Lesson 4

Question 1

Neuritis

Answer 1

• inflammation of the nerve
• mainly the sheath and connective tissue are affected
  (usually the axon is not)
• constant dull pain
• can also get numbness and tingling

Question 2

Neuritis Causes

Answer 2

• secondary to a pathology (DM, leprosy, TB)
• trauma to nerve
• chronic exposure (to a toxin like lead, drugs or alcohol)

Question 3

Neuralgia

Answer 3

• nerve pain
• recurrent attacks of sudden excruciating pain along dstribution of the nerve
• no associated pathology
• has a trigger zone

Question 4

trigger zone

Answer 4

• area that causes an attack when stimulated
• Usually it’s an area of skin supplied by the nerve
• movement of the area increases pain
• commonly affected are trigeminal and intercostal nerves

Question 5

Intercostal Neuralgia

Answer 5

-affects intercostal nerves that travel between the internal and innermost intercostal muscles

Question 6

Intercostal Neuralgia causes

Answer 6

• diabetes
• post-herpes zoster

Question 7

Herpes Zoster/ Post-Herpetic Neuralgia

Answer 7

• starts with chicken pox
• varicella zoster virus is the virus that causes chicken pox in children
• after recover from chicken pox in childhood, the virus is not eliminated from the body but lies dormant within the sensory ganglia of cranial or spinal nerves and can become activated later in life to cause herpes zoster (shingles)

Question 8

Herpes Zoster/ Post-Herpetic Neuralgia

Reactivation

Answer 8

• years later, when the immune system is depressed, the virus reactivates
• usually only 1 nerve affected
• when reactivated, the virus causes a generalized inflammatory response starting in the sensory ganglion
  and spreading along the nerves causing demyelination and degeneration
• inflammation produces pain and tingling in the involved dermatome with a rash and then vesicles that burst and encrust

Question 9

Herpes Zoster/ Post-Herpetic Neuralgia

Symptoms/mc affected nerves

Answer 9

• skin lesions can last up to a month and disappear as the effects of the virus resolve
• thoracic and trigeminal nerves are the most common
• intermittent attacks of deep, burning, sharp shooting pain along the affected nerve
• trigger is often light touch and movement over affected area

Question 10

Pinky and Thumb dermatomes

Answer 10

• Pinky: C8
• Thumb C6