0731 Spinal Cord and PNS Syndromes

Question 1

The biceps jerk is occurs in a reflex via which nerve?

Answer 1

C5-6

Question 2

The brachioradialis jerk is occurs in a reflex via which nerve?

Answer 2

C5-6

Question 3

The triceps jerk is occurs in a reflex via which nerve?

Answer 3

C7

Question 4

The finger jerk is occurs in a reflex via which nerve?

Answer 4

C8 (but absence can be normal)

Question 5

The knee jerk is occurs in a reflex via which nerve?

Answer 5

L4

Question 6

The ankle jerk is occurs in a reflex via which nerve?

Answer 6

S1

Question 7

List signs of upper motor neuron (UMN) loss.

Answer 7

“spastic weakness”, increased tone, preservation of upper limb flexors and lower limb extensors, increased reflexes, positive Babinski and Hoffman’s reflexes, minimal atrophy of muscle (secondary to disuse, not UMN loss)

Question 8

List signs of lower motor neuron (LMN) loss.

Answer 8

“flaccid weakness”, decreased tone, non-pyramidal weakness, decreased reflexes, negative Babinski and Hoffman’s reflexes, marked atrophy, muscle fasciculation.

Question 9

List some causes of spinal cord compression.

Answer 9

cervical spondylosis, disc prolapse, tumours, haematoma, abscess.

Question 10

Does cauda equine syndrome involve UMN or LMN signs?

Answer 10

all LMN.

Question 11

List some typical causes of cauda equine syndrome.

Answer 11

lumbar disc prolapse, metastasis, tumour, meningitis, trauma, abscess, viral polyradiculitis (e.g. CMV)

Question 12

List some typical signs/symptoms of cauda equine syndrome.

Answer 12

saddle area sensory loss in S2-5 dermatomes, atonic bladder with bladder distension, constipation, faecal incontinence, loss of erectile function, weakness in sacral myotomes such as knee flexion and ankle plantar flexion.

Question 13

List some of the causes of radiculopathy.

Answer 13

compression at neural exit foramen due to disc prolapse, joint hypertrophy, osteophytes, or compression, tumours, haematomas, abscesses, cervical rib disorder, infection, trauma.

Question 14

List some of the signs/symptoms of radiculopathy.

Answer 14

Sensory loss or change in affected dermatome, pain along pathway of nerve, LMN weakness in affected myotome

Question 15

The radial nerve innervates which muscle movements?

Answer 15

Shoulder, wrist and finger extension,
forearm supination,
thumb abduction

Question 16

The median nerve innervates which muscle movements?

Answer 16

thumb flexion and opposition,
flexion of digits 2 and 3,
wrist flexion and abduction,
forearm pronation

Question 17

The ulnar nerve innervates which muscle movements?

Answer 17

finger adduction and abduction (other than thumb),
thumb adduction,
flexion of digits 4 and 5,
wrist flexion and abduction

Question 18

The axillary nerve innervates which muscle movements?

Answer 18

abduction of the arm at shoulder beyond the first 15 degrees.

Question 19

The musculocutaneous nerve innervates which muscle movements?

Answer 19

flexion of the arm at elbow,

supination of forearm.

Question 20

The femoral nerve innervates which muscle movements?

Answer 20

leg flexion at the hip,

leg extension at the knee

Question 21

The obturator nerve innervates which muscle movements?

Answer 21

adduction of the thigh.

Question 22

The sciatic nerve innervates which muscle movements?

Answer 22

leg flexion at knee

plus other movements by its branches, the tibial and peroneal

Question 23

The tibial nerve innervates which muscle movements?

Answer 23

foot plantar flexion and inversion,

toe flexion

Question 24

The superficial peroneal nerve innervates which muscle movements?

Answer 24

foot eversion

Question 25

The deep peroneal nerve innervates which muscle movements?

Answer 25

foot dorsiflexion,

toe extension

Question 26

List some of the causes of peripheral neuropathy

Answer 26

alcoholism, diabetes, autoimmune diseases, heavy metal poisoning, some chemotherapeutics and other medications, infections (lyme disesase, VZV, EBV, HepC, HIV, diphtheria, leprosy), genetic diseases, paraneoplastic syndrome, vitamin deficiencies (B1, B6, B12, Vit E and niacin), bone marrow disorders, end organ failure.