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Neurology (SA) > Spinal disease > Flashcards

Spinal disease Flashcards

1
Q

Describe the difference between the clinical signs of a bladder with an UMN lesion compared to a LMN leson

A

UMN - tense distended bladder, difficult to express

LMN - floppy distended bladder, overflowing and dribbling

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2
Q

Name a drug that increases urethral tone

A

Phenylpropanolamine

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3
Q

Name a drug that decreases urethral tone

A

Prazosin

Diazepam

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4
Q

Name a drug that increases detrusor contraction

A

Bethanechol

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5
Q

Name a drug that decreases detrusor contraction

A

Propantheline bromide

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6
Q

What causes acute, non-compressive nucleus pulposus extrusion?

A

Trauma

exercise, RTA, fall from height

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7
Q

Is the herniated nucleus pulposus mineralised with Acute, non-compressive nucleus pulposus extrusion?

A

No mineralisation

Contusion only

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8
Q

What size and age dogs are predisposed to AA instability?

A

Toy breeds

Young dogs

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9
Q

What causes AA instability?

A

Congenital

Aplasia or hypoplasia of dens (part of axis/C2)

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10
Q

AA instability can be acute or chronic, causing waxing and waning of clinical signs. Give examples of what symptoms may be seen with this condition

A

Neck pain
Ataxia
Tetraparesis

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11
Q

How is AA instability treated?

A

Conservative Tx: splint for 6-12 weeks

Surgical: ventral stabilisation

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12
Q

What is cervical spondylomyelopathy or ‘Wobbler’s’?

A

Compression of the spinal cord and nerve roots

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13
Q

What breeds of dog are predisposed to Wobbler’s/cervical spondylomyopathy?

A

Rottweiler
Dobermann
Bassett Hound
Dalmatian

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14
Q

Wobbler’s causes paresis, ataxia, a short-stilted gait and muscle atrophy. Is it worse in the forelimbs or hindlimbs?

A

HLs

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15
Q

Wobbler’s is multifactorial. Give 2 examples of conditions that may lead to Wobbler’’s

A

Type II IVDD

Hypertrophy of spinal ligaments

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16
Q

What is the treatment for Wobbler’s cervical spondylmyelopathy?

A

Conservative: ant-inflm and rest
Treatment: surgical decompression or distraction-stabilisation

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17
Q

What is Chiari-like malformation?

A

Caudal displacement of cerebellum through foramen magnum

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18
Q

A Cavalier presents with a head tilt, scratching it’s neck, almost like an ‘air guitar’. What is your most likely diagnosis?

A

Chiari-like malformation

Syringomyelia - head tilt

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19
Q

What are the 3 types of Chiari-like malformation?

A

Hydromyelia - dilation of central canal
Syringomyelia - fluid filled cavity in spinal cord (head tilt)
Syringohydromyelia - both

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20
Q

Is surgery an option for Chiari like malformation treatment?

A

Possibly but high recurrence rate

Does not correct fluid filled cavities (syringomyelia)

21
Q

What drugs can be used for medical treatment of Chiari like malformation?

A

Analgesia - gabapentin, amantadine, paracetamol, opioids
NSAIDs or steroids
Drugs that reduce CSF production - omeprazole, furosemide

22
Q

What is degenerative myelopathy?

A

Progressive ataxia and paresis of HLs

Progresses to paralysis over 6-18 months

23
Q

Which section of the spine is usually affected by degenerative myelopathy? Is it symmetrical and painful?

A

T3-L3
Asymmetrical
Non-painful

24
Q

Degenerative myelopathy is a diagnosis of exclusion. What breeds are predisposed to degenerative myelopathy?

A

Boxer
German Shepherd
Corgi

25
Q

Is there a treatment for degenerative myelopathy?

A

No

Physio and analgesia to prolong QOL

26
Q

What is discospondylitis?

A

Infection of intervertebral discs and adjacent vertebrae

27
Q

Where in the spine is discospondylitis most common?

A

L7-S1

28
Q

Discospondylitis causes marked spinal pain and possible systemic signs of illness. What other infections is it associated with?

A

Urinary or prostate infections

29
Q

What is the treatment for discospondylitis?

A

Antibiotics for 8+ weeks

Analgesia

30
Q

What is the treatment for a fibrocartilaginous embolism and traumatic disc?

A

Physio, supportive care

No surgery required as nothing to remove

31
Q

What is the prognosis for fibrocartilaginous embolisms and traumatic discs?

A

Depends on extent of lesion

But often ambulatory within 2 weeks, recovered in 3 months

32
Q

How can a spinal fracture be stabilised before transporting to referral?

A

Splint

Or surgery

33
Q

What are the 5 grades of IVDD?

A 
Grade 1 - no deficits, just pain 
Grade 2 - paresis, ambulatory 
Grade 3 - paresis, non-ambulatory 
Grade 4 - paralysis
Grade 5 - no pain sensatin
34
Q

For what grades of IVDD is conservative treatment of 4-6 weeks recommended?

A

Grades 1-3

35
Q

For what grades of IVDD is a hemilaminectomy recommended?

A

Grades 4 + 5

36
Q

What are the two types of IVDD and how do they differ?

A

Type I - extrusion. Painful, in young chondrodystrophic breeds or older normal breeds, chondroid metamorphosis
Type II - protrusion. May have pain, in older normal breeds, fibroid metamorphosis

37
Q

Ischaemic myelopathies are peracute conditions where the blood supply to the spinal cord is interrupted. Is this condition painful? When does it typically occur?

A

Non-painful

Occurs at exercise usually

38
Q

Lumbosacral degenerative stenosis is degeneration of the lumbosacral junction and which spinal nerve?

A

L7

39
Q

What are the clinical signs of lumbosacral degenerative stenosis?

A 
Reluctance to exercise/go up stairs
Pain 
Proprioceptive deficits 
Muscle atrophy
Incontinence
40
Q

Lumbosacral degenerative stenosis is associated with which type of IVDD?

A

Type II (protrusion)

41
Q

What are the treatment options for lumbosacral degnerative stenosis?

A

Conservative - rest, analgesia (gabapentin)

Surgery - dorsal laminectomy, fusion or foraminotomy

42
Q

Meningomyelitis of unknown origin is a sub/acute, progressive condition that is painful and multifocal. What condition does it present similar to?

A

IVDD

43
Q

How is meningomyelitis of unknown origin diagnosed?

A

CSF - pleocytosis

MRI

44
Q

How is meningomyelitis of unknown origin treated?

A

Steroids or other immunosupressives

45
Q

What is the main symptom of steroid responsive meningitis-arteritis? In which age dogs does it typically present?

A

Neck pain

Young dogs 6-18 months

46
Q

What is seen on CSF analysis with steroid responsive meningitis-arteritis? (Acute and chronic)

A

Acute - neutrophilic pleocytosis

Chronic - mononuclear pleocytosis

47
Q

How is steroid-responsive meningitis-arteritis treated?

A

Steroids/immunosuppression

For 6-9 months

48
Q

What is spinal shock? Do animals recover?

A

Flaccid paralysis and loss of spinal reflexes following trauma
Yes- gradually reflexes return starting with anal tone

Neurology (SA) (8 decks)

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