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Year 2 Neuro (JK) > Surgical diseases of the spinal cord and nerve roots > Flashcards

Surgical diseases of the spinal cord and nerve roots Flashcards

1
Q

List the number of each type of vertebrae eg cervical

A 
C1-7
T1-12
L1-5
S1-5
coccygeal
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2
Q

What are the 2 components of the vertebral disc

A

annulus fibrosis

nucleus pulposus

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3
Q

What is ligamentum flavum between?

A

pedicles

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4
Q

Name the 5 vertebral ligaments from posterior to anterior

A 
supraspinal 
interspinal
ligamentum flavum 
posterior longitudinal 
anterior longitudinal
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5
Q

What are the 2 pops heard on lumbar puncture?

A

ligamentum flavum and dura

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6
Q

Where does the spinal cord extend from and to?

A

C1-L2

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7
Q

4 ways to localise the lesion

A

pain
weakness
sensory
UMN vs LMN

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8
Q

List some of the symptoms of C6 spinal cord compression

A 
sensory loss at C6
increased tone in legs 
weakness in elbow below 
brisk reflexes 
Babinski +ve
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9
Q

What is a myelopathy? LMN or UMN?

A

neurological defecit due to compression of spinal cord

UMN

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10
Q

Symptoms of L4 nerve root lesion

A

pain down ipsilateral leg
numbness in L4 dermatome
weakness in ankle dorsiflexion
reduced knee jerk

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11
Q

Radiculopathy - what is it? UMN or LMN?

A

Compression of nerve root leading to dermatomal and myotomal defecits

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12
Q

What is a disc prolapse?

A

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

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13
Q

Disc prolapse -symptoms and age of patients

A

young patient
acute pain down leg/arm
numbness and weakness in distribution of nerve root involved

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14
Q

Diagnosis and treatment of disc prolapse

A

MRI

rehab, nerve root inject, lumbar/cervical discectomy

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15
Q

What occurs in central disc prolapse in lumbar region?

A

cauda equine syndrome

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16
Q

3 red flags of cauda equine syndrome

A

bilateral sciatica
saddle anaesthesia
urinary dysfunction

17
Q

What does cauda equine require?

A

emergency MRI

emergency lumbar discectomy

18
Q

3 things causing degenerative conditions of spinal cord

A

oseophyte formation
ligamentum hypertrophy
disc prolapse

19
Q

Define cervical spondylosis

A

umbrella term for degenerative change in cervical spine leading to spine and nerve root compression

20
Q

Would a patient with cervical spondylosis present with myelopathy or radiculopathy?

A

either or both

21
Q

Speed of onset of cervical spondylosis

A

months to years

22
Q

Management of cervical spondylosis

A

conservative - no/mild myelopathy
surgery if progressive or severe
anterior and posterior approach

23
Q

Symptoms of lumbar spine stenosis

A

pain down both legs - spinal claudication

worse on walking and relieved by sitting or bending forward

24
Q

Management of lumbar spine stenosis

A

lumbar laminectomy

25
Q

Examples of intramedullary tumours

A

astrocytomas, Teratoma, ependymoma, haemangioblastoma

26
Q

Examples of intradural tumours

A

meningioma, neurofibroma, lipoma

27
Q

Examples of extradural tumours

A

metastases eg breast, lung, prostate

primary bone tumour eg osteoblastoma

28
Q

Malignant cord compression symptoms

A

pain, weakness, sphincter disturbance

29
Q

If a patient with known cancer and developing back pain presents what would you do?

A

emergency MRI

30
Q

Management of malignant cord compression

A

decompression

radiotherapy

31
Q

osteomyelitis

A

infection within vertebra body

32
Q

discitis

A

Infection within vertebral disc

33
Q

epidural abscess

A

Infection in epidural space

34
Q

epidural abscess triad for emergency MRI

A

pyrexia
back pain
focal neurology

35
Q

Risk factors for epidural abscess

A

IVDA, diabetes, chronic renal failure, alcoholism

36
Q

Organisms causing epidural abscess

A

staph aureus, streptococcus, e coli

37
Q

Management of epidural abscess

A

urgent surgical decompression

long term antibiotics

38
Q

Risk factors of osteomyelitis

A

IVDU, alcohol, AIDS, chronic renal failure, diabetes

39
Q

Management of osteomyelitis

A

antibiotics

surgery if evidence of neurology

Year 2 Neuro (JK) (50 decks)

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