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ADELE-Noodles of Neurology > Spine > Flashcards

Spine Flashcards

1
Q

Where are the two enlargements in the spinal cord?

A

Cervical

Lumbar

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2
Q

What is the name of the tapered cone shape where the spinal cord terminates?

A

Conus medullaris

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3
Q

What is the name of the thin connective tissue cord which is a continuation of the spinal cord after the conus medullar is?

A

Filum terminale

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4
Q

What is the film terminal anchored to?

A

Dorsum of the coccyx

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5
Q

What do the denticulate ligaments keep suspended?

A

the spinal cord in the canal

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6
Q

The dentriculare ligaments are formed from all three layers of the meninges TRUE/FALSE

A

FALSE

formed of pain and arachnoid tissue, attaches to dura

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7
Q

What are the 3 parts of the white matter?

A

Posterior (dorsal) column
Lateral column
Anterior (ventral) column

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8
Q

What are the 4 parts of the grey matter?

A

Left and Right posterior and anterior horns

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9
Q

What is the name of the band of nerve tissue connecting the hemispheres of the brain?

A

Commissure

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10
Q

Of the 3 major longitudinal spinal arteries there is one anterior and two posterior TRUE/FALSE

A

TRUE

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11
Q

Segmental arteries split into anterior and posterior ——– arteries

A

radicular

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12
Q

What is included in the epidural space?

A

Adipose tissue

Anterior/posterior epidural venous plexus

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13
Q

If there is damage to the extradural venous plexus what can be the sequalae?

A

Epidural haematoma which compresses spinal cord or caudal equina

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14
Q

Which part of the spinal vertebrae is responsible for wt bearing?

A

Vertebral body

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15
Q

Which two structures form the vertebral arch?

A

Pedicles

Laminae

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16
Q

What part of the spinal vertebrae serves as an attachment point for the muscles of the back?

A

Spinous process

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17
Q

TRUE/FALE

C3-5 have short and bifid spinous processes

A

TRUE

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18
Q

What is annulus fibrosis?

A

Outer ring consisting of concentric lamellae of fibrocartilage

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19
Q

What is nucleus pulposus?

A

Contained within the annulus fibrosis and consists mostly of water

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20
Q

What does the ligamentum flavum help to maintain?

A

Maintain posture and assist straightening the spine after flexion

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21
Q

Why does the ligamentum flavum appear yellow?

A

It is rich in elastin

22
Q

Why do you get LMN symptoms is the spinal disease is lateral?

A

As it is pressing on the nerve root

23
Q

What type of back pain does this describe?

Morning stiffness, resolves with movement and worse by prolonged sitting/rising from a seated position

A

Mechanical back pain

24
Q

When facet joint hypertrified patients get referred pain from the nerve supplying the facet joint that mimics sciatica. How can you differentiate the two?

A

The referred pain does not radiate below the knee

25
Q

Some of the Red flags for back pain?

A 
Age >60 or <20
Pain not improved by rest
Pain wakes patient at night
Urinary retention/incontinence &amp; faecal incontinence
Saddle anaesthesia
History of anaesthesia
History of malignancy
Unexplained wt loss or fever
Immunosupression or IV drug use
26
Q

What is lumbar disc herniation?

A

When nucleus herniates through a tear in the annulus ring and compresses adjacent nerve root

27
Q

What are the most common locations for lumbar disc herniation?

A

L4/5

L5/S1

28
Q

What is the most common direction of prolapse?

A

Paramedian herniated disc (aka posterolateral)

29
Q

What is radiculopathy?

A

Dysfunction of nerve root

dermatomal sensory deficit w weakness of muscle groups supplied by the nerve

30
Q

What is sciatica?

A

Pain along the sciatic nerve usually due to compression of its nerve roots (L4-S3)

31
Q

After how long of back pain do you scan?

A

6wks

32
Q

Why is caudal equina an emergency?

A

As persistent compression of nerve roots, 48h before complete and irreversible damage

33
Q

85% of sciatica resolves spontaneously TRUE/FALSE

A

TRUE

34
Q

What condition does this presentation describe?

Painless urinary retention

A

Cauda equina

35
Q

How is caudal equine treated?

A

Depends on cause
If herniated disc- discectomy
If fracture- decompression +- fixation
If haematoma- evacuation

36
Q

TRUE/FALSE

IF ankle reflexes are present then it is highly unlikely they the patient has caudal equina syndrome

A

TRUE
As with severe exacerbation of back pain can cause intermittent bladder problems with bladder spasms and small volume incontinence/retention

37
Q

What is neurogenic claudication precipitated or relieved by?

A

Precipitated by standing or back extension

Relieved by sitting, lumbar flexion or walking uphill (as opening up foramina)

38
Q

What is the difference in distribution between neurogenic and vascular claudication?

A

Neurogenic- dermatomal

Vascular- Sclerotomal

39
Q

What is the difference in the type of pain between neurogenic and vascular claudication?

A

Neurogenic is burning pain

Vascular is cramping pain

40
Q

What is the treatment for spinal stenosis?

A

Initially- whilst symptoms tolerable physiotherapy and analgesia
As symptoms worsen and intolerable- surgery offered

41
Q

which levels is cervical spondylosis most common at?

A

C5/C6

C6/7

42
Q

In what condition are hands affected first resulting in “numb clumsy hands”, Finger tip paraestoesia, difficulty with fine motor tasks and dropping objects

A

Degenerative cervical myelopathy

43
Q

Hoffman’s and Lhermitte’s sign are present in which type of lesion?

A

UMN

44
Q

Cervical Myelopathy can be cured with decompression spinal surgery TRUE/FALSE

A

FALSE
This is the treatment of choice however any surgery is just to stop the symptoms getting worse. It does not improve symptoms

45
Q

What is the commonest cause of spinal cord compression?

A

Tumours

46
Q

If there is a complete cord resection then there will initially be a flaccid areflexic paralysis which is followed by…

A

UMN signs

47
Q

Anterior cord syndrome produces….

A

Paralysis, loss of pain and temperature below the level of injury

48
Q

Brown-Sequard causes…

A

Paralysis/Loss of proprioception on the same side as the lesions
Loss of pain/temperature on opposite side (beginning 1-2 segments below)

49
Q

What is syringomyelia?

A

Cysts within spinal cord

50
Q

Why is a lesion in the central cord more likely to damage to upper limb fibres?

A

As the fibres supplying the upper limbs in the lateral corticospinal tracts are more medial than the fibres supplying the lower limbs

51
Q

Failed back syndrome occurs after what?

A

Recurrent, residual compression

ADELE-Noodles of Neurology (38 decks)

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