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The Nervous System: Pathology > Surgical diseases of the spinal cord and nerve roots > Flashcards

Surgical diseases of the spinal cord and nerve roots Flashcards

1
Q

What is the anatomy of the spinal cord

A

Extends C1-L2, the continues as the conus medularis and further cause equina

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2
Q

What is the sigs in an upper motor neurone lesion

A

Weakness (below lesion level)
Increases reflexes
Increased tone
Babinski present

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3
Q

What is the signs in a lower motor neurone lesion

A 
Weakness
atrophy 
decreased reflexes
decreased tone 
fasciculations 
numbness
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4
Q

What are five factors that can affect the spine

A

Degenerative

Tumour

Infection

Trauma - disc prolapse

Congenital - lumbar spinal stenosis

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5
Q

What occurs in a disc prolapse

A

Acute herniation of intervertebral disc causing compression of spinal roots or spinal cord

(trauma affecting younger people_

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6
Q

What is the presentation of disc prolapse

A

Acute onset pain

Acute pain down leg/arm

Numbness and weakness in distribution of nerve root involved

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7
Q

What two parts of the spinal cord does disc prolapse occur

A

Cervical

Lumbar

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8
Q

What is it called when disc prolapse occurs centrally in the lumbar region

A

Cauda equina syndrome

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9
Q

What is the red flag symptoms of cauda equina syndrome

A

Bilateral sciatic (pain due to compression)

Saddle anaesthesia (loss of sensation in buttocks area)

Urinary dysfunction

(presents as an emergency)

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10
Q

How do you diagnose disc prolapse/cauda equina syndrome

A

Clinically

MRI

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11
Q

What is the management of cauda equina syndrome

A

Emergency lumbar discectomy

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12
Q

What is the management of disc prolapse

A

Rehabilitation
Nerve root inject
Lumbar/cervical discectomy

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13
Q

What occurs in degenerative spines

A

Loss of spinal structure

Mostly seen in older patients

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14
Q

What are potentially causes of degenerative spine

A

Disc prolapse

Ligamentum hypertrophy

Osteophyte formation

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15
Q

What occurs in osteophyte formation

A

bone spurs are bony projections that form along joint margins

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16
Q

What can a degenerative spine cause

A

Myelopathy

Radiculopathy

17
Q

What is cervical spondylosis

A

Degenerative changes in cervical spine leading to spine and nerve root compression
(presents with either myelopathy/radiculopathy)

18
Q

What is the management of cervical spondylosis

A

Conservation if no or mild myelopathy

Surgery for progressive moderate to severe myelopathy

19
Q

What is the presentation of lumbar spinal stenosis

A

Pain down both legs (spinal claudication)

Worse on walking/standing and relived by sitting or bending forward

20
Q

What is the management of lumbar spinal stenosis

A

Lumbar laminectomy (remove the back of a vertebra)

21
Q

What is the percentage distribution of tumours affecting the spinal cord

A

5% - Intramedullary

40% - Intradural

55% - Extradural

22
Q

What is examples of intramedullary tumours affecting the spine

A

Astrocytome
Ependymoma
Teratoma
Hemangioblastoma

23
Q

What is examples of intradural tumours affecting the spine

A

Meningioma
Neurofibroma
Lipoma

24
Q

What is examples of extradural tumours affecting the spine

A

Metastases

  • Lung
  • breast
  • Prostate

Primary bone tumours

  • chrodomas
  • osteoblastomas
  • osteiud osteoma
25
Q

What is the presentation of a malignant cord compression

A

(known cancer)
Pain
Weakness
Spinchter disturbance

26
Q

What is the management of malignant cord compression

A

Urgent MRI

Surgical decompression

Radiotherapy

27
Q

What is three examples of spinal infections

A

Osteomyelitis

Discitis

Epidural abscess

28
Q

What occurs on osteomyelitis

A

Infection within the vertebral body

29
Q

What is the risk factors for osteomyelitis

A 
IV drug abuse 
Diabetes 
Chronic renal failure 
Alcoholism 
AIDS
30
Q

What is the management of osteomyelitis

A

Antiobiotics

Surgery

31
Q

What is Discitis

A

Infection of the vertebral disc

32
Q

How do diagnose epidural abscess (infection in the epidural space)

A

Urgent MRI

33
Q

What is the triad of symptoms of epidural abscess

A

Back pain
Pyrexia
Focal neurology

34
Q

What is the risk factors for epidural abscess

A

IV drug abuse
Diabetes
Chronic renal failure
Alcoholism

35
Q

What organisms are responsible for epidural abscess

A

Staph aureas
Streptococcus
E.Coli

36
Q

What is the management of epidural abscess

A

Urgent spinal decompression

Long term IV antibiotics

37
Q

Spinal cord

A 
C1-7
T1-12
L1-5
S1-5
Coccyx fused -4
= 33 vertebrae

The Nervous System: Pathology (25 decks)

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