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Y3 Neurology > Spinal Cord Conditions > Flashcards

Spinal Cord Conditions Flashcards

1
Q

is increased tone an upper or lower MN sign

A

UMN

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2
Q

are fasciculation an upper or lower MN sign

A

LMN

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3
Q

is early atrophy an upper or lower MN sign

A

LMN

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4
Q

is spasticity an upper or lower MN sign

A

UMN

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5
Q

are absent or decreased reflexes an upper or lower MN sign

A

LMN

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6
Q

is clonus an upper or lower MN sign

A

UMN

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7
Q

are upgoing plantars upper or lower MN sign

A

UMN

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8
Q

what ages are red flags for back pain

A

over 60 or under 20 yr

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9
Q

back pain that wakes you up in the night is a red flag for what

A

cancer and infection

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10
Q

what region of the back having pain is a red flag

A

thoracic

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11
Q

what are the common ages of mechanical back pain presentation

A

20 to 55 yr

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12
Q

mechanical back pain….
is more stiff in the morning/night
resolves with rest/movement

A

mechanical back pain is more stiff in the morning and resolves with rest

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13
Q

what is a radiculopathy

A

pinched nerve root

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14
Q

does a radiculopathy cause a sensory or motor problem

A

both (pain and weakness)

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15
Q

does a radiculopathy have a myotomal or dermatomal distribution

A

pain follows dermatomal distribution, weakness follows myotomal distribution

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16
Q

does a radiculopathy cause UMN or LMN signs?

A

LMN signs

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17
Q

what is a myelopathy

A

pinched spinal cord

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18
Q

does a myelopathy cause UMN or LMN signs

A

UMN signs

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19
Q

what muscle jerk reflex tests for a C6 radiculopathy

A

brachioradialis reflex

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20
Q

what muscle jerk reflex tests for a C7 radiculopathy

A

triceps reflex

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21
Q

C6 is responsible for flexing/extending the wrist

C7 is responsible for flexing/extending the wrist

A

C6 extends wrist

C7 flexes wrist

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22
Q

is C6 or C7 responsible for extending the fingers

A

C7

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23
Q

what is the pathology of a lumbar disc prolapse

A

nucleus pulposus herniates through tear in annulus, compresses adjacent nerve roots

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24
Q

lumbar disc prolapses occur in younger and old age groups. what is the common mechanism in a younger patient?

A

strain eg. carrying heavy load

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25
Q

lumbar disc prolapses occur in younger and old age groups. what is the common mechanism in a older patient?

A

spondylosis degeneration

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26
Q

does a lumbar disc prolapse cause UMN or LMN signs?

A

LMN

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27
Q

would a paramedian (posterolateral) prolapse compress the traversing nerve below or above the level of prolapse?

A

below level of prolapse

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28
Q

would a extraforaminal (lateral) prolapse compress the traversing or exiting nerve

A

exiting nerve

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29
Q

what effect does a lumbar disc prolapse have on leg reflexes

A

may be present or diminished

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30
Q

what is the general presentation of a lumbar disc prolapse

A

dermatomal unilateral leg pain

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31
Q

can a lumbar disc prolapse cause weakness

A

it can do

32
Q

what nerve root is affected in a lumbar prolapse causing:
anterior thigh pain
decreased knee jerk
anterior thigh/knee/medial lower leg paraesthesia

A

L4

33
Q

what nerve root is affected in a lumbar prolapse causing:
posterior thigh pain radiating to the heel
weak plantar flexion
lateral foot sensory prob
decreased ankle jerk

A

S1

34
Q

what nerve root is affected in a lumbar prolapse causing:
posterior thigh pain radiating to big toe
weak dorsiflexion
sole/big toe sensory prob
normal reflexes

A

L5

35
Q

what is the 1st line Mx of a lumbar disc prolapse

A

conservative eg. PT, NSAID

36
Q

what is the 2nd line management of a lumbar disc prolapse

A

discectomy

37
Q

what feature of the presentation of a lumbar disc prolapse / sciatica warrants quick investigation

A

bilateral symptoms

38
Q

what is cervical spondylosis

A

disc degeneration causing a radiculopathy or myelopathy

39
Q

what is the pathology of cervical myelopathy

A

central cervical disc prolapse compressing SC

40
Q

what age is cervical myelopathy commonest in

A

elderly

41
Q

what is the initial presentation of cervical myelopathy

A

bilateral non-dermatomal finger pain/ clumsy/ tingling

42
Q

in cervical myelopathy, after bilateral non-dermatomal finger pain/ clumsy/ tingling, how would symptoms progress

A

fine motor loss
spastic leg weakness
foot drop

43
Q

is hoffman’s sign in UMN or LMN lesions

A

UMN

44
Q

investigations for cervical myelopathy

A

cervical mri

45
Q

what is seen on mri in cervical myelopathy

A

disc degeneration, ligament hypertrophy

46
Q

what is the management of cervical myelopathy

A

decompressive surgery to present progression

47
Q

lumbar disc prolapses can cause cauda equina synd, what level is cauda equina most associated with

A

L4/5 midline prolapse

48
Q

investigations for cauda equina synd

A

PR + MRI

49
Q

what is the management of cauda equina due to a lumbar disc prolapse

A

discectomy

50
Q

what is the commonest level effected by lumbar spinal stenosis

A

often L4/5

51
Q

is lumbar spinal stenosis a radiculopathy

A

no

52
Q

is lumbar spinal stenosis a progressive condition

A

yes

53
Q

what is the name of the symptoms specific to lumbar spinal stenosis

A

neurogenic claudication

54
Q

describe neurogenic claudication distribution, characters, exacerbating and relieving factors

A 
uni/bilateral 
hip/buttock/leg 
burn
worse standing/extending back
relief uphill/flex/sit
55
Q

is neurogenic claudication dermatomal or myotomal

A

dermatomal

56
Q

investigations for lumbar spinal stenosis

A

mri

57
Q

1st line mx of lumbar spinal stenosis

A

conversative

58
Q

2nd line mx of lumbar spinal stenosis

A

decompression laminectomy

59
Q

what is the mechanism of anterior cord syndrome

A

anterior spinal artery infarct

60
Q

is anterior cord syndrome chronic or acute

A

acute

61
Q

what is the presentation of anterior cord syndrome

A

complete motor loss
loss of pain and temperature sensation
intact dorsal column

62
Q

what modalities are unaffected by anterior cord syndrome

A

proprioception, vibration

63
Q

how does a complete cord transection initially present

A

spinal shock flacid arreflexic paralysis

64
Q

what is the mechanism of brown sequard syndrome

A

cord hemisection

65
Q

what is the aetiology of brown sequard synd

A

trauma, demyelination

66
Q

what is the presentation of brown sequard synd

A

ipsilateral loss of motor + proprioception + fine touch below lesion
contralateral loss of pain + temp 2 segments below lesion

67
Q

is brown sequard an acute or chronic condiotn

A

acute

68
Q

is central cord syndrome acute or chronic

A

acute

69
Q

what is the aetiology of central cord syndrome

A

syringomelia
tumour
extension trauma to stenotic neck

70
Q

how does central cord synd present

A

bilateral distal upper limb weakness

cape like spinothalamic loss (pain + temp)

71
Q

is the lower limb effected in central cord synd

A

no

72
Q

is the dorsal column effected in central cord synd

A

no

73
Q

what is the commonest type of extradural tumour

A

met (lytic)

74
Q

management of spinal extradural bone met

A

IV dexamethasone + radiotherapy

75
Q

management of primary spinal intradural bone tumour

A

surgical excision

Y3 Neurology (23 decks)

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