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Neurology > Spine and Nerve Injuries > Flashcards

Spine and Nerve Injuries Flashcards

1
Q

What is cauda equina syndrome?

A

Nerve roots at the base of the spine are compressed

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2
Q

What is the most common cause of cauda equina syndrome?

A

Herniated disc L4/5 or L5/S1

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3
Q

What is the presentation of cauda equina?

A

Saddle anaesthesia
Bilateral sciatica
Incontinence
Bilateral motor weakness in legs
Reduced anal tone on PR exam

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4
Q

What is the gold standard diagnosis for cauda equina?

A

MRI whole spine to localise lesion

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5
Q

What test indicates a problem at L4?

A

Femoral stretch test

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6
Q

What is the gold standard management of cauda equina?

A

Lumbar decompression surgery

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7
Q

What does HORSETAIL stand for in cauda equina?

A

Orgasm changes
Retention
Sciatica
Erectile dysfunction
Tone changes
Altered sensation
Inability to stop
Leakage

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8
Q

What is carpal tunnel syndrome?

A

Compression of the median nerve in the carpal tunnel

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9
Q

What is the median nerve roots?

A

C5-T1

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10
Q

What are some risk factors for carpal tunnel syndrome?

A

Obesity
Pregnancy
RSI
DM
Acromegaly

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11
Q

What fingers are affected in carpal tunnel?

A

Thumb
Index
Middle fingers

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12
Q

What muscles can waste in cauda equina?

A

Thenar

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13
Q

What are some tests for cauda equina?

A

Phalens - reverse prayer sign causes symptoms
Tinels - tapping over median nerve causes symptoms
Flick sign - patient makes flicking movement of wrist to alleviate symptoms

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14
Q

What is the gold standard test for diagnosis of carpal tunnel?

A

EMG shows slowed conduction over the median nerve

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15
Q

What is the management of carpal tunnel?

A

Stretching and wrist splints
Oral prednisolone
Resect transverse carpal ligament

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16
Q

What is damaged in foot drop?

A

Common peroneal nerve

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17
Q

What is there weakness of in foot drop?

A

Ankle dorsiflexion

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18
Q

What are the nerve roots of the sciatic nerve?

A

L4-S3

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19
Q

What does the sciatic nerve split into at the knee?

A

Tibial and common peroneal

20
Q

What is charcot marie tooth syndrome?

A

A group of inherited diseases which affect peripheral motor and sensory nerves

21
Q

What is the ABCDE aetiology of CMT?

A

Alcohol
B12 deficiency
Cancer and CKD
Diabetes and drugs
Every vasculitis

22
Q

What are some presentations of CMT?

A

High foot arches - pes cavus
Hammer toes
Inverted champagne bottle legs
Claw hand and foot drop

23
Q

What is anterior cord syndrome?

A

Damage to the anterior 2/3rd of the spinal cord and posterior part is spared

24
Q

What is the most common cause of anterior cord syndrome?

A

Ischaemia of the anterior spinal artery

25
Q

What is the presentation of anterior cord syndrome?

A

Bilateral weakness - quadriplegia or paraplegia
Bilateral loss of pain and temperature
Autonomic dysfunction

26
Q

What are some investigations for anterior cord syndrome?

A

MRI
LP
ECHO

27
Q

What are the nerve roots of the radial nerve?

A

C5-T1

28
Q

What are the most common causes of radial nerve injuries?

A

Humerus fractures or excessive pressure on the nerve

29
Q

What nerve is damaged in claw hand?

A

Ulnar nerve

30
Q

What nerve is damaged for winged scapula?

A

Long thoracic nerve

31
Q

What are the defects of Brown Sequard?

A

Ipsilateral loss of position, light touch and vibration at the level of the lesion
Contralateral loss of pain and temperature below the level of the lesion

32
Q

What is GBS?

A

Ascending acute demyelinating polyneuropathy following GI/ URT infection, most commonly C. jejuni

33
Q

What are targeted in GBS?

A

PNS schwann cells

34
Q

What are some symptoms of GBS?

A

Ascending weakness - lower limbs first
Loss of knee jerk
Flaccid paralysis
Facial weakness and droop
Hypotonia

35
Q

What is the diagnosis for GBS?

A

Nerve conduction studies show reduced velocity
LP - isolated finding of raised protein
Brighton criteria

36
Q

What is the management for GBS?

A

IV immunoglobulins
Plasma exchange
Monitor vital capacity and breathing rate

37
Q

How does diabetic neuropathy present?

A

Glove and stocking sensory and/ or pain loss
Proximal weakness

38
Q

What is the most common type of diabetic neuropathy?

A

Distal symmetrical sensory neuropathy

39
Q

What can be offered for pain relief in diabetic neuropathy?

A

Gabapentin or Pregabalin

40
Q

What nerve roots are the brachial plexus?

A

C5-C8 and T1

41
Q

What is Erb’s palsy?

A

dermatomal sensory loss in C5-C6 showing waiters tip sign

42
Q

What is Klumpke’s palsy?

A

Dermatomal sensory loss in C8-T1 distribution

43
Q

What is neurofibromatosis?

A

Loss of function of tumour suppressor genes causing benign tumour growth

44
Q

What is the inheritance of neurofibromatosis?

A

Autosomal dominant

45
Q

What are some presentations of neurofibromatosis?

A

Cafe au lait spots
Lisch nodules
Scoliosis
HTN
Learning difficulty
Epilepsy
Meningiomas
Posterior lens opacities
Astrocytomas

Neurology (12 decks)

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