Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

A - MSRA MSK [11] > [14] Cauda Equina Syndrome > Flashcards

[14] Cauda Equina Syndrome Flashcards

1
Q

What is cauda equina syndrome?

A

A surgical emergency caused by a compression of the cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can cauda equina lead to if untreated?

A

Debilitating complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the result of the potential for the development of debilitating complications from cauda equina syndrome?

A

A high level of suspicion and rapid intervention is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the peak age of onset of cauda equina syndrome?

A

40-50 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the cauda equina?

A

A bundle of nerves situated inferior to the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where does the spinal cord taper to an end?

A

At approximately the first lumbar vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the tapering end of the spinal cord called?

A

The conus medullaris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do nerve roots L1-S5 leave the spinal cord?

A

They pass down the spinal canal (as the cauda equina) to exit at their respective foramina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the cauda equina contain?

A

Lower motor neurones, containing motor and sensory impulses to the lower limbs, motor innervation to the anal sphincter, and parasympathetic innervation from the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is cauda equina syndrome caused by?

A

Compression of cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can cause compression of the cauda equina?

A
  • Disc herniation
  • Trauma
  • Neoplasm
  • Infection
  • Chronic spinal inflammation
  • Iatrogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

At what level does disc herniation most commonly cause cauda equina syndrome?

A

L5/S1 and L4/5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What trauma can cause cauda equina syndrome?

A
  • Vertebral fracture
  • Subluxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the common metastatic cancers that spread to spinal vertebrae?

A
  • Thyroid
  • Breast
  • Lung
  • Renal
  • Prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What infections can cause compression of the cauda equina?

A
  • Discitis
  • Pott’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What disease can cause chronic spinal inflammation leading to cauda equina?

A

Ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the iatrogenic causes of cauda equina compression?

A

Haematoma secondary to spinal anaesthesia

18
Q

What can cauda equina syndrome be divided into?

A

Complete or incomplete

19
Q

Of what nature will most cases of cauda equina syndrome be?

A

Progressive, and will not immediately cause complete compression of the cauda equina

20
Q

Why is the classification of complete or incomplete cauda equina syndrome important?

A

Because incomplete cauda equina syndrome has a greater potential for neurological recovery

21
Q

What are the symptoms of cauda equina syndrome?

A

Lower motor neurone signs and symptoms, including;

  • Reduced lower limb sensation (often bilateral)
  • Bladder or bowel dysfunction
  • Lower limb motor weakness
  • Severe back pain
  • Impotence
22
Q

What is an important feature to assess in cauda equina syndrome?

A

Bladder dysfunction, specifically the presence of retention

23
Q

What is the importance of assessing bladder dysfunction in cauda equina syndrome?

A

Confirmed retention or reduced ability to void (loss of desire, reduced urinary sensation) suggests complete or incomplete CES respectively

24
Q

What are the features of cauda equina syndrome on examination?

A
  • Saddle anaesthesia or lower limb anaesthesia
  • Loss of anal tone
  • Urinary retention
  • Lower limb weakness and hyporeflexia
25
Q

What is saddle anaesthesia?

A

Anaesthesia of the lower sacral dermatomes (perianal area)

26
Q

What should be done as part of the examination for suspected CES, regardless of symptoms?

A
  • PR examination
  • Post-void bladder scan
27
Q

What are the differential diagnoses of cauda equina syndrome?

A
  • Radiculopathy
  • Cord compression
28
Q

How is radiculopathy differentiated from cauda equina syndrome?

A

There will be no faecal, urinary, or sexual dysfunction in radiculopathy

29
Q

What is cord compression?

A

A surgical emergency with similar pathophysiology to CES

30
Q

What is cord compression characterised by?

A

Upper motor neurone signs

31
Q

What investigations should be done for suspected cases of cauda equina syndrome?

A

An emergency whole spine MRI

32
Q

What % of patients suspected to have CES from clinical assessment have an abnormality found on MRI?

A

60%

33
Q

Is further imaging required in CES?

A

It may be required depending on underlying cause, but if CES is confirmed then urgent surgical intervention is the priority

34
Q

How is cauda equina syndrome managed?

A
  • An early neurosurgical review for urgent decompression must be initiated
  • Most patients will initially be started on high-dose steroids
  • In trauma, immobilisation is often employed
35
Q

In whom is it particularly important that an early neurosurgical review is important?

A

Those with incomplete CES

36
Q

Why is especially important that those with incomplete CES undergo early neurosurgical review?

A

As the prognosis is potentially more favourable

37
Q

Give an example of a steroid used in CES

A

Dexamethasone

38
Q

What is the purpose of high dose steroids in CES?

A

Reduce any swelling

39
Q

What is done for cases of CES deemed suitable for neurosurgical intervention?

A

The neurosurgical team will discuss plans for surgical decompression

40
Q

How can CES be managed in cases caused by malignancy?

A

Radiotherapy and chemotherapy, especially if hte patient is not suitable for surgery

41
Q

What is the prognosis of CES variable depending on?

A
  • Aetiology
  • Time taken from symptom onset to surgery

A - MSRA MSK [11] (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions