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Neuropath Class 4

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taylormaloney's version from 2017-01-25 04:26

Section 1

Question Answer
What are the two synonyms for Horner's Syndrome?Bernard-Horner Syndrome, Oculosympathetic Palsy.
What is Horner's syndrome?A relatively rare disorder that presents with unilateral physical symptoms. (Usually).
What are the four classic signs of Horner's Syndrome?Constricted pupil (miosis), Drooping of upper eyelids (Ptosis), Absence of sweating of the face (anhidrosis), and sinking of the eyeball (enophthalmos).
What causes Horner's Syndrome?An interuption in the sympathetic nerve supply to the eye due to a lesion or growth.
What are some possible examples of causes?Tumor in neck or chest cavity, pancoast tumor (upper pt of lung), lesion in mid brian/brain stem/ Upper SC/ Neck/ or Eyeball, Inflam./Growth affecting lymph nodes in neck, surgery/trauma, Idiopathic.
What is unique about those who are diagnosed with Horner's Syndrome before ageThe iris of the affected eye is uncolored.
What is the cause of congenital Horner's Syndrome?Idiopathic, also very rare.
Horner's Syndrome is thought to have what origin?Possibly genetic- w/ autosomal dominant genetic traits.
How is is diagnosed?Pharmacological tests, ultrasound, MRI.
How is it treated?Dependent on the location/cause. Surgery, Radiation/Chemo, Symptomatic Tx.
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Section 2

Question Answer
Define NeuropraxiaSegmental demyelinization- w/ no structural damage to the axon or tissue distal to lesion.
What may result in neuropraxia?Compression or Entrapment of a peripheral nerve that causes a local conduction block.
What may cause neuropraxia?External forces ( pressure from cast/splint), Internal Forces ( hypertonic muscle), Structural abnormalities (Poorly developed bony callous), Trauma/overuse ( Edema and scar tissue), Poor limb positioning, or Systemic Conditions (DM/pregnancy).
Define the pathophysiology of Compression/Entrapment.Nerve response - causing inflammation of nerve. Increased vascular permeability and local edema causing impaired transmission of nerve impulses.
What are the common symptoms of these types of pathologies?Numbness/tingling/pain, and weakness in affected.
What factors may influence the severity of the nerve lesion?Duration and Magnitude of the compression.
What is the general recovery time?Varies, dependent on severity. Ie- 'saturday night palsy' = 6 wks. Tourniquet 'radial/median/ulnar n' - 10 wks.
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Section 3

Question Answer
What is the name of Meralgia Paresthetica/Bernhardt-Roth Syndrome?Lateral Femoral Cutaneous Nerve entrapment.
What is it?Painful mononeuropathy of the Lat Fem Cut N, which is a purely sensory nerve. (No motor).
What are the causes of LFCN?Most common cause- focal entrapment of LFCN where it passes through inguinal Lig, Rarely caused by direct trauma/stretch injury/ischemia.
What symptoms are likely to present w/ Meralgia Paresthetica?Paresthesia/Numbness in upper lat thigh-possibly painful. Usually unilateral 80%, Relief w/ sitting + Aggravated by standing/walking.
How is it treated?Looser clothing, weightloss, NSAIDS. Rarely- surgery when necessary to decompress the nerve. Only used in long term/severe cases.
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Section 4

Question Answer
Femoral N- arises from, motor pt, sensory pt.Largest of lumbar plexus, arises from Ventral Rami L2-L4. Motor- Hip flexors + Extensors of knee. Sensory- Ant/Med aspect thigh/leg/foot.
What ma.y cause Femoral N Syndrome?External Forces (Disc hernia/pelvic fracture), Internal Forces ( Hypertonic mms), Trauma/Overuse ( Edema/Scar tissue), Poor limb positioning, Systemic Conditions (DM, Pregnancy)
What motor symptoms would be present in Femoral N Syndrome?Weakness in leg or knee, difficulty with stairs. (Especially going down).
What sensory symptoms would be present in Femoral N Syndrome?Parestesias
Examination of Femoral N Syndrome may show..Weakness to straighten knee or bend at hip, sensation changes, abnormal knee reflex, Atrophic Quads
What tests may be used to diagnose FNS?Electromyography, nerve conduction tests, MRI.
How may FNS be treated?Injection of corticosteroids, Surgery ( if it does not go away, impedes walking) Or to relieve pressure on nerve and remove tumors.
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Section 5

Question Answer
What is the other name for Obturator Nerve Syndrome?Obstetric Palsy.
Obturator N- origins/sensory/motor.Originates in L2-L4, sensory supplies skin over medial thigh, motor supplies adductor mms.
What is Obturator N Syndrome?Obturator N paralysis caused by difficult delivery/birth, forceps delivery, surgery (gynecological, laparoscropic injury.)
What are the sensory symptoms seen in ONPMedial Thigh/Groin Pain, sensory loss in medial thigh.
What are the motor symptoms seen in ONS?Weakness in leg adduction.
How is ONS diagnosed?History/Physical Exam/Electromyography.
How is ONS treated?NSAIDS, Surgery to decompress N.
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Section 6

Question Answer
What is peroneal N syndrome?Damage to the Peroneal (Fibular) N leading to loss of movement or sensation in leg/foot.
Peroneal N- origin, branches.Branch of Sciatic N, originates from L4-S2, Branches into Deep and Superficial.
Sensory/Motor SuppliesSensory- Ant and lateral legs and dorsal surface foot. Motor- Muscles of dorsiflexion.
What may cause Peroneal N Damage?Trauma/Injury, Fracture of fibula, use of tight cast, regular crossing of legs, regular wear of high heels, Pressure on knee due to positioning of limb, and injury during surgery.
What are the major causes of Common Peroneal N Entrapments?Squatting, compression between biceps/gastroc/head of fibula, Fibular Tunnel, Anterior Tarsal Tunnel.
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