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Clin Med > MSK - Head and Neck > Flashcards

MSK - Head and Neck Flashcards

1
Q

cervical raducolopathy sx

A

pain/weakness of arms

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2
Q

C5 compression motor

A

deltoid

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3
Q

C6 compression: motor

A

bicep

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4
Q

C7 compression: motor

A

tricep, wrist ext

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5
Q

C7 compression: sensory/pain

A

upper arm to fingers 2+3

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6
Q

MC cervical disc herniation

A

C6-7 (C7 nerve root compressed)

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7
Q

C5 compression: sensory/pain

A

lateral shoulder

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8
Q

C6 compression: sensory/pain

A

lateral arm to thumb

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9
Q

C7-T1 disc hernation compresses what root

A

C8

2nd MC cervical compression

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10
Q

C8 compression: motor

A

hand intrinsics

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11
Q

C8 compression: sensory and pain

A

4+5 fingers

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12
Q

cervical root compression dx

A

MRI + PE

if unclear EMG

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13
Q

cervical spondylosis - define

A

degenerative progress that narrows spinal canal + neuralforamen

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14
Q

cervical myelopathy - define, sx

A 
progression of cerv spondy = motor, sensory, reflex problems
clumsiness/fine motor control
LE spasticity
hyperflexia
stocking glove (sensory)
\+HOFFMAN
inverse radial reflex
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15
Q

ALS v myelopathy

A

sensory changes NOT in ALS

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16
Q

cervical myopathy

A

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

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17
Q

cervical myopathy tx

A

usually surgery decompression- prevents it from getting worse

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18
Q

cervical myopathy left untreated leads to

A

paralysis… progressive spinal cord narrowing

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19
Q

leading cause of disability for <45 yo

A

back pain

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20
Q

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

A

1% each

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21
Q

where is arthritis in back

A

facet joints

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22
Q

acute, sub-acute, chronic back pain timeline

A

<6 week, <3mo, >3mo

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23
Q

distinguish new v old compression fx - imaging modality

A

MRI

24
Q

radiculopathy (type of nerve root syndrom) sx

A

mild back pain, radiates down leg

coughing/valsalva elicits pain

25
Q

nerve root syndrome sx

A

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

26
Q

L4 nerve - motor

A

quad weakness

27
Q

L4 nerve - pain

A

ant thigh pain

28
Q

L4 nerve - sensation

A

decreased in medial malleous and lateral foot

29
Q

L5 - motor

A

tibalis anterior (foot drop)

30
Q

L5 - sensation

A

dec top of foot to big toe

31
Q

L5 - pain

A

posterior thigh, wraps to shin below knee

32
Q

MC HLDs

A

L4-5, effecting L5 (50%)

L5-S1, effecting S1 (50%)

33
Q

S1 - pain

A

posterior leg to little toe side of foot

34
Q

S1 -sensation

A

lateral malleolus + lateral foot

35
Q

S1 - motor

A

plantar flexion weakness

36
Q

HLD tx

A
  • pain management - no surgery
  • self-resolves - disc dries up
  • need 4 weeks conservative therapy before MRI
37
Q

degenerative spine dz risk factors

A 
smoking
osteoporisis
age
trauma
poor core strength
38
Q

lumbar spinal stenosis sx

A

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

39
Q

lumbar spinal stenosis imaging

A

xray - ht loss,, alignment

MRI - 2nd, but can be + in asymp

40
Q

lumbar spinal stenosis tx

A

conservative
epidural steroid injections
elective surgery

41
Q

spondylolistesis tx

A

most need surgery (fusion)

42
Q

degenerative scoliosis hx

A

past other joint replacements , chronic back pain

43
Q

degenerative scoliosis tx

A

PT - prevent from getting worse

surgery

44
Q

cauda equina sx

A

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

45
Q

cauda equina cause

A
  • massive midline HD
  • tumor, infection, trauma
  • hematoma (lovenox)
46
Q

cauda equina

A

surgical emergency

47
Q

epidural abcess epi

A

DM, IV drugs

48
Q

epidural abcess sx

A

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

49
Q

epidural abcess workup

A

cbc, esr, blood cultures

50
Q

epidural abcess tx

A

PICC line abx and send home if reliable and not neuro sx

urgency decompression surgey if neuro sx or can’t return

51
Q

compression fx epi

A

postmenopausal white women
chronic steroid
tobacco use
obesity

52
Q

compression fx signs

A

tender to palpation

back pain

53
Q

compression fx tx

A

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

54
Q

spinal mets sx

A

back pain, legs feeling heavy, persists when laying down

hx Ca

55
Q

spinal mets tx

A

surgery - palliative (leg weakness tx) if appropriate

otherwise conservative

Clin Med (12 decks)

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