MF2 Midterms Topic

The mildest form of nerve injury

Sustained external pressure or internal factors can cause mechanical or ischemic nerve injury. These injuries cause focal demyelination and conduction block

This injury to the peripheral nerve provokes segmental demyelination, but in most cases, the Schwann cell tube remain preserved, allowing the possibility of recovery

Excessive pulling or stretching force applied to the nerve , causing it to tear and become damaged

A cut or tear in the nerve, often
caused by a sharp object like a knife,
glass, or metal fragment or by a bullet

Nerve damage caused by extreme temperatures

Injuries, such as from motor vehicle
accidents, falls or sports injuries, can
sever or damage peripheral nerves.

Autoimmune dse that can cause PNI, except:

Usual Affected Site in Neuopraxia

Usual affected Site in Axonotmesis

Usual affected site in Neurotmesis

Consequence of Neuropraxia

Consequence of Axonotmesis

Consequence of Neurotmesis

Deficiencies in essential vitamins, particularly , vitamin _____ cause nerve damage and PN

affects a single nerve or nerve group. It often results from physical injury, prolonged pressure on a nerve, or repetitive motions.

affects 2 or more separate nerves in different areas of the body

affects multiple peripheral nerves simultaneously, usually symmetrically

involves damage
to the autonomic nerves,
which control involuntary
bodily functions, such as
heart rate, blood pressure,
digestion, and sweating.

affects the
sensory nerves, which are
responsible for transmitting
sensations such as pain,
temperature, and touch to
the brain.

This type of
neuropathy involves damage
to the motor nerves, which
are responsible for
controlling voluntary muscle
movements

also known as the dying-back phenomenon: This
type of degeneration usually
manifests as symmetrical
polyneuropathy (around 80%) and
tends to cause weakness, most
notably weakness in dorsiflexion of
the ankles and foot, with
accompanied trophic changes to
muscle.

occurs after a
nerve axon degenerates due to a
lesion or physical compression; the
portion distal to the axon passively
wastes away, likely due to a lack of
nutrients from the cell body.

refers to
the degeneration of the myelin
sheath, with sparing of the nerve
axon. ex. include Charcot-Marie-Tooth

Function of Axon

Function of Schwann Cell

Function of Mesoneurium

Function of Perineurium

Function of Epineurium

Type 1 and 2 Inherited dso

Type 3 dso

Type 4 dso

Vitamins crucial to nerve health, except

Often described as "pins and
needles," this sensation is one
of the initial signs of nerve
damage. It typically starts in
the toes or fingers and
gradually spreads upward.

This type of pain is often
severe and can feel like
electric shocks or a burning
sensation. It's commonly
worse at night, which can
interfere with sleep and daily
activities

occurs when even
light touch, like brushing
against the skin, causes
significant pain. This
heightened sensitivity can
make routine activities, such as
wearing clothes or walking,
extremely painful.

reduced
ability to feel sensations,
particularly in the hands and
feet. This can make it difficult
to detect temperature
changes, pain, or injuries,
leading to an increased risk of
burns, cuts, and other injuries
that go unnoticed.

Surgical procedure to free a nerve from scar
tissue that is restricting it

reconstructing a
severed nerve with a graft taken from
the nerves in one’s body (autograft)
or from a cadaver (allograft).

borrowing a
redundant motor nerve and
plugging it into a damaged nerve
that is important for one’s quality of
life.

releasing a
nerve that is “pinched” by a
surrounding tissue or pinned against
a muscle, bone, or tendon.

reestablishing
the continuity of the epineurium

Surgical suturing on a divided nerve

reconnecting the
nerve ends by epineurial
suture

consists of
suturing individual nerve
bundles

OTC pain medications

NSAIDS

Anticonvulsants medications

Tricyclic antidepressants

This cream contains chili pepper oils

This is a blend of
menthol and other herbal
ingredients that can soothe muscle
pain. Other menthol-based creams
may also help. They include Flex-All,
Flexgen, Tiger Balm, or Vicks
VapoRub.

Made from botanical
oils, this cream is meant specifically
for nerve pain on hands and feet.

This is another
botanical anesthetic that may
provide some relief for neuropathic
discomfort.

Pharmacological management for Polio that contains formalin inactivated virus,2 injections, 1 month apart, followed by booster at 6 months; this prevents CNS invasions, but does not stop viraemia

Polio vaccine which contain Live attenuated virus given orally and will stimulate subclinical infection. 3 doses, 2 months apart

Type pf poliomyelitis that attributes to < 90% of all infections

Type of Poliomyelitis that occurs in 1% of patient. Examination of CSF reveals normal glucose and protein concentrations and lymphocytic pleocytosis (with PMNs sometimes predominating early)

Type of poliomyelitis in which weakness is generally asymmetric, is proximal more than distal, and msy involve the legs( nost commonly); the arms; or the abdominal, thoracic, or bulbar muscles

ALS affects these structures; except

UMN + LMN signs in 1 body region OR UMN signs in 2 or more regions of the body

UMN + LMN signs on clinical exam in 3 body regions

UMN + LMN signs on clinical exam in 2 body regions , with some UMN signs rostral to the LMN signs

ALS stage that presents with symptoms in 1 region( arms, legs, and bulbar); mild weakness and is often misdiagnosed

ALS stage is which ALS is confirmed; localized symptoms affects tasks like gripping or walking

ALS stage : 2nd region affected ; assistive tools may be needed

ALS Stage: 3 regions involed; assistive devices required, swallowing issues worsen

ALS Stage: Severe swallowing difficulty, PEG(Percutaneous Endoscopic Gastrotomy tube needed for nutrition

ALS Stage: Respiratory Decline , NIV (e.g. BiPAP) supports breathing

ALS stage: End Stage , Full paralysis, Palliative care for comfort

LMN common pathologies; except:

UMN common pathologies; except:

Bulbar common pathologies; except:

Respiratory common pathologies; except:

Pharmacological mx for ALS:

a surgery that creates a hole at the front of the neck leading to
their windpipe.

A feeding tube inserted directly into the
stomach to provide nutrition when swallowing becomes difficult (dysphagia).

An implanted device that stimulates the diaphragm to
support breathing in patients with weakened respiratory muscles. However, it is
only effective in patients who still have some diaphragm function

A procedure to improve voice and
swallowing functions by repositioning weakened vocal cords, helping patients
communicate better and reduce choking risks.

Helps improve limb function by rerouting tendons to
compensate for lost muscle strength.

focus on improving impairments and activity
limitations. However, in the early and middle stages of ALS, these interventions offer
only temporary benefits due to the progressive nature of the disease. In the late stage,
restorative efforts primarily address complications from other conditions, such as
pressure sores, edema, pneumonia, atelectasis, and adhesive capsulitis.

involve modifying activities, tasks, or the
environment to minimize activity limitations and participation restrictions. During the early
and middle stages, tasks and activities may be adapted to maintain function, but as the
disease advances, increasing environmental modifications become necessary.

aim to minimize impairments such as loss of range
of motion, aerobic capacity, strength, and respiratory function. In the early stages,
prevention programs may help temporarily preserve physical function, enhance
well-being, and reduce fatigue. However, in the late-middle and late stages, mobility
becomes severely restricted, making prevention efforts more focused on mitigating
complications, such as preventing adhesive capsulitis through passive range of motion
exercises.

Patients remain independent in mobility and ADLs. Therapy focuses on
education, energy conservation, and home safety, with ROM, aerobic, and
resistance exercises as tolerated.

Moderate weakness appears, slightly reducing independence. Therapy
includes bracing and ROM exercises (active, active-assisted, or passive).

Severe weakness affects some muscle groups, though patients can still
walk. Therapy involves wheelchair planning, functional training, and possible use
of a cervical collar for neck weakness.

Patients require a wheelchair. Therapy emphasizes pressure relief
through seating modifications and skin monitoring.

Transfers and repositioning become difficult. Therapy includes transfer
training and positioning strategies to reduce immobility-related pain.

Patients become fully dependent for ADLs and require respiratory
support. Therapy prioritizes quality of life and caregiver training for extensive care
needs.

is the most common form of the disease, occurring randomly without
identifiable risk factors or a family history. Although family members of individuals with ________ have a slightly increased risk, the overall likelihood of developing
the condition remains low.

accounts for approximately 5–10% of cases and is inherited from a
parent, typically requiring only one parent to carry the disease-causing gene.
Mutations in more than a dozen genes have been identified as causes of familial
ALS, emphasizing its genetic basis.

Cranial Nerve Affectation of Bulbar-Onset ALS

the degeneration of __________in the motor cortex contributes to demyelination and gliosis of
the corticospinal and corticobulbar tracts, leading to dysfunction (lateral sclerosis).

Clinical Seveity of SMAs wherein the px is unable to sit unsupported

Clinical severity of SMAs wherein the px is able to sit unsupported; but unable to walk and stand unaided

Clinical Severity of Smas wherein the px is able to stand and walk

Pharma Mx for SMA; except:

Surgical Mx for Type 2

Surgical Mx for Type 1

Surgical Mx for Type 3

_____ are noted to have a higher frequency of SMN1 gene mutation

Characterized by extreme muscle weakness apparent before 6 mts of age likely had prenatal onset.

SMA type that prevents with severe hypotonicity, Summetrical mm weakness, absent DTR, markedly delayed motor development, cannot sit s support and have poor hesd control,weak cry and cough,dysphagia, feeding and handling oral secretion, paradoxical breathing , abnormal protrusion,bell-shaped trunk c chest wall collapse

SMA: presents with Bulbar weakness c swallowing difficulties,

SMA type : onset of Sx after 18 months. Normal life span , independent in amb and maintain it until 3rd and 4th decade of life LE>UE. Strength is not sufficient for stair climbing and has balance problem., Muscle aches and jt overuse sxs and frequently reported

Erb-Duchenne affected Nerves

Klumpke palsy affected nerves

Tarsal Tunnel Syndrome affect nerve

Affects only upper motor neurons, causing muscle stiffness and spasticity without significant muscle atrophy

Target only lower motor neurons, resulting in mm weakness and muscle atrophy without spasticity

Involves both UMN and LMN degeneration, leading to spasticity, atrophy and weakness

Nerve Affected in Fat wallet syndrome

Nerve Affected in Meralga Paresthetica

Strawberry Picker's Palsy

Cheralgia Paresthetica

SMN protein crucial for motor neurons survival

produces smaller amounts of SMN protein, and can't compensate fully for a mutated SMN1 protein

gene inherited in Fazio Londe dse

Antisense Oligonucleutide

Gene Therapy

SMN2 Splicing Modifier

Myostatin Inhibitor

SMA: onset after 10 yrs of age , normal expectancy and no respiratory complications. Maintain amb during adult yrs

X-Linked (CAG repeated expansion in the AR gene). less often Autosomal dominant