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Neurology System > Surgical Diseases of the Spinal Cord and Nerve Roots > Flashcards

Surgical Diseases of the Spinal Cord and Nerve Roots Flashcards

1
Q

How many cervical vertebrae are there?

A

7

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2
Q

How many spinal nerves are there?

A

8

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3
Q

How many thoracic vertebrae are there?

A

12

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4
Q

How many thoracic spinal nerves are there?

A

12

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5
Q

How many lumbar vertebrae are there?

A

5

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6
Q

How many lumbar spinal nerves are there?

A

5

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7
Q

What type of joint is found between each vertebrae?

A

Intervertebral disc

Fibrous joint

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8
Q

Where is the nucleus pulposus located?

A

In the centre

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9
Q

Where is the annulus fibrosus located?

A

On the periphery of the nucleus pulposus

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10
Q

What structures do you pass through when performing a Lumbar puncture?

A

Supraspinal ligament, Interspinal ligament, Ligamentum flavum, dura

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11
Q

What is the 1st pop heard on a LP?

A

Going through ligamentum flavum

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12
Q

What is the 2nd pop on LP?

A

Going through the dura matter

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13
Q

Whats does the anterior horn of the spinal cord contain

A

Motor cell ganglia (cell bodies)

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14
Q

Where does the spinal cord extend from and to?

A

C1-L2

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15
Q

Where is a LP typically performed?

A

L4/L5

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16
Q

What does the spinal cord end as?

A

Cornus medularis

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17
Q

What does the spinal cord nerve extend as?

A

Cauda equina

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18
Q

Where does the spinal cord terminate?

A

Filum terminale

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19
Q

What is the myotome for C5?

A

Elbow flexors

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20
Q

What is the myotome for C6?

A

Wrist extensors

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21
Q

What is the myotome for C7?

A

Elbow extensors

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22
Q

What is the myotome for C8?

A

Finger flexers

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23
Q

What is the myotome for T1?

A

Finger abduction

Intrinsic finger muscles

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24
Q

What is the myotome for L2?

A

Hip flexors

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25
Q

What is the myotome for L3?

A

Knee extensors

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26
Q

What is the myotome for L4?

A

Ankle dorsiflexors

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27
Q

What is the myotome for L5?

A

Big toe extensors

28
Q

What is the myotome for S1?

A

Ankle Plantar Flexors

29
Q

What is a myotome?

A

Group of muscles that a single nerve innervates

30
Q

What is a dermatome?

A

An area of the skin supplied by nerves from a single spinal root

31
Q

Is weakness present in UMN or LMN lesions?

A

Both

32
Q

Is atrophy present in UMN of LMN lesions?

A

LMN

33
Q

Are reflexes increased in UMN or LMN lesions?

A

UMN

34
Q

Are reflexes decreased in UMN or LMN lesions?

A

LMN

35
Q

Is tone increased in UMN or LMN lesions?

A

UMN

36
Q

Are fasiculations present in UMN or LMN lesions?

A

LMN

37
Q 
o	Weakness in elbox below 
o	Sensory level at C6
o	Increased tone in legs 
o	Brisk reflexes 
o	Babrinski +ve 
What is the problem?
A

Myelopathy - UMN - neurlogical deficit due to compression of the spinal cord

38
Q

What are the categories of problems concerning the spinal cord?

A 
Degenerative 
Congenital 
Trauma 
Infection 
Tumour
39
Q

What is a disc prolapse?

A

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

40
Q

What is the investigations for disc prolapse?

A

MRI

41
Q

Who does disc prolapse tend to affect?

A

Younger patients

42
Q

What are the symptoms of disc prolapse?

A

Acute onset pain
Acute pain down leg/arm
Numbness (sensory) and weakness (motor) in distribution of nerve root involved

43
Q

What is the management for disc prolapse?

A

Rehabilitation
Nerve root injections
Lumbar/cervical discectomy

44
Q

Is cauda equina syndrome a medical emergency?

A

Yes

45
Q

What are the red flag symptoms for cauda equina syndrome?

A

Bilateral sciatica
Saddle anaethesia
Urinary dysfunction

46
Q

What does cauda equina syndrome require urgently?

A

MRI

47
Q

What is the treatment for cauda equina syndrome?

A

Emergency lumbar discectomy

48
Q

What is cervical spondylosis?

A

Umbrella term for degenerative changes in cervical spine leading to spine and nerve root compression

49
Q

What is lumbar spinal stenosis?

A

Image result for lumbar spinal stenosiswww.spine-health.com

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back,

50
Q

What are the symptoms of lumbar spinal stenosis?

A

Pain down both legs (spinal claudication)

Worsening on walking/standing and relieved by sitting or bending forward

51
Q

What is the treatment or lumbar spinal stenosis?

A

Lumbar laminectomy

52
Q

What is a lumbar laminectomy?

A

Surgical procedure that creates space by removing the lamina
Enlarging the spinal canal to relieve pressure on the cord

53
Q

What % of spinal tumours are intradural?

A

40%

54
Q

What % of tumours are extra dural?

A

55%

55
Q

What % of tumours are intramedullary?

A

5%

56
Q

Where are common primary sites for spinal cord tumours?

A

Lung
Breast
Prostate

57
Q

If the patient has a known cancer and presents with back pain what should be ordered immediately?

A

MRI

58
Q

What is osteomyelitis?

A

Infection within vertebral body

59
Q

What is discitis?

A

Infection of intervertebral disc

60
Q

What is an epidural abscess?

A

Infection in the epidural space

61
Q

What are the 3 main symptoms for an epidural abscess?

A

Back pain
Pyrexia
Focal Neurology

62
Q

What are the risk factors for epidural abscess?

A

IV drug abuse
Diabetes
Chronic renal failure
Alcoholism

63
Q

What are the responsible organisms for epidural abscess?

A

Staph aureus, streptococcus, E.coli

64
Q

What is the treatment for epidural abscess?

A

Urgent surgical decompression

Long term IB Antibiotics

65
Q

What are the risk factors for oesteomyelitis?

A

IV drug abuse, diabetes, chronic renal failure, alco

Neurology System (35 decks)

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