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Y3 Neurology > Spinal Cord Conditions > Flashcards

Spinal Cord Conditions Flashcards

1
Q

is increased tone an upper or lower MN sign

A

UMN

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2
Q

are fasciculation an upper or lower MN sign

A

LMN

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3
Q

is early atrophy an upper or lower MN sign

A

LMN

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4
Q

is spasticity an upper or lower MN sign

A

UMN

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5
Q

are absent or decreased reflexes an upper or lower MN sign

A

LMN

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6
Q

is clonus an upper or lower MN sign

A

UMN

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7
Q

are upgoing plantars upper or lower MN sign

A

UMN

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8
Q

what ages are red flags for back pain

A

over 60 or under 20 yr

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9
Q

back pain that wakes you up in the night is a red flag for what

A

cancer and infection

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10
Q

what region of the back having pain is a red flag

A

thoracic

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11
Q

what are the common ages of mechanical back pain presentation

A

20 to 55 yr

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12
Q

mechanical back pain….
is more stiff in the morning/night
resolves with rest/movement

A

mechanical back pain is more stiff in the morning and resolves with rest

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13
Q

what is a radiculopathy

A

pinched nerve root

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14
Q

does a radiculopathy cause a sensory or motor problem

A

both (pain and weakness)

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15
Q

does a radiculopathy have a myotomal or dermatomal distribution

A

pain follows dermatomal distribution, weakness follows myotomal distribution

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16
Q

does a radiculopathy cause UMN or LMN signs?

A

LMN signs

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17
Q

what is a myelopathy

A

pinched spinal cord

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18
Q

does a myelopathy cause UMN or LMN signs

A

UMN signs

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19
Q

what muscle jerk reflex tests for a C6 radiculopathy

A

brachioradialis reflex

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20
Q

what muscle jerk reflex tests for a C7 radiculopathy

A

triceps reflex

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21
Q

C6 is responsible for flexing/extending the wrist

C7 is responsible for flexing/extending the wrist

A

C6 extends wrist

C7 flexes wrist

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22
Q

is C6 or C7 responsible for extending the fingers

A

C7

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23
Q

what is the pathology of a lumbar disc prolapse

A

nucleus pulposus herniates through tear in annulus, compresses adjacent nerve roots

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24
Q

lumbar disc prolapses occur in younger and old age groups. what is the common mechanism in a younger patient?

A

strain eg. carrying heavy load

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25
lumbar disc prolapses occur in younger and old age groups. what is the common mechanism in a older patient?
spondylosis degeneration
26
does a lumbar disc prolapse cause UMN or LMN signs?
LMN
27
would a paramedian (posterolateral) prolapse compress the traversing nerve below or above the level of prolapse?
below level of prolapse
28
would a extraforaminal (lateral) prolapse compress the traversing or exiting nerve
exiting nerve
29
what effect does a lumbar disc prolapse have on leg reflexes
may be present or diminished
30
what is the general presentation of a lumbar disc prolapse
dermatomal unilateral leg pain
31
can a lumbar disc prolapse cause weakness
it can do
32
what nerve root is affected in a lumbar prolapse causing: anterior thigh pain decreased knee jerk anterior thigh/knee/medial lower leg paraesthesia
L4
33
what nerve root is affected in a lumbar prolapse causing: posterior thigh pain radiating to the heel weak plantar flexion lateral foot sensory prob decreased ankle jerk
S1
34
what nerve root is affected in a lumbar prolapse causing: posterior thigh pain radiating to big toe weak dorsiflexion sole/big toe sensory prob normal reflexes
L5
35
what is the 1st line Mx of a lumbar disc prolapse
conservative eg. PT, NSAID
36
what is the 2nd line management of a lumbar disc prolapse
discectomy
37
what feature of the presentation of a lumbar disc prolapse / sciatica warrants quick investigation
bilateral symptoms
38
what is cervical spondylosis
disc degeneration causing a radiculopathy or myelopathy
39
what is the pathology of cervical myelopathy
central cervical disc prolapse compressing SC
40
what age is cervical myelopathy commonest in
elderly
41
what is the initial presentation of cervical myelopathy
bilateral non-dermatomal finger pain/ clumsy/ tingling
42
in cervical myelopathy, after bilateral non-dermatomal finger pain/ clumsy/ tingling, how would symptoms progress
fine motor loss spastic leg weakness foot drop
43
is hoffman's sign in UMN or LMN lesions
UMN
44
investigations for cervical myelopathy
cervical mri
45
what is seen on mri in cervical myelopathy
disc degeneration, ligament hypertrophy
46
what is the management of cervical myelopathy
decompressive surgery to present progression
47
lumbar disc prolapses can cause cauda equina synd, what level is cauda equina most associated with
L4/5 midline prolapse
48
investigations for cauda equina synd
PR + MRI
49
what is the management of cauda equina due to a lumbar disc prolapse
discectomy
50
what is the commonest level effected by lumbar spinal stenosis
often L4/5
51
is lumbar spinal stenosis a radiculopathy
no
52
is lumbar spinal stenosis a progressive condition
yes
53
what is the name of the symptoms specific to lumbar spinal stenosis
neurogenic claudication
54
describe neurogenic claudication distribution, characters, exacerbating and relieving factors
``` uni/bilateral hip/buttock/leg burn worse standing/extending back relief uphill/flex/sit ```
55
is neurogenic claudication dermatomal or myotomal
dermatomal
56
investigations for lumbar spinal stenosis
mri
57
1st line mx of lumbar spinal stenosis
conversative
58
2nd line mx of lumbar spinal stenosis
decompression laminectomy
59
what is the mechanism of anterior cord syndrome
anterior spinal artery infarct
60
is anterior cord syndrome chronic or acute
acute
61
what is the presentation of anterior cord syndrome
complete motor loss loss of pain and temperature sensation intact dorsal column
62
what modalities are unaffected by anterior cord syndrome
proprioception, vibration
63
how does a complete cord transection initially present
spinal shock flacid arreflexic paralysis
64
what is the mechanism of brown sequard syndrome
cord hemisection
65
what is the aetiology of brown sequard synd
trauma, demyelination
66
what is the presentation of brown sequard synd
ipsilateral loss of motor + proprioception + fine touch below lesion contralateral loss of pain + temp 2 segments below lesion
67
is brown sequard an acute or chronic condiotn
acute
68
is central cord syndrome acute or chronic
acute
69
what is the aetiology of central cord syndrome
syringomelia tumour extension trauma to stenotic neck
70
how does central cord synd present
bilateral distal upper limb weakness | cape like spinothalamic loss (pain + temp)
71
is the lower limb effected in central cord synd
no
72
is the dorsal column effected in central cord synd
no
73
what is the commonest type of extradural tumour
met (lytic)
74
management of spinal extradural bone met
IV dexamethasone + radiotherapy
75
management of primary spinal intradural bone tumour
surgical excision

Y3 Neurology (23 decks)

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