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MS4 - Neurology > Cervical Spondylosis + Myopathy > Flashcards

Cervical Spondylosis + Myopathy Flashcards

1
Q

Cervical spondylosis

A

Degeneration of annulus fibrosis

+/- osteophytes

Narrows spinal canal

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2
Q

Signs of cervical spondylosis

A

Limited painful neck movement

Crepitus

Tingling down spine

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3
Q

Radiculopathy definition

A

Root compression

(rather than cord compression)

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4
Q

Signs of root compression

A

Pain / electrical sensation in arms at level of compression

Dull reflexes

LMN weakness

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5
Q

Dynatome definition

A

Area of pain / pins and needles

From trapped nerve root

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6
Q

C3 and 4 dynatome

A

Neck pain

Trapezius pain

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7
Q

C5 dynatome

A

Pain in shoulders + down front of arms

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8
Q

C6 dynatome

A

Carpal tunnel

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9
Q

C7 dynatome

A

Pain in dorsal arm + middle finger

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10
Q

C8 dynatome

A

Pain in ring and little fingers + medial lower arm

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11
Q

C5 motor deficit

A

Deltoid

Supraspinatus

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12
Q

C6 motor deficit

A

Biceps

Brachioradialis

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13
Q

C7 motor deficit

A

Triceps

Finger extenders

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14
Q

C8 motor deficit

A

Finger flexors

Small muscles of hand

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15
Q

Mx of cervical spondylosis

A

Firm neck collar

Transforaminal steroid injection

Surgical root decompression

Anterior spinal fusion

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16
Q

Types of surgical root decompression

A

Laminectomy

Laminoplasty

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17
Q

Laminectomy

A

Remove portion of bone

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18
Q

Laminoplasty

A

Cut bone and insert bridging plate + screws

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19
Q

Features of myopathy vs neuropathy

A

Myopathy:

Slower onset

Symmetrical

Proximal weakness

Preserved tendon reflexes

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20
Q

Muscular dystrophy definition

A

Group of genetic diseases

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21
Q

Muscular dystrophy classical features

A

Progressive degeneration and weakness of specific muscle groups

Variation in muscle fibre size

Deposition of fat

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22
Q

Causes of muscular dystrophy

A

Duchenne’s muscular dystrophy

Becker’s muscular dystrophy

Facioscapulohumeral muscular dystrophy

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23
Q

Duchenne’s muscular dystrophy inheritance

A

X linked recessive

30% spontaneous mutation

24
Q

Pathology of Duchenne’s muscular dystrophy

A

Non functional dystrophin produced

25
Q

Age of presentation of Duchenne’s muscular dystrophy

A

~ 4 yrs

26
Q

Sx of Duchenne’s muscular dystrophy

A

Clumsy walking

Difficulty standing

Respiratory failure

Pseudohypertrophy of calves

27
Q

Ix for Duchenne’s muscular dystrophy

A

Raised creatine kinase 40x

28
Q

Prognosis of Duchenne’s muscular dystrophy

A

Some survive beyond 20 yrs

29
Q

Mx of Duchenne’s muscular dystrophy

A

No specific Rx

Home ventilation

Genetic counselling

30
Q

Becker’s muscular dystrophy definition

A

Same mutation as Duchenne’s but produces partially functioning dystrophin

31
Q

Presentation of Becker’s muscular dystrophy

A

Later age

Similar but milder sx to Duchenne’s

Better prognosis

32
Q

Another name for Facioscapulohumeral muscular dystrophy

A

Landouzy-Dejerine

33
Q

Facioscapulohumeral muscular dystrophy inheritance

A

Autosomal dominant

34
Q

Facioscapulohumeral muscular dystrophy age of presentation

A

~ 12-14 yrs

35
Q

Sx of Facioscapulohumeral muscular dystrophy

A

Face, shoulder, upper arm weakness

Foot drop

Scapular winging

Scoliosis

36
Q

Features of Facioscapulohumeral muscular dystrophy facial weakness

A

Can’t puff out cheeks

37
Q

Features of Facioscapulohumeral muscular dystrophy upper arm weakness

A

Difficulty raising arms

Asymmetrical

Deltoid sparing

38
Q

Myotonic disorder definition

A

Cause tonic muscle spasms

39
Q

Histology of myotonic disorders

A

Long chains of central nuclei within muscle fibres

40
Q

Main type of myotonic disorder

A

Dystrophia myotonica

41
Q

Dystrophia myotonica inheritance

A

Autosomal dominant

42
Q

Dystrophia myotonica pathology

A

Chloride channelopathy

43
Q

Dystrophia myotonica onset

A

25 yrs

44
Q

Sx of Dystrophia myotonica

A

Distal onset weakness

Facial weakness

Muscle wasting

45
Q

Other features of Dystrophia myotonica

A

Male frontal baldness

DM

Cataracts

Reduced cognition

46
Q

Prognosis of Dystrophia myotonica

A

Most pts die in middle age

47
Q

Mx of Dystrophia myotonica

A

Mexiletine

Phenytoin

Acetazolamide

Genetic counselling

48
Q

Types of myotonic disorder caused by Na channelopathy

A

Paramyotonia congenita

Adynamia episodica hereditaria

49
Q

Causes of acquired myopathies of late onset

A

Often part of systemic disease

50
Q

Systemic disease causes of acquired myopathies of late onset

A

Hyperthyroidism

Malignancy

Cushing’s

Hypo- or Hypercalcaemia

51
Q

Most common cause of inflammatory myopathy

A

Inclusion body myositis

52
Q

Age of onset of inclusion body myositis

A

> 50 yrs

53
Q

Pathology of inclusion body myositis

A

Peripheral tauopathy

Tau protein aggregates

54
Q

Sx of inclusion body myositis

A

Weakness of quads, finger flexors or pharynx

Affects ventral extremities most

55
Q

Histology of inclusion body myositis

A

Ringed vacuoles

Intranuclear inclusions

56
Q

Rx of inclusion body myositis

A

Nothing really

57
Q

Drug causes of myopathy

A

Alcohol

Statins

Steroids

Chloroquine

MS4 - Neurology (11 decks)

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