexed. What do they have? What is this clinical presentation called?

Back 23

Erb’s palsy: C5–C6 nerve roots or upper trunk

Waiter's tip position

Front 24

obstetrical traction injury causes?

Back 24

Klumpke palsy: C8–T1 nerve roots or lower trunk

Front 25

The patient may have wasting of the small hand muscles and a claw hand deformity (lumbrical weakness). The shoulder girdle muscle function is preserved.

What do they have?

Back 25

Klumpke palsy: C8–T1 nerve roots or lower trunk

Front 26

what leads to claw hand deformity in Klumpke palsy

Back 26

get extension at MCP and then get passive flexion at DIP and PIP

Front 27

a secondary plexopathy can arise from these tumors and their treatment...


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Back 27

Lung/breast tumor

Front 28

what are the muscles controlled by the median nerve?

Back 28

1/2 LOAF

Lumbricals (1,2)
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis (superficial head

Front 29

if you see weakness of the Lumbricals (1,2)
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis (superficial head
what does your patient have

Back 29

carpal tunnel

Front 30

is there a motor or sensory loss in Superficial radial neuropathy

Back 30

ONLY SENSORY

Front 31

this problem may be due to thyroid disease, CHF, renal failure, tumor, hematoma and pregnancy. It involves problems with the median nerve

Back 31

Carpal tunnel syndrome

Front 32

this affects all ulnar-innervated sensation and muscles except the flexor carpi ulnaris...

Back 32

Cubital Tunnel Syndrome

Front 33

What causes cubital tunnel syndrome? where does it normally occur

Back 33

entrapment of ulnar nerve

compression of the elbow

Front 34

please list the muscles controlled by the deep motor branch of the ulnar nerve

Back 34

“4,3,2,1,1/2 muscles”

Palmaris brevis
4 Dorsal interossei—(“DAB”: Abduction)
3 Palmar interossei—(“PAD”: Adduction)
2 Lumbricals
1 Adductor pollicis
1/2 Flexor pollicis brevis (deep head)

Front 35

Affects all ulnar-innervated intrinsic muscles of the hand, but dorsal ulnar cutaneous nerve (DUC) nerve is spared.

Back 35

Guyon’s canal (a.k.a. Cycler’s or Biker’s palsy)

Front 36

Due to cycling activities, wrist ganglions or rheumatoid arthritis. What is this? What is affected and what nerve is spared?

Back 36

Guyon’s canal (a.k.a. Cycler’s or Biker’s palsy)

Affects all ulnar-innervated intrinsic muscles of the hand, but dorsal ulnar cutaneous nerve (DUC) is spared.

Front 37

patient has been on crutches and now has problems with shoulder flexion and abduction, and external rotation. What is going on?

Back 37

axillary neruopathy due to crutch use

Front 38

patient has been on crutches and now has problems with triceps and lost sensation over the posterior arm and forearm. What do they have?

Back 38

crutch palsy involving the radial nerve

Front 39

Superficial radial neuropathy (a.k.a. Cheiralgia Paraesthetica, Wristwatch syndrome, Handcuff palsy)

Back 39

Due to compression at the wrist from a wristwatch, tight handcuffs, etc.
Pure sensory syndrome with paresthesias on dorsal radial aspect of the hand.

Front 40

Due to compression at the wrist from a wristwatch, tight handcuffs, etc.
Pure sensory syndrome with paresthesias on dorsal radial aspect of the hand.

Back 40

Superficial radial neuropathy (a.k.a. Cheiralgia Paraesthetica, Wristwatch syndrome, Handcuff palsy)