cervical spondylosis and neuropathies

Question 1

what is cervical spondylosis?

Answer 1

the specific terms for osteoarthritis of the cervical spine due to degeneration of the disc or facet joints

Question 2

what are the S&S of cervical spondylosis?

Answer 2

spontaneous onset of neck pain

cervical muscle pain and spasm

headaches or occiptial pain - referred pain

weakness or numbness

radiating arm pain

reflex changes

• increased in myelopathy
• decreased in radiculopathy

Question 3

what is a cervical radiculopathy?

Answer 3

radiating arm pain following a single cervical nerve root distribution due to mechanical compression of a nerve root as it exits the spinal cord

Question 4

what is a cervical myelopathy?

Answer 4

syndrome of neurological deficit in upper and lower extremities resulting from increased spinal cord pressure in the cervical spine due to degenerative changes in the disc and/or facet joints

Question 5

what would a radiculopathy at C5 root (C4/5 disc) cause

Answer 5

• Weak deltoid & supraspinatus; ↓supinator jerks; numb elbow.

Question 6

what would a radiculopathy at C6 (C5/6 disc) root cause

Answer 6

• Weak biceps & brachioradialis; ↓biceps jerks; numb thumb & index finger.

Question 7

what would a radiculopathy at C7 (C6/7 disc) root cause

Answer 7

Weak triceps & finger extension; ↓triceps jerks; numb middle finger.

Question 8

what would a radiculopathy at C8 (C7/T1 disc) root cause

Answer 8

Weak finger flexors & small muscles of the hand; numb 5th & ring finger

Question 9

below the level of a myelopathy there may be UMN signs indicating cord compression. What are they?

Answer 9

Spascity
weakness
brisk reflexes
upgoing plantars

Question 10

what investigations are done in cervical spondylosis?

Answer 10

Cervical MRI

• bone destruction
• spinal cord or nerve compression

Cervical X-ray
- degenerative joint disease

Cervical myelogram
- disc herniation or nerve root compression

Question 11

how is cervical spondylosis treated?

Answer 11

analgesia 
PT 
oral corticosteroids 
surgical decompression - laminectomy or laminoplasty 
immobilsation in hard collar 
transforaminal steroid injections

Question 12

how does radial nerve palsy present?

Answer 12

painless wrist and finger drop

sensory change over radial distribution

Question 13

weakness of which muscles are involved in radial nerve palsy?

Answer 13

extensor carpii radialis longus - wrist extension
extensor digitorum communis - finger extension
brachioradialis - elbow flexion in mid pronation

Question 14

how does ulnar nerve palsy present?

Answer 14

claw hand and inability to cross fingers

Question 15

for other nerve palsies look at notes lol

Answer 15

bitch