Term
| 3 forms of alzheimers and their cause |
|
Definition
sporatic: age (APOE4)
familial: presenilin mutation
down syndrome: 3 copy CH21 with APP |
|
|
Term
| 5 diagnostic signs of alzheimers |
|
Definition
apraxia: unable do to tasks
aphasia: problems speaking
agnosial: not realizing deficit (parietal)
social/occulational impairment
gradual onset/progressive decline |
|
|
Term
| what are the 3 stages of alzheimers, what happens in each, what is the MMSE |
|
Definition
mild: 20-24: short term memory loss, cannot find words
moderate: 11-19: severe memory loss, loss of complex language, impaired insight, decreased visuospatial orientation
severe: <10: apraxia, no recall, restricted language, mute in 1y |
|
|
Term
| how is dementia diagnosed 5 |
|
Definition
history - family, pt
physical
RO other cause with labs
MMSE
brain scan |
|
|
Term
| explain the neurochemical changes in alzheimers |
|
Definition
ACh activity decreased in hippocampus, cortex, amyglida due to plaques
nicotinic receptors blocked due to plaques |
|
|
Term
| 3 things we could see on a MRI in alzheimers |
|
Definition
amyloid angiopathy: AB on vessels: T1 high signal right parienta, T2 low signal slight prominence of sulci
generalized atrophy: gyri narrow, sulci deepen, hydeocephalus ex vaculo
acute metabolism impaired: functional MRI of hippocampus shows prosporgnosia (unable to recognize faces) |
|
|
Term
| what is the pattern of damage based on location in the brain in alzheimers |
|
Definition
1. hippocampus - memory
2. tempporal - language
3. parietal/fronta - visuospatial
4. abstract reasoning |
|
|
Term
|
Definition
denepazil: ACHest inhibitor advanced dementia, had meds before
rivastigmine: ACHest inhibitor patch, bypasses GI SE
Memantine: glutamate (NMDA) receptor blocker lets Ca in |
|
|
Term
| adjunctive lifestyle changes or tx in alzheumers 8 |
|
Definition
vitamin E
NSAIDS
HMG-CoA reductase - good if high TG
red wine - prevention
smoking cessation
aerobic exercise
behavioral contron: SSRI, anti-psychotics |
|
|
Term
| what is the difference in symptoms between alzheimers and frontotemporal dementia |
|
Definition
| fronto spares prazis, visuospatial skills, and memory |
|
|
Term
| pathological changes of pick disease |
|
Definition
pick bodies: Tau inclusions, cortex, basal ganglia, brainstem
balloned neurons |
|
|
Term
| what diseae does JC virus cause, 5 signs |
|
Definition
| progressive multifocal leukoencephalopathy - dementia, visual loss, progressive hemiparesis, occipital demyelination, oligogendrocytes with eosinophilic intranuclear lesions |
|
|
Term
|
Definition
| PrPsc accumulates and damages neurons cause vacolules and in cytoplasm with intracellular spontigorm vacoules in the brain matter |
|
|
Term
| 5 types of prion disease and their symptoms |
|
Definition
sporatic: dementia, ataxia, myoclonus
familial: dementia, ataxia, myoclonus
varient: psych, ataxia, paresthesia, spastic, dementia
GSS: ataxia and dementia
fatal familial insomnia: insomnia, ataxia, dementia |
|
|
Term
| 5 types of prion disease and their location in brain and type of damage |
|
Definition
sporatic: anterior basal ganglia, vacules gliosis
familial: gray matter vacules, gliosis
varient: pulvinar thalamus, plaque, spongiosis
GSS: plaque, gliosis, less vacules
FFI: thalamus olives gliosis |
|
|
Term
| how are prion diseases diagnosed |
|
Definition
CSF: 14-3-3 protein
EEG: no changes (except in sporatic has sharp waves complexes bilateral anterior basal ganglia high singnal) |
|
|
Term
| 5 types of prion disease and their age of onset |
|
Definition
sporatic: 70
familial <60
varient 5-11
GSS: <60
FFI: 30-55 |
|
|
Term
| bishwangers dementia signs, MRI signs |
|
Definition
HTN, vascular disease, abnormal gait, muscle rigidity, neurogenic bladder
bilateral subcortical laukoaraiosis |
|
|
Term
| what does CADASIL stand for |
|
Definition
cerebral
autosomal dominant
ateriopathy
subcortical
infarcts/strokes
leukoencephalopathy |
|
|
Term
| risk factors of parkinsons |
|
Definition
10% genetic
85% idiopathic (age)
diet: decreased vitamins
rural areas: dopamine neurotoxins |
|
|
Term
| what can prevent parkinsons |
|
Definition
|
|
Term
| what are the 6 stages of parkinsons and their characteristics |
|
Definition
0. no signs
1. unilateral
2. bilateral
3. bilateral, postural instable
4. severe dissability, able to walk
5. wheel chair or bedridden |
|
|
Term
| what are the 4 premotor symptoms of parkinsons, when do they occur |
|
Definition
1-2y before motor... CARD...
constipation
anosmia
REM behavior sleep disorder: kicking, acting out
Depression |
|
|
Term
| what are the 5 motor deficits in parkinsons |
|
Definition
TRAPD
tremor: high amp, low freq, resting, pill roll
rigidity: cogwheel (resistance to tone)
akinesia/bradykinesia: decreased arm swing, masked facies, difficult rise from chain, shiffle/fenistrating gait
postural instability: check retropulsion and propulsion
dementia: late in disease (if early check for lewy body dementia |
|
|
Term
|
Definition
loss of dopaminergic neurons in SUBSTANTIA NIGRA PARS COMPACTA causes depigmentation too
lewy bodies: a-syneculin inclusions in basal ganglia |
|
|
Term
| DOC for parkinsons older patient, why, MOA |
|
Definition
| carbidopa-levodopa, neuroprotective, increases dopamine |
|
|
Term
| DOC for parkinsons younger patient, MOA |
|
Definition
| ropinrole, mimics dopamine |
|
|
Term
|
Definition
| blocks breakdown of levopa in periphery |
|
|
Term
|
Definition
| prevent dopamine breakdown in brain |
|
|
Term
| types of brain surgery that can help parkinsons |
|
Definition
thalamotomy: thalamic nuclei stimulation
pallidotomy: internal globus pallidus stimulation
neural dopamine transplantation
duodenal levodopa infusion
gene therapy |
|
|
Term
| what are the requirements before a parkinsons brain surgery |
|
Definition
disease course >5y
lack of dementia
few hallucinations
good response to levodopa |
|
|
Term
| progressive supranuclear palsy: signs |
|
Definition
square wave jerks: slow saccades
supranuclear gase deficit
language impairment
subcortical dementia
parkinsonian: symmetric
gait: reckless turns, long stride, fall
mirrior movements
retrocollis: hyperxetended neck
frontal dysexecutive impairment: cannot mirror fist, palm, side
frontal release signs
pseudobulbar palsy
dysphagia
dysarthria |
|
|
Term
| progressive supranuclear palsy cause |
|
Definition
| neurofibrillary tangles in midbrain neurons causes midbrain and pons atrophy |
|
|
Term
|
Definition
cause: clogged arachnoid granulations
signs: wet, wacky, wobbly (wide base, arm swing, sudden onset freezing, "magnetic") |
|
|
Term
| what is the difference between lewy body and parkinsons disease |
|
Definition
| lewy body: dementia is early onset like in 1y, stimultanagnosia (does not describe part of picture), optic ataxia, visual hallucinations |
|
|
Term
|
Definition
| atrophy of cortical lobes via lewy bodies |
|
|
Term
| cortico basilar gnaglionic degeneration signs |
|
Definition
parkinsonian asymmetric
supranuclear gaze palsy
alien hand syndrome
sensory trick
cortical spinal tract impairment
subcortical dementia |
|
|
Term
| cortobasilar ganglionic degeneration cause |
|
Definition
| parietal atrophy contralateral and substantia nigra |
|
|
Term
| what is pugiliztic parinsonism |
|
Definition
| parkinsons caused by head trauma |
|
|
Term
| essential tremor: cause, signs |
|
Definition
50% hamily hx AD, bimodal peak 20s/60s, worse with caffiene, bettwe with alcohol, some drugs induce
low amplitude, fast beat, kinetic flexion/extension (worse with movement), spreads to hands, head, voice |
|
|
Term
| dystonia: type types, signs |
|
Definition
tarditive dyskinesia: oral buccal lingual region muscle contraction (speak fine)
full tarditive dystonia: lower face with retrocoil contractions, interferes with speech, elbow extension, internal rotation of shoulders, wrist flexion |
|
|
Term
|
Definition
oromangibular dystonia
blepharospasm
difficulty with jaw movement and speech
lingual dystonia activated by speech and chewing |
|
|
Term
| 3 changes in brain tissue in bacterial meningitis |
|
Definition
vasogenic cerebral edema: cytokines, IL
leptomeningeal and perivascular infiltration
PMN, leukocytes, inflammation |
|
|
Term
| clinical signs of most bacterial meningitis |
|
Definition
altered LOC, confusion,coma
stiff neck
seizure, CN palsies
skin abscess
otitis media
petechial rash |
|
|
Term
| changes in CSF in bacterial meningitis |
|
Definition
increased ICP, WBC, protein
decreased glucose
positive gram stain |
|
|
Term
| what type of meningitis is cephtriaxone used to tx 6, which are DOC |
|
Definition
E. coli DOC
listeria DOC
H. influenza DOC
pneumococcal meningitis DOC
N. meningitis
S. pneumonia |
|
|
Term
| what type of meningitis is pen G used to tx 4, which is DOC |
|
Definition
meningococcal meningitis DOC
N. meningitis
S. pneumo
H. influenza |
|
|
Term
| what type of meningitis is ancomycin used to tx3, which is DOC |
|
Definition
Staph DOC
GNB DOC
pneumococcal meningitis |
|
|
Term
| which types of meningitis require rifampin prophylaxis in family |
|
Definition
H. influenza
Meningococcal meningitis |
|
|
Term
| how is TB meningitis treated |
|
Definition
|
|
Term
| how is HSV meningitis treated |
|
Definition
|
|
Term
| what type of meningitis does amphociterin B tx, what is it DOC for |
|
Definition
fungal DOC
cryptococcal meningitis (with flucytosine) DOC |
|
|
Term
| how is parasite meningitis treated 2 |
|
Definition
|
|
Term
| H. influenza meningitis: age range, signs different than normal meningitis |
|
Definition
<6yo
ischemic cerebral vascular lesion
hearing loss
hemiplegia
visual and speech difficulities
facial paresis
incoordination
mental retardation |
|
|
Term
| pneumonoccal meningitis: age rage, cause/signs |
|
Definition
pediatric
URI, otitis media
congenital defect
CSF rinorrhea |
|
|
Term
| meningococcal meningitis: signs different than normal meningitis |
|
Definition
bacterial embolization
gram negative toxic shock and DIC (waterhouse-friderichsen)and organ failure |
|
|
Term
| TX meningococcal meningitis |
|
Definition
pen G
colloid IV fluid
A-adrenergic blocker
HYPOTHERMIA
rifampin prophylaxis for family |
|
|
Term
| TB meningitis: signs different than normal meningitis |
|
Definition
hydrocephals
tubercles on brain surface
positive TB culture - diagnostic |
|
|
Term
| signs of brain abscess different from meningitis |
|
Definition
lateralizing: papilledema, hemiparesis, increased DTR, pupil changes, extensor plantar responses, homonymous hemianopia
localized percussion tenderness of skull
complications due to scaring: seizure, MR, hydrocephalus |
|
|
Term
| diagnosis of brain abscess |
|
Definition
rim enhancing lesions
avoid LP - high ICP causes herniation RO with CT |
|
|
Term
| sighs of viral meningitis different from bacterial |
|
Definition
photophobia
pain with eye movement
lymphadenopathy
pharyngitis
jaundice
organomealgy
diarrhea
skin rash
CSF increased WBC, negative gram stain |
|
|
Term
| how is HSV 1 and 2 meningitis different |
|
Definition
1. necrotizing asymettric hemorrhagic
2. neonatal encephalitis via birth canal
both have temporal and inferior frontal lobe mass |
|
|
Term
| signs of fungal meningitis different from bacterial |
|
Definition
visual loss
pitosis
CN palsies
papilledema
focal weakness
CT: MASS (when cryptococcus) |
|
|
Term
| signs of parasite meningitis different from bacterial |
|
Definition
skin rash
lymphadenopathy
splenomeagly
arthralagia
pneumonia |
|
|
Term
| diagnosis of parasite meningitis |
|
Definition
| multiple ring enhancing lesions on MRI |
|
|
Term
| signs of HIV meningitis different from bacterial |
|
Definition
CN palsies esp facial
occurs at time of seroconversion
acute confusion |
|
|
Term
|
Definition
CNS white matter inflammation and demyelination leads to glial scaring and sclerosis
autoimmune, some family hx, enivornmental changes (seen away from equator) |
|
|
Term
| how is MS officially diagnosed |
|
Definition
relapsing and remitting course
CNS markers
Schumakers...
2 seperate CNS lesions
2 attacks or 6mo progression
objective exam findings
white matter disease
age 10-50yo |
|
|
Term
|
Definition
muscle weakness, spasticity
hyperreflexia
babinski sign
circumducting gait: spasticity in one leg causes wide swing
ataxia
tremor: coarse
nystagmus
disarthria: explosive, soft, then loud |
|
|
Term
| autonomic and psych signs of MS |
|
Definition
bladder, bowel, and sexual dysfunction
sweating
vascular abnormalities
fatigue
depression
euphoria
congnitive abnormalities |
|
|
Term
|
Definition
impaired vibratory, position, pain, temp touch
lhermitte sign: brisk flexion causes electric sensation down spine into limbs |
|
|
Term
|
Definition
optic neuritis
swelling and pallor ot temporal disc
centrocecal scotoma: central vision loss
marcus gunn pupil: swinging of light over one eye causes paraxocical widening of both pupils
bilateral intranuclear opthalmoplegia (MLF lesions): one one eye looks lateral |
|
|
Term
|
Definition
white periventricular and infratentoral lesions
gangolinum enhancement
ovoid lesions
thinned corpus callosum |
|
|
Term
|
Definition
protein normal or mild increase
lymphocytes mild increase in attack
oligoclonal IgG bands
increased free kappa light chains |
|
|
Term
| 3 ways to test for previous MS attack |
|
Definition
visual evoked resonse: plaque on optic nerve, chiasm, tract
brain stem auditory: detect pontine lesion
somatosensory: mild sensory abnormalities detected |
|
|
Term
| what are the 4 possabilities for the course of the disease in MS |
|
Definition
relapsing remitting: acute attacks then go back to baseline
chronic progressive: acute attack then get better but not all the way to baseline
primary progressive: never remits
progressive relapsing: relapsing and remitting, sometimes gets to baseline, sometimes dosent |
|
|
Term
| how is acute MS attack treated, what symptoms does this get rid of |
|
Definition
IV methylprednisone followed by PO prednisone
bladder, cerebellar, fatigue, sexual dysfunction, depression, spasticity |
|
|
Term
| 3 ways to treat chronic MS, which is the prefered |
|
Definition
interferon
betaseron: long duration
avonex: low SE, SLOWS PROGRESSION
copaxone: SE uncommon, need to follow with blood work |
|
|
Term
| cause of acute disseminated encephalopmyelitis |
|
Definition
| post-infection immune mediated demyelinating disorder |
|
|
Term
| signs of acute disseminated encephalopmyelitis |
|
Definition
confusion, coma
focal neurological
fever, headache
ataxia, seizure, myelopathy
1 EPISODE, ACUTE ONSET
USUALLY IN CHILD |
|
|
Term
| CSF signs of acute disseminated encephalopmyelitis |
|
Definition
|
|
Term
|
Definition
acute bl optic neuritis and transverse myelitis
whole optic chiasm disorder |
|
|
Term
|
Definition
MS varient
large bilateral lesions |
|
|
Term
| what is the difference between decorticate and decerebrate |
|
Definition
decorticate: arms curl up, lesion above brainstem
decerebrate: arms shoot down, lesion in brainstem |
|
|
Term
| what is the difference between ataxic and cheyene respiration |
|
Definition
ataxic: irregular rate and amplitude (deadly), medilla or posterior fossa damage
cheyene: hyperpenia and apnea, bl cerebral disease, metabolic issue |
|
|
Term
| what causes pinpoint, fixed dilated, and anisocoria |
|
Definition
pinpoint: opioid OD, pons damage
fixed dilated: herniation, CN III damage
asymmetric: 1mm or less is normal in 20% of people |
|
|
Term
| what does it mean if eyes deviate away or towards hemiparesis |
|
Definition
away: cerebral lesion
towards: pons lesion |
|
|
Term
| what do the results of the caloric test mean |
|
Definition
normal: nystagmus away from water
coma: nystagmus towards water
brain stem damage: no response |
|
|
Term
| supratentorial lesion: cause and signs |
|
Definition
cerebellum through foramen
midbrain and pons compression --> respiratory and postural abnormalities |
|
|
Term
| uncal herniation: cause, signs |
|
Definition
temporal uncal through cerebellar tentorium
CN III compression causes ipsilateral pupil enlargement and eye down and out |
|
|
Term
| infratentorial herniation: cause, signs |
|
Definition
brainstem through foramen
pushes of brainstem causing coma, ataxic breathing, pinpoint pupil |
|
|
Term
| cause of parainfectious encephalomyelitis |
|
Definition
| autoimmune response following measles, mumps, varicella |
|
|
Term
| epidural hematoma: cause, signs |
|
Definition
middle meningeal vessel breaks in space between skull and dura
causes lens shaped lesion that stops at sutures
asymptomatic until it gets big enough |
|
|
Term
| subdural hematoma: cause, signs |
|
Definition
subdural collection of blood due to bridging vein rupture (often in old and baby)
diffuse bleeding into space, progressive neurological signs |
|
|
Term
| signs of mild sustained, brief anoxic, and sustained severe hypoxia |
|
Definition
mild sustained: cognitive impairment, confusion, delirium
brief anoxic ischemia: syncopa, seizure
sustained severe hypoxia: coma, seizure, watershed infarcts, postanoxic demyelination
*infarct distal to arterial stenosis or occlusion* |
|
|
Term
| post-anoxic coma: define, signs |
|
Definition
prolonged anoxia with loss of consciousness causes cerebral damage
decerebrate/decorticate
seizure: worse if myoclonus |
|
|
Term
| cause and signs of persistent vegitative state |
|
Definition
cause: severe generalized cortex damage
open eyes, decorticate/decerebrate, normal brainstem reflexes/sleep/wake
EEG: severly abnormal and slow |
|
|
Term
| cause, signs delayed post-anoxic demyelination |
|
Definition
cause: pt recovered from coma then relapsed
confusion, ataxia, movment disorder, dysarthria
MRI: lesions on basal ganglia |
|
|
Term
| management of anoxic encephalopathy |
|
Definition
hypothermia
anti-epileptic, cardio support as needed |
|
|
Term
| EEG in hypoxic encephalopathy: why, what are you looking for, 3 grades |
|
Definition
check for seuzure (cant see in coma) and get prognosis. generalized asynch slow waves (delta) of moderate to high amplitude
1. normal --> good prognosis
2/3. mild abnormal --> variable
4/5. intermittenet attenuations or electrocerebral silance --> poor |
|
|
Term
| give a unique sign for each encehphalopathy: toxic, hepatic, uremic, hypoglycemia, hyperglycemia, hyponatremia, hypernatremia, hypercalcemia, hypocalcemia, hyperMg |
|
Definition
toxic: rolling eye movement
hepatic: flapping of hands
uremic: psychsosis, twitching
hypoglycemia: restless, sweating
hyperglycemia: disorientation, coma
hyponatremia: confusion, seizure, coma
hypernatremia: LOC
hypercalcemia: LOC, weak, tremor
hypocalcemia: paresthesia mouth/tetany
hyperMg: confusion, arrhythmia |
|
|
Term
| cause of central pontine myelinosis |
|
Definition
rapid correction of hyponatremia causes demyelination of CENTRAL PONS (BASIS PONTIS)
usually done in alcoholics, liver disease, malnourished, pancreatitis |
|
|
Term
| signs of central pontine myelinosis |
|
Definition
locked in syndrome: EOM, pupil, cornea reflex, facial sensation in tact
flaccid paralysis
dysarthria
dysphagia |
|
|
Term
| tx of central pontine myelinosis |
|
Definition
| correct natremia slowly (15meq in 24h) |
|
|
Term
| myasthenia gravis cause and epidemology |
|
Definition
autoantibodies to nicotonic ACh receptors (post synaptic)
usually <40yo, female |
|
|
Term
| signs of myasthenia gravis |
|
Definition
stores of ACh depleted with movement so patient is bettwe with rest
fluctuating bl weakness: cannot smile, whistle, puff cheeks
ocular weakness: diplopia, ptosis
bulbar muscle weakness: dysphagia, dysarthria, facial weakness
limb and neck weaknes (proximal>distal)
speech: mushy, nasal
sensory, cerebellar, DTR normal |
|
|
Term
| 4 ways to diagnose myasthenia gravis |
|
Definition
tensilon test (endorphonium): short acting ACHesterase inhibitor
jolly test: repetitive nerve stimulation: measure befer and after
ACh receptor antibody assay: 90% of pt are + for AChR antibodies
single fiber EMG |
|
|
Term
|
Definition
anti-acetylcholinesterase (pyridostigmine)
immune supression
plasmapharesis |
|
|
Term
| cause of lambert eaton myasthenic syndrome |
|
Definition
autoantibodies to voltage gated Ca channels on presynaptic cholinergic nerve trminals decreases release of ACh
2/3 associated with small cell lung cancer |
|
|
Term
| signs of lambert eaton myasthenic syndrome |
|
Definition
movement forces more ACh out of the cell despite Ca channel blocks improving movement with effort
proximal leg and arm weakness
dry mouth
CN or bulbar involvement rare |
|
|
Term
| 2 ways to diagnose lambert eaton myasthenic syndrome |
|
Definition
Jolly test: repetitive nerve stimulation, high/fast stimulation increases Ca in nerve terminal and ACh release
voltage gated Ca channel Ab: positive in 50% of pt |
|
|
Term
|
Definition
stops presynaptic ACh release
constipation, opthalmoparesis, bulbar weakness, respiratory compormise |
|
|
Term
| duchenne-becket muscular dystrophy: cause |
|
Definition
x-linked
dystrophin absence (duchenne) or decrease (becket)
replacement of skeletal muscle with adipose tissue |
|
|
Term
| duchenne vs beckett: CPK, aldolase, dystrophin stain, onset |
|
Definition
duchenne: high CPK, high aldolase, no dystrophin staining, childhood onset
beckett: some CPK elevation, some aldolase elevation, partial dystrophin staining, late childhood |
|
|
Term
| changes in muscles and movement in duchenne beckett |
|
Definition
delayed walking
toe walking
gowers sign
onset in proximal muscles: quad, trunk, shoulder girdle
scoliosis and lordosis
beckett: can ambulate beyond 12yo
pseudohypertrophy: calves, deltoid, infraspinatus |
|
|
Term
| systemic signs in duchenne |
|
Definition
cardiac conduction defects
fat infiltration of heart, lungs allows for infection and death
COGNITIVE IMPAIRMENT |
|
|
Term
|
Definition
| prednisone until wheelchair bound |
|
|
Term
| polymyositis: cause, epidemology, age of onset and death |
|
Definition
anti-myosin antibody causes inflammation of muscle (myopathy)
30-60yo
female > male |
|
|
Term
| polymyositis: CPK, aldolase levels, EMG signs |
|
Definition
CPK 90% increase
aldolase high
EMG: low amplitude polyphysic MUP fibrillation and sharp waves |
|
|
Term
| changes in muscle and movement in polymyositis |
|
Definition
proximal muscle weakness
pelvic girdle: difficult to chimb stairs, stand from chair
shoulder girdle: difficult reaching, washing face
neck muscle weakness
dysphagia
PAIN IN EFFECTED MUSCLES
REFLEXES PRESERVED |
|
|
Term
| systemic signs in polymyositis |
|
Definition
weightloss
anorexia
fever
loss of appetite
collagen vascular disease (RA)
scleroderma
sjogerns
carcinoma |
|
|
Term
|
Definition
prednosone
IVIG
imuran: cytotoxic (rare drug) |
|
|
Term
|
Definition
| ZnCu superoxide dysmutase mutation increases ROS which damages neurons in anterior lateral horn (LMN) and lateral cortical spinal tract (UMN) |
|
|
Term
|
Definition
death in 3-5y due to pulmonary infection
bulbar involvement suggests worse prognosis |
|
|
Term
|
Definition
fasiculations
muscle wasting and weakness
gaunt face
plantars extensor
sensation always spared
reflexes remain brisk |
|
|
Term
| signs of charcot marine tooth disease |
|
Definition
champagine glass leg or stork leg
calf muscle atrophy
shin bone predominance (wasted tibialis anterior)
high arches with claw toes
wasting of distal thigh |
|
|
Term
| charcot marine tooth neuropathy 1: cause sign |
|
Definition
AD duplication of PMP22
onion bulb nerve appearance
axon degeneration |
|
|
Term
| charcot marine tooth neuropathy 2: cause, sign |
|
Definition
AD duplication of PMP22
axon sensorimotor peripherial neuropathy |
|
|
Term
| charcot marine tooth neuropathy 3: cause, sign |
|
Definition
mutation in PMP22
<2yo
delayed development
slow conduction velocity |
|
|
Term
| guillain barr syndrome aka |
|
Definition
| acute idiopathic polyneuropathy |
|
|
Term
| cause of acute idiopathic polyneuropathy |
|
Definition
infection: camplobacter
surgery
innoculation
demyelination: USA
axon damage: china |
|
|
Term
| signs of acute idiopathic polyneuropathy |
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Definition
progressive weaness of more than one limb
distal areflexia
proximal arefleia or hyperreflexia
progressive
symmetric
CN 3, 4, 12 involvement
increased CSF protein 1wk, normal WBC
nerve conduction slowed or blocked after several weks |
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Term
| tx of acute idiopathic polyneuropathy |
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Definition
adult: plasmapharesis
adult with CV problem or kid: immunoglobulin |
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Term
| when should someone with acute idiopathic polyneuropathy go to the ICU |
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Definition
respirator or vascular collapse
volume replacement needed
pulmonary emboli prevention needed
vital capacity <1L and need mechanical ventilation |
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Term
| prognosis of acute idiopathic polyneuropathy |
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Definition
usually stops worsening at 4wk
70% full recovery
25% mild neuro deficits
5% die of respiratory failure
worse prognosis if old, need ventilator, had camplobacter |
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Term
| C5: sensory/pain areas, reflex, muscles, cause of damage |
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Definition
lateral border of upper arm to elbow
bicep jerk
deltoid, supraspinatus, infraspinatus, rhomboids
brachial neuritis, cervical spondylosis, upper plexus avulsion |
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Term
| C5: sensory/pain areas, reflex, muscles, cause of damage |
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Definition
lateral forearm, thumb, index
supinator jerk
pronators, supinators, biceps, brachioradialis
cervical spondylosis, acute disc lesion |
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Term
| C7: sensory/pain areas, reflex, muscles, cause of damage |
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Definition
sensory: tricep, mid forearm, middle finger
tricep jerk
triceps, weist extensors and flexors, lats, pec major
acute disc lesion, cervical spondylosis |
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Term
| C8: sensory/pain areas, reflex, muscles, cause of damage |
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Definition
medial forearm and little finger (loss stops at wrist)
finger jerk
finger flexors and extensors
flexor carip unlaris
disc lesion, spondylosis |
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Term
| T1: sensory/pain areas, reflex, muscles, cause of damage |
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Definition
axilla to olecranon
small hand muscles, thenar muscles
cervical rib, altered 1st rib anatomy, pancost tumor, metastasis in deep cervical nodes, outlet syndromes |
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Term
| cervical spondylosis cause |
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Definition
| sudden flexion/extension in neck after collision causes acute root symptoms or cord damage in old people with weak neck |
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Term
| cervical spondylosis signs |
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Definition
| bl arm symptoms in multiple roods, acute tetraparesis |
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Term
| erb duchene syndrome: cause, signs |
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Definition
C4-6 lesion
arm abduction, elbow flexion, supination, lateral arm rotation |
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Term
| klumpke syndrome: cause, signs |
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Definition
C8-T1 lesion
flexor paralysis
flattened simian hand
severe shoulder pain
tingling and numbness in medial arm, forearm, 4-5th fingers |
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Term
| carpal tunnel: cause, signs |
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Definition
median nerve damage (Ra, cyst, osteophyte, DM, pressure palsy, pregnancy,hypothyroid, amyloidosis)
severe pain at night, relieved by swingin or flex/extend
tinel: tingle with wrist percussion
phalen: tingle with wrist flexion
sensory loss and pain at median nerve |
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Term
| unlar nerve damage: cause, signs |
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Definition
compression at albow
tardy unlar palsy: prior fracture deforms humerus
cubital ulnar syndrome: unlar nerve trapped between tendons
sensory loss in 4-5th finger, median hand (never in arm)
motor weakness: flexors of hand |
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Term
| radial nerve damage: cause, signs |
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Definition
crutches, saturday night palsy, midshaft humerus fracture
effects wrist only, tricep weist extensor weakness wrist drop) |
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Term
| where do lumbar discs usually herniate and why |
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Definition
| anterior longitudinal ligament is stronger than posterior so they herinate posterior or posterolateral |
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Term
| signs of lumbar disc herniation |
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Definition
dull intermattent low back pain
numbness and tingling in nerve distribution
lasegues sign postive
mid like dis protrucsion / cauda equine syndrome (bl leg weakness, incontinence) |
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Term
| sciatic neuropathy: cause, signs |
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Definition
pelvic surgery or fracture
retroperitoneal hematoma
weakness of knee flexion and foot drop |
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Term
| peroneal neuropathy cause, signs |
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Definition
compression at fibular head, DM neuropathy, crossed legs, trauma
peroneal nerve: dorsiflexor and foot elevator
foot drop, parasthesia on top of foot and web of big toe |
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