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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

what are the other symptoms of parkinsons

can 'freeze' and struggle to initiate and stop movements
shuffling gate
stooped posture
changes in mood
handwriting gets smaller (micrographia)
balance problems
depression and anxiety
sleeping problems
loose paralysis in dreams so cant act out what they are dreaming
REM sleep disorder
loose sense of smell and taste (before motor symptoms)
memory changes
voice gets quieter
constipation
bladder problems