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6- Neuro Diag > Ch8 8 Spinal Nerve Roots > Flashcards

Ch8 8 Spinal Nerve Roots Flashcards

1
Q

List the spinal nerve roots distribution

A 
8  cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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2
Q

Spinal cord ends at which level

A

L1-L2

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3
Q

What structure is formed at the end of spinal cord

A

cauda equina

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4
Q

Define: area of skin innervated by a single nerve

A

dermatome

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5
Q

Define: muscles innervated by a single nerve root

A

myotome

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6
Q

Sclerotogenous pain aka

A

referred pain

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7
Q

Def: Neuropathy

A

peripheral nerve disorder

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8
Q

Def: Radiculopathy

A

nerve root level disorder

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9
Q

Mononeuropathy distribution can be due to

A

Trauma
Local infection
Local Toxicity

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10
Q

Polyneuropathy distribution can be due to

A

Nutritional deficiency
Systemic infection
Autoimmunity
Systemic toxicity

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11
Q

What Causes radiculopathy?

A
  1. compressive, mechanical
  2. metabolic
  3. reflexive
  4. inflammatory
  5. infectious
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12
Q

Evaluation of radiculopathy steps

A
  1. muscle testing
  2. tendon reflexes
  3. dermatome sensory testing
  4. Valsalva and orthopedic testing
  5. nerve conduction (velocity testing)
  6. radiography
  7. MRI
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13
Q

Radiculopathy location

A

at the spine or lateral canal (in the IVF)

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14
Q

Radiculitis location

A

out side the lateral canal (but before the plexi)

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15
Q

Radiculopathy/Radiculitis symptoms

A
  • Burning or tingling dermatomal pain
  • Loss of reflexes
  • Motor strength loss
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16
Q

Causes of Mechanical Injury

A
  1. disc lesion (MC C6 C7 L6 S1 nerve roots – C5, C6, L4, L5 discs)
  2. laceration
  3. neoplastic
  4. traction- whiplash injury
  5. degeneration - stenosis
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17
Q

Def: mild temporary interruption of nerve transmission

A

Neurapraxia

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18
Q

what results from injury or chronic compression?

A

Wallerian degeneration

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19
Q

Spondylosis is degenration due to

A

osteophytes, spinal stenosis

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20
Q

Spondylolysis is a

A

a Fracture/break in continuity

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21
Q

Spondylolisthesis is

A

displacement/shifted vertebra

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22
Q

Cervical stenosis signs & symptoms

A

LMNL and radicular signs in upper extremities

UMNL in lower extremities

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23
Q

Lumbar stenosis signs & symptoms

A

bilateral leg pain, and weakness with walking (LMNL sign)

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24
Q

what’s the difference between ALS vs Cervical stenosis:

A

cervical stenosis Pts still have sensory signs

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25
Q

leg pain or discomfort is called

A

Claudication

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26
Q

Neurological Claudication- gets worse and better with

A

position

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27
Q

Vascular Claudication- gets worse when

A

Pt walks more

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28
Q

Claudication testing

A

stationary bike test

if pain occurs after paddling, then it’s due to a vascular issue

29
Q

how to test for Medial and Lateral Disc Bulge

A

Kemp test

(medial: away, Lateral: toward)

30
Q

Central disc protrusion that affects multiple nerve roots bilaterally is called

A

Cauda Equina Syndrome

31
Q

Cauda Equina Syndrome is caused by

A
  • Central (median) disc lesion
  • Canal stenosis
  • Vertebral fracture
  • Luxation
  • tumor
32
Q

Cauda Equina Syndrome management:

A

refer out immediately (medical emergency)

33
Q

Cauda Equina Syndrome

A

Bilateral involvement of multiple levels (s1, s2, s3):

  • urinary and fecal incontinence
  • impotence
  • loss of tendon reflexes
  • muscle atrophy
  • saddle anesthesia
  • foot drop
  • bilateral sciatica
34
Q

vascular compromise to peripheral nerves is due to

A

Diabetic Neuropathy

35
Q

Diabetic Neuropathy symptoms

A 
Stocking glove sensory loss
Charcot (neurogenic) joint
Autonomic loss
motor loss
diabetic reinopathy
36
Q

Def: Stocking glove sensory loss

A
  • numbness
  • pain, and paresthesia
  • vibration loss
37
Q

Autonomic loss includes

A
  • hypo-tension
  • arrhythmia
  • alter bowl, bladder, and sexual function
38
Q

Metal Toxicity symptoms

working around metal

A
  • tingling in the extremities
  • unsteady gait
  • muscle tremor, pain, or tics
  • headache
  • general pain
  • fatigue
39
Q

Reflex Sympathetic Dystrophy Syndrome “RSDS”

must have 1 symptom from the 3 of the following

A
  1. sensory: hypersthesia or allodynia
  2. vasomotor: temperature or skin asymmetry
  3. pseudomotor: edema or symmetric sweating
  4. moto/trophic: weakness, dystonia, hair nail or skin changes
40
Q

whats the difference between RSDS 2 types?

A

one include nerve injury, and the other doesn’t

41
Q

RSDS Type 1

A
  • complex regional pain syndrome
  • less specific
  • rapid severe swelling
  • long term pain, along peripheral nerve fowwlowing minor injury (allodynia)
  • sever sympathetic reaction
  • includes regional osteoporosis
42
Q

RSDS Type 2

A
  • causalgia
  • involves specific nerve damage
  • begins with a nerve injury
  • more specific
  • follows the nerve distributions
43
Q

Raynaud Disease is effect on peripheral vessels

A

causes peripheral vasospasm

44
Q

Raynaud is associated with

A

migraines

45
Q

Raynaud is more common with (which population)

A

women

46
Q

Raynaud happens due to ____ exposure

A

cold

47
Q

Raynaud color stages

A

white, blue, red

48
Q

Raynaud can be diagnosed with _____ test

A

Allen’s

49
Q

Guillian Barre Syndrome aka

A

Inflammatory polyneuropathy

acute idiopathic polyneuritis

50
Q

Guillian Barre Syndrome characteristic

A
  1. post Epstein Barr infection
  2. PNS demyelination
  3. sensory loss
  4. weakness comes next LMNL signs
51
Q

Guillian Barre Syndrome is more common in what ages

A

30-50

52
Q

Guillian Barre Syndrome prognosis

A

90% self healing

53
Q

Myasthenia Gravis is disorder of

A

neuromuscular junction

54
Q

in Myasthenia Gravis, autoimmune attack

A

acetylcholine receptor

55
Q

Myasthenia Gravis MC in what population?

A

young women or old men

56
Q

Myasthenia Gravis MC symptoms

A

weakness of eyes (ptosis), lips, face , and hands

thymoma or enlarged thymus

57
Q

in Myasthenia Gravis weakness get worse with

A

repeated use of muscle or later in day

58
Q

why the weakness get worse though the day with MG patients

A

Pt is loaded with Ach, by afternoon, Pt is depleted of Ach

59
Q

what MG Pts are given?

A

anti-Ach esterase

edrophonium chloride

60
Q

MG sensory findings

A

No sensory findings

61
Q

MG Treatment

A

thymectomy, immunosuppressants, and anti-Ach drugs

62
Q

Test to detect MG

A

tensilon

63
Q

Eaton Lambert syndrome

A
  1. presynaptic disorder of inadequate Ach
  2. usually with underlying cancer
  3. symptoms as myasthenia gravis
64
Q

Polio is caused by

A

viral infection

65
Q

Polio is spread through

A

fecal oral

66
Q

Polio attack

A

affects anterior horn cells

67
Q

Polio Signs

A

muscle wasting and deformity

68
Q

Polio prevention includes

A 
Salk vaccine (dead virus)
Sabin vaccine (live virus)

6- Neuro Diag (10 decks)

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