PNS final

According the the data of Yuen, et al, of 100 patients seen in his edx lab at Mayo clinic, what percentage of them were due to hip arthroplasty?

22%

What percentage of diabetic polyneuropathy patients exhibit altered deep tendon reflexes?

75

According to the monograph by Christian Bischoff on late responses:

A and C

The femoral triangle:

A and C are correct

Which of the following is true about the F-wave or response according to the monograph by Masrati et al?

A, B and C

As described in our monograph this week by Dr. Ferrante about brachial plexopathy, which of the following is true regarding Parsonage-Turner syndrome?

A, B and C are correct

Which of the following are thought to be a cause of tarsal tunnel syndrome?

A, B, and C

In the manuscript by Cherian, et al regarding sciatic neuropathy, published in the journal Muscle and Nerve, which of the following is a correct statement regarding their findings?

A, B, and. C

A needle EMG waveform recorded from normal skeletal muscle is known as?

A. motor unit potential

Which of the following is(are) signs and symptoms of tarsal tunnel syndrome?

All of the above

According to the manuscript on BMI and CTS/Ulnar neuropathies by Landau, et al in Muscle and Nerve, which of the following is CORRECT?

B and C

The axillary nerve:

B and C

he Ulnar nerve is derived from :

C8-T1 nerve roots

According to the Manuscript by Pourmemari et al, entitled "Carpal tunnel release: lifetime prevalence, annual incidence and risk factors", which of the following is INCORRECT?

CTS levels are higher among those with higher education levels

The most common inherited, or genetic polyneuropathy is?

Charcot-Marie-Tooth

The most common metabolic disturbance in the USA that leads to polyneuropathy is?

DM type II

According to the manuscript by Colorado, et al in Muscle and Nerve, "Prevalence of carpal tunnel syndrome presenting with symptoms in an ulnar nerve distribution", the percentage of patients with CTS that presented with ulnar symptoms was less than 10%.

False

Although tibial nerve lesions in the popliteal fossa are not common, the most common cause is due to a Morton's neuroma.

False

The median nerve derives the majority of its axons from both the lateral and posterior cords of the brachial plexus.

False

According to the manuscript entitled "the Diabetic Neuropathies" by Gooch and Podwall, the most common autonomic finding in men with diabetic polyneuropathy is?

Genitourinary dysfunction

Which of the following IS NOT an EDX feature of de-innervated muscle?

Increased recruitment

Which nerve root level is most likely involved in a patient with foot drop?

L5

The waveform recorded as a result of routine sensory nerve conduction studies is referred to as ?

SNAP

Which of the ffollowing is correct with respect to the biceps femoris muscle?

The short head receives most axons from the L5 nerve root level

An elbow (cubital) region fracture sustained by an adult is more likely to fracture the olecranon process and radial head/neck, whereas an elbow region fracture in a child will more likely involve the condyles.

True

Diagnostic Ultrasound may be a reliable technique to diagnose piriformis syndrome according the research published in the manuscript by Zhang, et al.

True

In a patient with foot drop, the mostly nerve root involved if its etiology is a radiculopathy is L5, and the most likely nerve lesion if its due to a peripheral nerve mononeuropathy is the fibular nerve at/about the fibular head and neck region.

True

Severe endometriosis can sometimes cause a lesion of the obturator nerve.

True

n a practical or pragmatic clinical setting, the sural nerve is the most frquently tested nerve to reveal the potential for diabetic polyneuropathy.

True

When performing the motor nerve conduction study of the median nerve, one records the CMAP from which of the following muscles?

abductor pollicis brevis

According to the Manuscript by Dishman, et al, on carpal tunnel syndrome and manual therapy, which of the following is CORRECT?

all of the above

In a patient with a severe radiculopathy, what might the EDX doctor see upon needle EMG examination?

all of the above

The polyneuropathic condition known as "hereditary neuropathy with liability to pressure palsies":

all of the above

Which of the following are common clinical features of diabetic polyneuropathy?

all of the above

Which of the following conditions are confounding influences on the development of carpal tunnel syndrome?

all of the above

The inability for a patient to form a "perfect circle" with their thumb and index finger is a sign of a lesion of which of the following nerves?

anterior interosseous

Which nerve passes through the quadrangular space?

axillary

The most common genetic polyneuropathy is Charcot-Marie Tooth disease. Which of the following features listed below IS NOT TRUE about the disorder?

can sometimes lead to a "steppage gait"?

As per the lecture, which specific antibiotic listed below has been found to lead to polyneuropathy?

cipro

The most common mononeuropathy in the lower limb is?

common fibular at the fibular neck

The waveform obtained as a result of performing a motor nerve conduction study is known as ?

compound muscle action potential (CMAP)

The nerve most responsible for the function of dorsiflexion of the foot is?

deep fibular

The skin between the great and second tow is innervated by which of the following nerves?

deep fibular

The dorsal interosseous muscles are innervated by the ___________nerve and their main action is ________of the digits.

deep ulnar, abduction

The most common cause of acquired polyneuropathy in the USA is?

diabetes

A motor unit is defined as all the alpha motor neurons that supply one skeletal muscle.

false

Carpal tunnel syndrome is the second most common mononeuropathy seen in humankind.

false

Cutaneous sensation of the skin between the great and second toe is provided by the superficial fibular nerve.

false

Neuroapraxic lesions of peripheral nerves are the most severe of the "Seddon classifications".

false

The long head of the biceps femoris is innervated by the fibular division of the sciatic nerve, whereas the short head is innervated by the tibial division of the sciatic nerve.

false

The majority of sciatic nerve lesions which occur as sequelae to hip arthroplasty lead to tibial division lesions as the dominant feature.

false

The pronator teres is considered the "power pronator" muscle, and the flexor digotorum profundus is considered the "power flexor" muscle.

false

The severity of the diabetes tends to produce linear or proportionate polyneuropathy symptoms.

false

A rare form of diabetic polyneuropathy is asymmetrical and proximal. This type of atypical presentation usually involves which nerve(s) listed below?

femoral

Which nerve listed below is the most likely to be lesioned in a severe pelvic fracture?

femoral

Which of the following muscles listed below receives dual innervation?

flexor digitorum profundus

Which of the following DO NOT pass through the tarsal tunnel?

flexor hallucis brevis tendon

Which nerve is often irritated by the psoas muscle and leads to paresthesias/dysthesias on the proximal middle thigh region?

genitofemoral

The most common cause of an axillary nerve injury is?

glenohumeral dislocation

The femoral nerve innervates all of the following muscles EXCEPT?

gracilis

Which nerve is often lesioned or disrupted as a result of inguinal hernia repair?

ilioinguinal

In a tarsal tunnel syndrome patient, which of the following edx findings may be present?

increased distal motor latency of the tibial nerve

the medial antebrachial cutaneous nerve:

is derived from the medial cord of the brachial plexus

Which of the following structures DOES NOT pass through the subsartorial canal?

main trunk of the femoral nerve

Which nerve innervates pronator teres muscle?

median

Which nerve listed below provides the majority of innervation to the deep anterior forearm muscles?

median?

Which of the following is NOT TRUE regarding carpal tunnel syndrome?

men more affected than women

Which of the following is most likely an axonotmetic lesion?

moderate carpal tunnel syndrome

The lateral forearm is innervated cutaneously by a branch of which nerve?

musculocutaneous

Which nerve pierces the belly of the coracobrachialis muscle and is derived from the lateral cord of the brachial plexus?

musculocutaneous

Which nerve(s) listed below is (are) the LEAST frequently injured nerve in humans?

musculocutaneous

Which type of EDX test procedure listed below is considered to be the "gold standard" for radiculopathy diagnosis?

needle electromyography

The inferior gemellus muscle is innervated by which nerve listed below?

nerve to quadratus femoris

Which of the following types of Seddon peripheral nerve lesions are the most amenable to conservative treatment?

neurapraxia

A patient with hypoesthesia on the medial thigh slightly above the knee most likely has a lesion of which of the following nerves?

obturator

Which muscle listed below is innervated by the obturator nerve yet is not an adductor of the thigh?

obturator externus

Which muscle listed below is an adductor of the thigh yet is not innervated by the obturator nerve?

pectineus

The so-called "FAIR-test" is an electrodiagnostic modality that may assist in the diagnosis of which condition listed below?

piriformis syndrome

The radial nerve is derived from:

posterior cord of brachial plexus

Which of the following is TRUE with respect to diabetic polyneuropathy and the cranial nerves?

pupillomotor function may be impaired

Cheiralgia paresthetica" involves a lesion of sensory fibers of which nerve listed below?

radial

The most likely nerve lesion following an upper limb fracture is?

radial

The most prominent feature of acquired neuropathies is?

sensory disturbances

According to the assigned reading this week of the monograph on brachial plexopathies, which of the following types of electrodiagnostic testing is most useful in indicating an axon loss brachial plexopathy?

sensory nerve conduction study

Which structure(s) does not pass through the tarsal tunnel?

superficial fibular nerve

The tensor fascia lata muscle is innervated by the __________nerve and receives most of its nerve root supply from the ______nerve root level.

superior gluteal, L5

The nerve that cutaneously inneverates the posterior leg and lateral foot is?

sural

Which of the following structures does not pass through the carpal tunnel?

tendon of flexor carpi radialis

When electricity is applied to the patient during routine nerve conduction studies it is said to be initiated from?

the cathode of the stimulator

In the monograph on the risks of edx in this week's reading list, which of the following is CORRECT regarding safety of EDX?

there is no real risk to those with prosthetic joints

1/3 of all polyneuropathy cases are considered "idiopathic" and 1/3 are genetic.

true

2/3 of patients with pernicious anemia develop polyneuropathy.

true

A fibrillation potential is typically a smaller amplitude waveform as compared to a MUP.

true

A normal healthy motor unit potential (MUP) is typically triphasic in morphology, while MUPs seen after re-innervation are typically polyphasic.

true

A patient with myopathy may reveal small amplitude MUPs upon a needle EMG examination.

true

According to the invited review of alchoholic neuropathy written by Mellion et al, and as elucidated in our lecture, the real problem lies in alcohol toxicity and not thiamine deficiency.

true

According to the manuscript in Muscle and Nerve by Jerosch-Herold, et al, there are 500,000 CTS surgical release procedures performed at a cost of approximately 2 billion dollars per year.

true

Charcot joints are not uncommon in patients with diabetic polyneuropathy.

true

Lyme disease and vasculitis are examples of disorders that lead to non-length dependent, asymmetrical polyneuropathies.

true

Most EDX laboratories perform their sensory nerve conduction studies using an antidromic recording technique.

true

The literature suggests that one should consider steroid injection, wrist splinting, and carpal manipulation in mild to moderate CTS rather than a release surgery procedure as first option.

true

The most common etiology of polyneuropathy as far as total number of cases, is leprosy.

true

The radial nerve motor study is recorded from the extensor indicis muscle routinely.

true

The so-called "benediction sign" is a result of a severe and proximal median nerve lesion.

true

Which nerve branch (nerve) derived from the brachial plexus listed below is the most likley to be lesioned in the axilla?

ulnar

Which of the following muscle(s) does not insert into the pes anserinus?

vastus medialis

Which statement(s) listed below is correct with respect to Yuen, et al and their data on sciatic nerve lesions?

when a sicatic lesion is present post hip arthropalsty most patients had more symptoms involving the fibular(peroneal) division than the tibial division