Getting on My Nerves!
What is the most common peripheral nerve affected in Parsonage-Turner Syndrome?
1) Suprascapular
2) LTN
3) AIN
What specific kind of brain bleed presents with a "bi-convex" lesion?
Epidural Hematoma
lens shaped = bi-convex lesion
Differentiate btwn erosions (symmetry) in OA vs RA
-OA = Asymmetric
-RA = Symmetric
What 1x specific test would be beneficial to differentiate btwn Conus Medullaris Syndrome & Caude Equina Syndrome?
EMG
-think pure LMN vs Mixed UMN/LMN
Unilateral, non-throbbing and non-lancinating pain that radiates from the neck into the occipital and frontal area is the classical description of a?
Cervico-genic Headache
Most common area of ulnar nerve entrapment?
Cubital tunnel
What is the formula for CPP?
CPP = MAP - ICP
What specific muscle should be stretched in Greater Trochanteric Pain Syndrome?
-Stretch = ITB
-Strengthen = Hip ABDuctors
Inhaling Nitric Oxide can lead to what specific pathology?
Subacute Combined Degeneration
Bonus: what 3x tracts affected?
What 1x specific MSK complication is associated with pulmonary malignancy?
Hypertrophic pulmonary osteoarthropathy:
-clubbing and periosteal proliferation of tubular bones
-usually in hands
What specific nerve palsy can occur months to years after a DISTAL Humerus fracture?
Tardy Ulnar Nerve Palsy
-involves ALL ulnar innervated muscles
-requires surgery
Describe diagnostic criteria (3x) for Post Concussion Syndrome
1) 3x symptoms
2) 4x weeks post head injury
3) impact QoL & functioning
Adequate strength in what 2x specific muscles are necessary for Lofstrand crutches?
1) Pec Major
2) Triceps
Name the most common cause of Charcot Joints at:
-Shoulder
-Knee
-Ankle
-Shoulder = Syringomyelia
-Knee =Syphilis
-Ankle = Diabetic Neuropathy (#1 cause overall)
Name the 1x specific surgical procedure that involves ablating the spinothalamic tract.
(esp useful in Pleural & Peritoneal Mesothelioma)
Cordotomy
-ablating spinothalamic tract
-providing selective loss of pain and temperature perception several segments below and contralateral to where the lesion is placed
Define Fiber Density with respect to NCS/EMG Studies?
the number of muscle fibers belonging to the same motor unit within the recording radius of the electrode
Describe timeline for:
-Immediate PTS
-Early PTS
-Late PTS
-Immediate PTS = within 24 hours post injury
-Early PTS = 24 hours to 7 days
-Late PTS = > 7 days
What effect does placing a Pin in the Posterior Channel of an AFO have on ankle ROM?
-Pins in the anterior channel of the AFO will prevent DF
-Springs in the anterior channel will assist PF
-Pins in the posterior channel will Prevent PF
-Springs in the posterior channel will assist DF
"Pins Prevent" & "Springs Promote"
What SCI level is needed to achieve modified independence with UE Dressing?
UE Dressing = C6
LE Dressing = C7
What 3x specific NSAID medications have reduced effects anti-platelet effects?
1) Naproxen
2) Ibuprofen
3) CElebrex
NICE!
Describe impact of colder temperature on the following:
-latency
-amplitude
-CV
-temporal disperson
-latency = prolonged
-amplitude = increased
-CV = reduced
-temporal dispersion = increased
Name 3x pharmacological interventions for Dysautonomia in TBI
1) Lipophillic BB (Propanolol)
2) Scheduled Pain Meds (Acetaminophen)
3) Dopamine Agonists (Amantdidine, Bromocriptine)
What is the proper cane height to offload a painful joint?
-2x correct answers
-the level of the patient's greater trochanter or the level of the hand when the elbow is flexed 20-30 degrees
Describe the pathophysiology of SMA Syndrome in SCI?
3rd portion of the duodenum is intermittently compressed by the overlying SMA, resulting in GI obstruction
-Bonus: Name Predisposing factors
Describe 3 Step Cancer Pain Analgesic Ladder
Step 1 = non-opioids & adjuvants
Step 2 = non-opioids & adjuvants --> & short acting opioids
Step 3 = non-opioids & adjuvants & short acting opioids --> & long acting opioids