Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
36 Cards in this Set
- Front
- Back
Define Motor Neuron disease, give examples
|
(Ant horn cell)
- disease within motor neurons cause secondary changes in motor axons and motor fibers - ie. ALS, spinal muscular atrophy, polio, West-Nile |
|
Define motor neuropathy, give examples
|
- disease that affects axons/myelin/both
- diabetes, renal insufficiency, lead |
|
Define NMJ disease, give examples
|
- disease affecting pre or post synaptic areas of NMJ
- MG= post synaptic - Eaton-Lambert- pre synaptic |
|
Define Paresthesiae
|
- abnormal sensations (tingle, prick, pins, warm, cold, burn)
|
|
Define hyperesthesia
|
- loss of a larger sensory neurons that leads to the over activity in smaller axons
- mild stimuli = painful |
|
Define Anesthesia
|
- no sensation 'numb'
|
|
What are teh 2 most common causes of autonomic symptoms?
|
1. diabetes
2. amyloid neuropathy (esp young patient) |
|
What are some autonomic symptoms?
|
- dry skin, hair loss
- impotence, constipation/diarrhea, incontinence/urinary retention, postural hypotension |
|
What is Gower's manuver?
|
- person has to climb up on themself in order to stand up
- hip weakness, weak thoracic muscles indicative of a myopathy |
|
What is hypertrophy/ pseudohypertrophy of a muscle and give an example
|
- muscle bulk appears sufficient but is replaced by fat/connective tissue
- Duchenne muscular dystrophy in calves/deltoid |
|
What are the 4 general categories of muscle weakness?
|
1. neuropathy
2. myopathy 3. motor neuron/ant horn 4. NMJ |
|
Which category of weakness is mainly distal? proximal?
|
distal= neuropathy
proximal= myopathy |
|
Which categories of weakness are usually decreased? normal?
|
Decreased= neuro/myo
Normal= ant horn/ NMJ |
|
Which is the only category of weakness that shows sensory loss and paresthesias?
|
- neuropathy
|
|
Fasciculations are present in which category? possible in which category?
|
- present in Ant horn
- possible in neuropathy |
|
Atrophy is present in all categories of weakness except?
|
- NMJ
|
|
Which category of weakness has severe fatigue?
|
- NMJ
|
|
Which is the category that never involves pain?
|
- NMJ
|
|
Nerve conduction study is evaluated by what 2 ways and what do they indicate?
|
1. amplitude (axonal damage)
2. velocity of response (demylination of nerve) |
|
How does electromyography differentiate between neuropathy and myopathy?
|
N= not enough motor units firing to make a full view of the repeating unit
M= unit amplittude is smaller as it requires little stimulus to fire |
|
What does CK levels indicate? How does this differentiate between neuropathy and myopathy?
|
- indicates muscle damage
N- normal CK M= high CK |
|
What is carpal tunnel classified under?
|
Compressive neuropathy (mononeuropathy)
|
|
Carpal tunnel usually involves what nerve?
|
Median
|
|
What is polyneuropathy characterize by?
|
- distal pain, paresthesia, weakness, neuro findings (ie motor impaired, hyporefleia)
|
|
What is the 2 most common cause of Acute polyneuropathy?
|
Guillain=Barre Syndrome (AIDP- ascending paralysis with weakness)
AIDS (severe and quick) |
|
What is the ost common causeof subacute polyneuropathy?
|
Diabetic polyneuropathy
|
|
What is the most common cause(s) of chronic polyneuropathy and what is unique about this category?
|
- Charcot-Marie-Tooth
- HNPP - Many of these are hereditary |
|
Describe Guillian-Barrer's course and treatment
|
- 1/3 cases preceded by URI
- electrophysiological studies show demyelination - Treat with IVIG (long) |
|
What is a common NMJ disorder?
|
Myasthenia gravis
|
|
Describe the course, testing, treatment of Myasthenia gravis
|
- disease of post-synatpic NMJ, involves proximal and distal, curtain sign, fatiguable
- Tensilon test, electrodiagnositc - Treat with steroids |
|
What are the 2 most common inflammatory myopathies?
|
1. polymyositis
2. dermatomyositis |
|
Describe dermatomyositis; signs, tests, those susceptible
|
- inflamed skin/muscle with minor clots at nail bed, rash on face
- muscular biopsy shows perifasicular atrophy -females over 40 |
|
What would a muscle biopsy look like in an individual with polymyositis?
|
- wBC invasion into muscles
|
|
What is most often used to treat neuropathies?
|
- the anticonvulsant gabapentin
|
|
What are possible causes of the Ant Horn disease, ALS?
|
- sporadic (most and involves UMN/LMN)
- environment - familial |
|
What is the pathology and related clinical signs of ALS?
|
- CNS (brain and spine), dendrites atrophy, then axonal degeneration
- drool, foot drop, chocke, fingers weak, speech problems - full cognition! |