Deck 25: The Peripheral Nervous System

Question 1

Why does demyelination occur in Guillain-Barré syndrome?

A) Schwann cells die too fast for the body to replenish them.
B) Macrophages strip myelin from the nerves.
C) There is a lack of acetylcholine at the presynaptic junction.
D) There is a lack of blood flow to the outermost covering of nerves.

Answer 1

Macrophages strip myelin from the nerves.

Question 2

Which of the following is a common clinical manifestation of ulnar nerve palsy?

A) flattening of the thenar eminence
B) claw hand deformity
C) ulnar deviation of the hand when the wrist is flexed
D) impaired sensation along the thumb and first digit

Answer 2

claw hand deformity

Question 3

Which of the following peripheral neuropathies involves the motor endplate?

A) neurapraxia
B) diabetes mellitus
C) Guillain-Barré syndrome
D) botulism

Answer 3

botulism

Question 4

Which of the following is a true statement regarding neuropathy?

A) There is hypertonia of muscles involved.
B) Motor symptoms tend to occur first distally.
C) Deep tendon reflexes are increased.
D) The most proximal deep tendon reflexes will be affected first.

Question 5

Which of the following is the least common symptom of a paraneoplastic neuropathy?

A) weakness
B) burning and aching
C) numbness
D) paresthesia

Question 6

Which of the following sensations has the slowest nerve conduction velocity?

A) proprioception
B) pressure
C) temperature
D) pain

Question 7

Prolonged compression of a nerve that produces an area of infarction and necrosis is defined as which of the following?

A) neurapraxia
B) myelinopathy
C) axonotmesis
D) neurotmesis

Question 8

Which of the following is correct advice for a PTA to give a patient with a diagnosis of post-polio syndrome that is beginning an outpatient physical therapy intervention program?

A) The patient should exercise to the point of fatigue at the first visit.
B) The patient should stop exercise if pain or weakness increases.
C) The patient should focus on lower extremity aggressive exercise.
D) Functional exercises should be of maximal intensity.

Question 9

Which of the following is not a normal aging effect on the peripheral nervous system?

A) The perineurium will thicken.
B) The epineurium will thicken.
C) The size and number of fascicles will decrease.
D) The endoneurium will become fibrosed.

Question 10

Which of the following diabetic neuropathies is considered rapidly reversible?

A) acute sensory neuropathy
B) chronic sensorimotor
C) autonomic
D) hyperglycemic neuropathy

Question 11

Lower motor neuron involvement occurs with trauma to several sites.Damage to which of the following sites will not produce lower motor neuron symptoms?

A) cerebellum
B) cell body of alpha motor neuron located in the spinal cord or brainstem
C) motor endplate of the axon
D) muscle fibers innervated by the motor nerve axon

Question 12

Which of the following disorders is not common with Charcot-Marie-Tooth (CMT)disease?

A) distally symmetric muscle weakness
B) increased deep tendon reflexes
C) high arch deformities
D) hammer toes

Question 13

Which layer of connective tissue surrounding peripheral nerves is responsible for maintaining the blood-nerve barrier?

A) endoneurium
B) perineurium
C) epineurium
D) axolemma

Question 14

Which test is considered the gold standard for carpal tunnel syndrome?

A) Phalen's test
B) Tinel's test
C) nerve conduction velocity testing
D) carpal compression test

Question 15

Disruption of which cranial nerve will result in Bell's palsy?

A) trochlear
B) trigeminal
C) facial
D) vagus

Question 16

What is the prognosis for reinnervation of muscle after a neurotmesis injury where there has been no return of function for 1 year?

A) poor
B) fair
C) good
D) excellent

Question 17

Which of the following will show a complete interference pattern with maximal contraction on electromyogram (EMG)?

A) normal innervation
B) segmental demyelination
C) axonal degeneration
D) myopathy

Question 18

At what stage of the complex regional pain syndrome (CRPS)is the skin thin,shiny,cyanotic,and dry?

A) acute
B) dystrophic
C) atrophic
D) subacute

Question 19

The medication amiodarone is toxic to peripheral nerves.What is this medication prescribed for?

A) cancer
B) irregular heartbeat
C) skin diseases
D) seizures and pain

Question 20

A patient presents to outpatient physical therapy with a diagnosis of thoracic outlet syndrome (TOS).Which of the following treatments would be inappropriate for this individual?

A) forceful stretching to mobilize the first rib
B) postural and breathing exercises
C) strengthening exercises for the shoulder girdle musculature
D) moist heat to the upper trapezius