CSP patho

Question 1

what is Radiculopathy (ROOT)

Answer 1

Injury/compression/irrtation to the nerve root STOPS it from CONDUCTING message to and from the brain

conduction/flow gets blocked

Lack of Signal

Question 2

What is Radicular Pain

Answer 2

pain from the nerve root in the spine is felt down the leg and arm

sharp, severe, felt in a line

inflammation of the nerve

lack of blood, O2 supply

Question 3

What is Referred Pain

Answer 3

pain from injured muscles, joints, and discs in the spine felt in the wrong place

deep ache pain

Question 4

What is Myelopathy (MIDDLE)

Answer 4

Sx due to compression/irritation of the spinal cord within spinal canal (more central)

affects all levels below

Question 5

Causes of spinal injuries (7)

Answer 5

direct impact/trauma
herniating disc
tumor
bone spurs
inflammation
Degenerative disc disease
spinal stenosis

Question 6

What is Neuropathy (Peripheral)

Answer 6

any conditions that affects the nerves outside the brain and spinal cord

Question 7

What is Myotome

Answer 7

a group of muscles innervated by a single nerve root

Question 8

What is Dermatome

Answer 8

The area of skin that is supplied by a single nerve root

Question 9

5Ds 3Ns

Answer 9

diplopia, dizziness, drop attacks, dysarthria, dysphagia
, nausea, numbness, and nystagmus

Question 10

Radiculopathy: pathophysiology

Answer 10

usually mechanical compress
Herniating Disc
Degenerating changes (bone spurs)
Injury - lifting heavy objects improperly, minor trauma (MVA)
Tumor and diabetes (ischemia/lack of blood flow)

Question 11

Radiculopathy presentation

Answer 11

Loss/Change of motor function and or sensation

pain, numbness, pin and needles
localized or radiating pain
hypersensitive to touch

motor weakness

Arm pain (localized or shooting), neck, shoulder, upper back, chest

hyper/hypo reflexes

affecting dermatome, myotome, reflexes of the affecting nerves

Question 12

Radiculopathy management/Tx (8)

Answer 12

substantial improvement 4-6 m (but can persist in some)
Analgesia
Ex targeted to CSP or upper limb
MT
coping strategies/stress management/ belief
MRI
injection
surgery

Question 13

Radicular pain presentation

Answer 13

pain felt down the arm or legs
sharp, in an line, severe
report high pain level in the limb that is worse than that in the spine

Question 14

Radicular pain management Tx (4)

Answer 14

education on whats going on

advise and reassurance that it will get better to calm them

pain killers to keep pain under control

encourage/motivate them to stay active

Question 15

Myelopathy mechanism

Answer 15

similar to radiculopathy (compression/irritation)

central herniating disc pushing the middle of the canal

bone spurs
trauma
tumor
spinal stenosis
degen

Question 16

CSP patho (6)

Answer 16

Nerve related neck pain (mechanical/chemical)

Non-specific neck pain

Spondylosis (OA)

WAD - whiplash associated disorder

CAD - cervical artery disease

UCI - Upper cervical Instability

Question 17

What is Upper cervical Instability

Answer 17

a loss of osseoligamentous integrity b//w occiput, C1 and C2

may compress spinal cord or vertebral A

Question 18

Rick factory/cause of Upper cervical Instability (3)

Answer 18

congenital (downs syndrome, Ehlers-Danlos or bony anomalies)

inflammatory arthropathy (RA, ankylosing spondylitis脊柱炎)

H/O trauma (whiplash)

Question 19

UCI presentations (5)

Answer 19

Neck pain and stiffness
need for external support for neck
feelings of instability, giving way
Anxiety
Neurological or vascular Sx

urgent medical referral

Question 20

CSP Vascular system:
2 systems

Answer 20

ant and post

Question 21

CSP Vascular system: ANT
____arteries
__% blood flow to brain

Answer 21

Carotid
80%

Question 22

CSP Vascular system: POST
____arteries
join to form ___ A
__% blood flow to brain

Answer 22

vertebral A
Basilar A
20%

Question 23

common Sx of CranioCervical artery dissection (5)

Answer 23

unsteadiness/ataxia
ptosis = drooping of upper eyelid
dysphasia/dysarthria = speech
upper or lower limb weakness
facial palsy = weakness of facial muscles

Question 24

2 types of CAD

Answer 24

dissection event/hemorrhage (tear in blod vessel)

non-dissection/ischaemic event (e.g. atherosclerosis/stiff, stenosis/narrowed, thrombus/blocked)

Question 25

Symptoms of ___ and _____ are often the first non-ischaemic symptoms of an underlying vascular pathology​

Answer 25

neck pain and headache

Question 26

with neck pain, need to try and establish whether there is a _____ cause​; How? (2)

Answer 26

vascular cause;

CV risk factors (smoking, hypertension, high cholesterol, diabetes, inactivity, OW/OB, family history, History)

ask abt ischaemic Sx

Question 27

Younger people are at an increased risk of ______ but less association with risk factors​

Answer 27

craniocervical artery dissection CAD