Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 NEUROLOGY > Spinal Cord and Root Dysfunction > Flashcards

Spinal Cord and Root Dysfunction Flashcards

1
Q

List the symptoms associated with dysfunction of the spinal cord and roots

A 
Pain
Sensory disturbance
Weakness
Sphincter dysfunction
Sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A lesion of the spinal cord affecting the cervical level would present with…

A

Involvement of arms

UMN or LMN symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A lesion of the spinal cord affecting the thoracic level would present with…

A

Arms not/minimally involved

UMN or LMN features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A lesion of the spinal cord affecting the lumbar level would present with…

A

Only legs involved

No UMN features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For UMN lesions and LMN lesions, outline the weakness distribution respectively

A

Corticospinal CENTRAL distribution (weak extensory in arms and weak flexors in legs)
Generalized, predominantly proximal, distal or focal. No preferential involvement of corticospinal innervated muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

For UMN lesions and LMN lesions, outline the pattern of sensory loss respectively

A

Central pattern

None - glove stocking, peripheral nerve or root distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

For UMN lesions and LMN lesions, outline the effect on deep tendon reflexes respectively

A

Increased/ brisk (unless very acute - flaccid)

Normal or decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

For UMN lesions and LMN lesions, outline the effect on muscle tone respectively

A

Increased

Normal or decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

For UMN lesions and LMN lesions, outline the effect on muscle bulk respectively

A

Sometime hypertrophy

Wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What types of pathology cause UMN lesion?

A

LESION IN SPINAL CORD OR BRAIN
Stroke
SOL
Spinal cord problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What types of pathology cause LMN lesion?

A

LESION IN SPINAL NERVE (AFTER CN NUCLEUS)
MND
Spinal muscular atrophy (lead poisoning, poliomyelitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Spinal cord dysfunction presenting with UMN symptoms suggests the position of the lesion is where on the spinal cord?

A

Central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spinal cord dysfunction presenting with LMN symptoms suggests the position of the lesion is where on the spinal cord?

A

Lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Brisk reflexes of the lower limb would suggest the lesion is coming from the lumbar spinal cord only? True/ False?

A

False

No lumbar spinal cord involvement as there is no UMN features at this level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

For UMN lesions and LMN lesions, state whether fasciculations are present, respectively

A

Absent

Present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

For UMN lesions and LMN lesions, outline the plantar response for each, respectively

A

Upgoing

Downgoing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

For UMN lesions and LMN lesions, state whether clonus is present, respectively

A

Present

Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which chart allows you to localise spinal cord lesions via dermatomes and myotomes?

A

ASIA chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which clinical symptoms would be suggestive of a cervical disc prolapse?

A 
Arm pain
Depends on level of lesion - think dermatomes and myotomes 
Numbness/ tingling along dermatome
Weakness along myotome
LMN symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which clinical symptoms would be suggestive of a thoracic disc prolapse? What is a common cause?

A 
Thoracic pain
Depends on level of lesion - think dermatomes and myotomes
Numbness/ tingling along dermatome
Weakness along myotome
Central causing myelopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which clinical symptoms would be suggestive of a lumbar disc prolapse?

A 
Leg pain
Depends on level of lesion - think dermatomes and myotomes
Numbness/ tingling along dermatome
Weakness along myotome
LMN symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Spinal claudication symptoms are typically continuous. True/ False?

A

False

Typically intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

List an exacerbating and relieving factor for spinal claudication

A

Mobilisation

At rest and bending forward (flexion) - ARTHROPOID posture

24
Q

List clinical features suggestive of spinal claudication

A

Dull achy pain (typically back of thighs/ calves)
Altered sensation
Heaviness/ weakness of limbs

25
Q

How does spinal claudication appear on imaging?

A

Whole canal is squashed and ligaments surround the canal are thick

26
Q

Chronic spinal claudication leads to…

A

Spinal stenosis

27
Q

What clinical feature would be more suggestive of vascular rather than spinal claudication? What investigation can be done to differentiate?

A

Absent peripheral pulses

ABPI

28
Q

What is cauda equina syndrome?

A

Emergency condition in which there is massive disc prolapse compressing all lumbosacral spinal roots

29
Q

How is cauda equina diagnosed?

A

MRI scan and PR exam

30
Q

Which clinical features are suggestive of cauda equina syndrome?

A 
Bilateral leg pain (can resolve) - S1
Perianal sensory loss to pinprick
Genital numbness
Erectile dysfunction
Painless urinary retention with overflow incontinence (no control or urgency) - S2-4
31
Q

List the red flag symptoms used for spinal conditions

A 
Bilateral leg pain
Thoracic back pain
Weight loss, night sweats, fever
Night pain
Sphincter disturbance
Perianal sensory loss
Age <20 or >55
History of carcinoma
Immunocompromised
Progressive neurological deficit
Trauma
32
Q

What is cervical myelopathy? Is it reversible?

A

Central disc prolapse in cervical spine, typically irreversible

33
Q

What are the presenting symptoms in a patient with cervical myelopathy?

A 
Finger tip paraesthesia progressing to 'numb clumsy hands' - usually bilateral
Difficulty with fine motor tasks
Dropping objects
Reduced mobility (FALLS)
Hypereflexia (legs jump at night)
34
Q

What two clinical signs should be checked for if cervical myelopathy is suspected?

A

UMN:

Hoffman sign: Finger reflex whereby flicking of the nail on the middle finger leads to flexion of the ipsilateral thumb
Lhermittes sign: Sudden sharp electric shock down all four limbs, especially on head movement

35
Q

Treatment for radiculopathy e.g. sciatica is typically conservative. True/ False?

A

True

Patients do not require surgery

36
Q

List some complications of spinal surgery

A 
Pain
Bleeding
Infection
CSF leak
Instability
Nerve injury/ paralysis
Failed back syndrome
Medical risks (DVT/ PE, chest, MI, drug reactions)
Cauda equine syndrome
Risk to life
37
Q

Outline the clinical features of failed back syndrome

A 
Recurrence, residual compression
Nerve injury
Altered joint mability/ instability
Fibrosis/ arachnoiditis
Infection
38
Q

List the main risk factors for failed back syndrome

A

Depression/ anxiety
Diabetes
Smoking
High BMI

39
Q

Outline management options for failed back syndrome

A 
Reoperation?
Antibiotics if infection
Anti-inflammatories
Anti-depressants
Physio
CBT
TENS
Spinal cord stimulation
Referral to chronic pain team
40
Q

What type of fracture is caused by rapid flexion to the spine, common in RTAs?

A

Burst fracture - crush injury to disc

41
Q

What acute spinal condition causes autonomic dysreflexia?

A

Spinal shock

42
Q

How does an epidural haematoma appear on imaging?

A

Long collection posterior to spinal cord

43
Q

A syrinx in the spinal cord is associated with what condition?

A

Syringomyelia - build up of CSF in spinal cord

44
Q

How does a syrinx appear on imaging?

A

Hyperdense mass in the spinal cord

45
Q

What is a chiari malformation?

A

Cerebellar tonsils displace downwards through the foramen mangnum

46
Q

Name 2 groups of people who are likely to have a disc herniation

A

Young patients carrying a heavy load

Older patient with degeneration or spondylosis

47
Q

A paramedian or posterolateral disc prolapse in L4/5 is likely to affect which nerve root?

A

L5

Traversing nerve root below the disc

48
Q

A lateral or extraforaminal disc prolapse in L4/5 is likely to affect which nerve root?

A

L4

Exiting nerve root leaving at level of prolapse

49
Q

What is a radiculopathy?

A

Dysfunction of nerve root resulting in dermatomal/ sensory deficit/weakness of muscle groups supplied

50
Q

Outline the management of cauda equina syndrome

A

Disectomy for herniated disc
Decompression and fixation for fracture
Haematoma evacuation

51
Q

How is spinal stenosis managed?

A

Conservation (physio, analgesia) 1st line

Laminectomy 2nd line

52
Q

What is cervical spondylosis? What can it lead to?

A

Reduction in water and fragmenting nucleus pulposus due to a degenerative arthritic process of cervical spine
Radiculopathy - LMN
Myelopathy - UMN

53
Q

What is the age of onset for cervical spondylosis?

A

Over 50yo

54
Q

How does cervical spondylosis appear on MRI scan?

A

Narrowing of disc space and osteophyte formation

55
Q

Outline the management for cervical spondylosis

A

Laminectomy (multilevel posterior compression)
Disectomy (anterior compression)
Foraminectomy (unilateral root compression)

Y3 NEUROLOGY (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions