Flashcards in Revisin Deck (186)
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1
what are 2 possible side effects of a statin
muscle pain and weakness
2
what do you worry about with night pain
cancer
3
what are spinal red flags
back pain (worse at night, new pain in old patient)
bilateral sciatica, urinary incontinence
impotence
saddle anaesthesia
4
what is cauda equina syndrome
Compression/ irritation of lumbosacral nerve roots below conus medullaris
5
what are the common causes of cauda equina syndrome
herniated disc, spinal stenosis, vertebral fracture, tumour
6
what are the clinical features of cauda equina syndrome
usually acute (<24hrs), rarely subacute or chronic.
Motor signs - LMN signs → weakness in multiple root distribution, reduced tendon reflexes
Sensory signs - low back pain radiating to legs aggravated by sitting, relieved by lying down. Saddle anaesthesia (S2-5)
Autonomic signs - urinary retention/ overflow incontinence, loss of anal tone (faecal incontinence).
7
treatment for cauda equina
PR
MRI of lumbar spine
decompression within 48 hrs
8
what reflexes are usually absent in cauda equina
ankle
9
where does the conus medullaris end
L1/2
10
what is degenerative cervical myelopathy
spinal cord dysfunction from compression in the neck.1 Patients report neurological symptoms such as pain and numbness in limbs, poor coordination, imbalance, and bladder problems. Owing to its mobility, the vertebral column of the neck is particularly prone to degenerative changes such as disc herniation, ligament hypertrophy or ossification, and osteophyte formation
11
what are the common symptoms of degernative cervical myelopathy
Neck pain/stiffness
Unilateral or bilateral limb/body pain
Upper limb weakness, numbness, or loss of dexterity
Lower limb stiffness, weakness, or sensory loss
Paraesthesia (tingling or pins and needles sensations)
Autonomic symptoms such as bowel or bladder incontinence, erectile dysfunction, or difficulty passing urine
Imbalance/unsteadiness
Falls
12
what are the motor signs of degenerative cervical myelopathy
o Pyramidal weakness (Upper limb; extensors more than flexors. Lower limb: flexors more than extensors)
o Limb hyperreflexia
o Spasticity (eg, clasp knife sign)
o Clonus, especially Achilles tendon
o Hoffman’s sign (thumb adduction/flexion +/− finger flexion after forced flexion and sudden release of a finger, distally)
o Babinski’s sign (upgoing plantar)
o Segmental weakness (corresponding to the level of compression)
13
what are the features of an upper motor neurone lesion
paralyses affects movement rather than muscles
slight muscle wasting
spasticity
hyperreflexia
hypertonia
normal power
14
what are the features of a lower motor neurone lesion
flaccid paralysis (of muscle or muscle group)
severe atrophy
hypotonia
absent reflexes
may have fasciculation and fibrillation
15
what is the most likely benign tumour of the brain
meningioma
16
what is foster kennedy syndrome
when a slow growing frontal lobe tumour compresses optic nerve causing it to atrophy
17
what level in spinal cord do sensory afferent from bladder enter
S2-4
18
what is danish
how to examine to cerebellum
-dyskensia
-ataxia
-nystagmus
-intention tremor
-staccato speech
-hypotonia
19
what tract will an upper motor neurone be in
pyramidal tracts
20
is parkinsons an UMN lesion
no as not within the pyramidal tract
21
are tremors pyramidal or extrapyramidal
extra pyramidal (involuntary movements)
22
where are LMNs
anywhere below L1/2 or out with the CNS
23
what is a tremor
involuntary movement in which there is rhythmicity, is a regular movement
24
what movements tend to develop in extrapyramidal disorders
involuntary- tremors
25
what are the types of tremors
resting- when sitting and relaxed
postural- holding arms in certain postitions
intention- when trying to complete an action
26
where must a lesion be if it affects the leg and arm
cervical spin or above
27
weakness is a symptoms of a lesion affecting which tract
pyramidal
28
why is there not weakness in parkinsons
as extrapyramidal
29
what are the hallmarks of parkinsons
SLOWNESS (bradykinesia- only symptoms seen in everyone)
tremor
tone (stiffness and rigidity)
30
