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3 Neurology > Neurosurgery Module- Spine > Flashcards

Neurosurgery Module- Spine Flashcards

1
Q

what parts of the spinal cord contain a lateral horn?

A

thoracic and upper lumbar spine

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2
Q

what does the lateral horn contain?

A

sympathetics

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3
Q

dermatome for medial malleolus?

A

L4

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4
Q

dermatome for toes 4 + 5 + lateral malleolus?

A

S1

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5
Q

dermatome for dorsum of the foot and toes 1-3

A

L5

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6
Q

what vertebrae have short and bifid spinous processes

A

C3-C5

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7
Q

most common locations for lumbar disc herniation?

A

L4/5

L5/S1

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8
Q

most common direction of a disc prolapse? what nerve will be affected from this?

A

posterolateral

will affect the lower nerve

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9
Q

what is a radicuopathy?

A

dysfunction of a nerve root causing a dermatomal sensory deficit with weakness of the affected nerve’s muscle groups

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10
Q

describe sciatic pain?

A

shooting pain from bum down to posterior leg/knee

exaggerated by valsalva

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11
Q

presentation of a prolapsed L5/S1 disc with S1 damage?

A

pain along posterior thigh with radiation to heel
weakness of plantar flexions
sensory loss in lateral foot
reduced/absent ankle jerk

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12
Q

pain in anterior thigh and wasting of the quad muscles and a reduced knee jerk is likely to indicate what nerve root’s pathology?

A

L4

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13
Q

what would make you do a discectomy?

A 
failure of physio and drugs
pain
central disc prolapse
tumour
neuro deficit
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14
Q

bilateral sciatica indicates a central disc prolapse T or F

A

T

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15
Q

a disc prolapse where can cause cauda equina syndrome?

A

L4/5 midline herniation

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16
Q

causes of cauda equina?

A 
prolapsed lumbar disc
tumour compression
trauma
infection
haematoma
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17
Q

Ix for cauda equina?

A

MRI lumbosacral spine

PR exam

18
Q

Tx for cauda equina syndrome from disc herniation/

A

discectomy

19
Q

Tx for cauda equina syndrome from fracture?

A

decompression + fixation

20
Q

symptomatic lumbar spinal stenosis most commonly occurs at what levels?

A

L4/5

L3/4 is next most common

21
Q

causes of spinal stenosis

A

hypertrophy of facet joints and ligamentum flavum
protruding intervertebral discs
spondylolisthesis

22
Q

presentation of spinal stenosis?

A 
unilateral burning hip/buttocks/leg pain 
insidious onset
relieved by sitting/lumbar flexion
better walking downhill
neurogenic intermittent claudication
23
Q

Ix of neurogenic claudication?

A

MRI lumbosacral spine

24
Q

surgical Tx of lumbar spinal stenosis

A

lumbar laminectomy

25
Q

pathological process in cervical spondylosis?

A

degenerative arthritis involving cervical spine and IV discs

26
Q

does a radiculopathy cause UMN or LMN signs

A

LMN

27
Q

clinical features of a cervical spondylosis?

A

radiculopathy

myelopathy

28
Q

classic radiographic appearance of cervical spondylosis?

A

narrowing of disc space

osteophytes

29
Q

Tx of cervical spondylosis?

A

laminectomy if due to osteophytes

discetomy if disc prolapse

30
Q

does myelopathy cause UMN or LMN signs?

A

UMN

31
Q

symptoms are more prominent where in degenerative cervical myelopathy

A

lower limbs hence FALLS

32
Q

presentation of degenerative cervical myelopathy?

A

imbalance of gait -> falls
clumsy hands
non-dermatomal pain
weakness

33
Q

examination findings of cervical myelopathy?

A 
weakness
hyperreflexia
spasticity
\+ve babinski and hoffman's signs
loss of dexterity
34
Q

Ix for cervical myelopathy?

A

MRI c spine

35
Q

cause of anterior cord syndrome?

A

infarction of the area supplied by the anterior spinal artery

36
Q

presentation of anterior cord syndrome?

A

BELOW the level of injury:
paralysis
loss of pain
temperature

37
Q

what cord functions are unaffected in anterior cord syndrome?

A

proprioception

vibration sensation

38
Q

presentation of a complete cord transection?

A

spinal shock THEN UMN symptoms

39
Q

ipsilateral UMN paralysis and contralateral loss of pain and temp sensation below the level of the lesion indicates what condition..

A

brown sequard syndrome

40
Q

bilateral upper limb weakness with some lower limb weakness is indicated by what condition and why?

A

central cord syndrome

the fibres for the arms are more medial to that for the legs so a central cord lesion will affect them more

3 Neurology (41 decks)

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