MSK - Head and Neck

Question 1

cervical raducolopathy sx

Answer 1

pain/weakness of arms

Question 2

C5 compression motor

Answer 2

deltoid

Question 3

C6 compression: motor

Answer 3

bicep

Question 4

C7 compression: motor

Answer 4

tricep, wrist ext

Question 5

C7 compression: sensory/pain

Answer 5

upper arm to fingers 2+3

Question 6

MC cervical disc herniation

Answer 6

C6-7 (C7 nerve root compressed)

Question 7

C5 compression: sensory/pain

Answer 7

lateral shoulder

Question 8

C6 compression: sensory/pain

Answer 8

lateral arm to thumb

Question 9

C7-T1 disc hernation compresses what root

Answer 9

C8

2nd MC cervical compression

Question 10

C8 compression: motor

Answer 10

hand intrinsics

Question 11

C8 compression: sensory and pain

Answer 11

4+5 fingers

Question 12

cervical root compression dx

Answer 12

MRI + PE

if unclear EMG

Question 13

cervical spondylosis - define

Answer 13

degenerative progress that narrows spinal canal + neuralforamen

Question 14

cervical myelopathy - define, sx

Answer 14

progression of cerv spondy = motor, sensory, reflex problems
clumsiness/fine motor control
LE spasticity
hyperflexia
stocking glove (sensory)
\+HOFFMAN
inverse radial reflex

Question 15

ALS v myelopathy

Answer 15

sensory changes NOT in ALS

Question 16

cervical myopathy

Answer 16

hyper-intensity of spinal cord @ T2, myelomalacia (edema of cord)

Question 17

cervical myopathy tx

Answer 17

usually surgery decompression- prevents it from getting worse

Question 18

cervical myopathy left untreated leads to

Answer 18

paralysis… progressive spinal cord narrowing

Question 19

leading cause of disability for <45 yo

Answer 19

back pain

Question 20

what % of back pain is a nerve root syndrome or herniated disc

Answer 20

1% each

Question 21

where is arthritis in back

Answer 21

facet joints

Question 22

acute, sub-acute, chronic back pain timeline

Answer 22

<6 week, <3mo, >3mo

Question 23

distinguish new v old compression fx - imaging modality

Answer 23

MRI

Question 24

radiculopathy (type of nerve root syndrom) sx

Answer 24

mild back pain, radiates down leg

coughing/valsalva elicits pain

Question 25

nerve root syndrome sx

Answer 25

sensory disturbance-dermatome motor weakness- myotome pain- straight leg raise

Question 26

L4 nerve - motor

Answer 26

quad weakness

Question 27

L4 nerve - pain

Answer 27

ant thigh pain

Question 28

L4 nerve - sensation

Answer 28

decreased in medial malleous and lateral foot

Question 29

L5 - motor

Answer 29

tibalis anterior (foot drop)

Question 30

L5 - sensation

Answer 30

dec top of foot to big toe

Question 31

L5 - pain

Answer 31

posterior thigh, wraps to shin below knee

Question 32

MC HLDs

Answer 32

L4-5, effecting L5 (50%) | L5-S1, effecting S1 (50%)

Question 33

S1 - pain

Answer 33

posterior leg to little toe side of foot

Question 34

S1 -sensation

Answer 34

lateral malleolus + lateral foot

Question 35

S1 - motor

Answer 35

plantar flexion weakness

Question 36

HLD tx

Answer 36

- pain management - no surgery - self-resolves - disc dries up - need 4 weeks conservative therapy before MRI

Question 37

degenerative spine dz risk factors

Answer 37

``` smoking osteoporisis age trauma poor core strength ```

Question 38

lumbar spinal stenosis sx

Answer 38

b/l pain of butt, hamstring, legs back pain less common relieved w/ shopping cart

Question 39

lumbar spinal stenosis imaging

Answer 39

xray - ht loss,, alignment | MRI - 2nd, but can be + in asymp

Question 40

lumbar spinal stenosis tx

Answer 40

conservative epidural steroid injections elective surgery

Question 41

spondylolistesis tx

Answer 41

most need surgery (fusion)

Question 42

degenerative scoliosis hx

Answer 42

past other joint replacements , chronic back pain

Question 43

degenerative scoliosis tx

Answer 43

PT - prevent from getting worse | surgery

Question 44

cauda equina sx

Answer 44

back pain + urinary/fecal problems saddle anethesia significant motor weakness leg and back pain (bilateral)

Question 45

cauda equina cause

Answer 45

- massive midline HD - tumor, infection, trauma - hematoma (lovenox)

Question 46

cauda equina

Answer 46

surgical emergency

Question 47

epidural abcess epi

Answer 47

DM, IV drugs

Question 48

epidural abcess sx

Answer 48

back pain (tender to palpation), leg pain, septic-appearing, fever

Question 49

epidural abcess workup

Answer 49

cbc, esr, blood cultures

Question 50

epidural abcess tx

Answer 50

PICC line abx and send home if reliable and not neuro sx urgency decompression surgey if neuro sx or can't return

Question 51

compression fx epi

Answer 51

postmenopausal white women chronic steroid tobacco use obesity

Question 52

compression fx signs

Answer 52

tender to palpation | back pain

Question 53

compression fx tx

Answer 53

bedrest bracing vertebroplasty - blow up balloon to vert and inject cement

Question 54

spinal mets sx

Answer 54

back pain, legs feeling heavy, persists when laying down | hx Ca

Question 55

spinal mets tx

Answer 55

surgery - palliative (leg weakness tx) if appropriate | otherwise conservative