10: Spinal cord and root dysfunction Flashcards Preview

Neurology Week 4 2018/19 > 10: Spinal cord and root dysfunction > Flashcards

Flashcards in 10: Spinal cord and root dysfunction Deck (44)
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1

Which symptoms do patients with spinal cord problems present with?

Sensory - pain, abnormal sensations

Motor - weakness, sphincter and sexual dysfunction

2

If the arms are involved, which segment of the spine is likely to be involved?

Cervical

3

If a spinal cord prolapse is central, ___ motor neurons are more likely to be involved.

upper

4

If a spinal cord problem is lumbar in origin, which limbs will be involved?

Lower limbs

5

Which chart can be used to diagnose the level of a spinal cord injury?

ASIA chart

6

Which motor neurons are affected by a lateral prolapse?

Lower motor neurons (LMNs)

7

Where does pain occur in cervical disc prolapses?

Arms (tends to be)

8

Which section of the spine does disc prolapse most often occur in?

Lumbar

9

Are upper motor neurons found in the lumbar spine?

No, so if a patient has problems in the lower limbs but they're typical of UMN lesions (see table), the problem is higher up

10

What is spinal / neurogenic claudicstion?

Pain caused by a narrowing of spine, putting pressure on nerve roots

often compared to vascular but v different

11

Spinal claudication must not be mistaken for ___ claudication.

vascular

12

What can be checked to differentiate spinal claudication from vascular claudication? 

Peripheral pulses

13

What is the triad of symptoms in cauda equina syndrome?

Saddle anaesthesia

Leg pain

Bowel/bladder dysfunction (painless retention and loss of anal tone)

14

What type of incontinence do patients with advanced cauda equina get?

Overflow incontinence

too late to treat

15

Which types of sensation should you test for in suspected cauda equina syndrome?

Light touch

Pin prick

16

Which spinal nerves are compressed in cauda equina syndrome?

S2 - 4

Pudendal nerve roots

17

How are patients with suspected cauda equina investigated?

Urgent MRI scan

18

Pain in which spinal region is a red flag?

Thoracic region

19

What are general red flag cancer symptoms?

Weight loss

Fever

Night sweats

20

Pain which patients notice at ___ is a red flag.

night

21

What is cervical myelopathy?

Progressive compression of the spinal cord in the cervical spine due to disc prolapse

22

Are the symptoms of cervical myelopathy unilateral or bilateral?

Bilateral

23

Which motor neurons are affected in cervical myelopathy?

UMNs

24

Which group of patients tend to develop cervical myelopathy?

Elderly

25

What are the symptoms of cervical myelopathy

'Numb, clumsy hands' -> bilateral, difficulty performing ADLs

Gait problems -> falls

26

Describe

a) Babinski's

b) Hoffman's

c) Lhermitte's

signs, which can all be seen in cervical myelopathy.

a) Toes extend on stroking the plantar surface of the foot

b) Thumb, index and middle fingers flex when the nail of middle finger is tapped

c) Patient experiences 'electric shock' sensation on neck flexion

27

Does surgery for cervical myelopathy reverse the symptoms?

No, only halts progress

28

What is the conservative treatment for a disc prolapse?

Analgesia

Physiotherapy

29

Does surgery make any difference to the final outcome of most disc prolapses?

No

Tends to speed up recovery, but most patients end up in the same place two years later

30

Surgery for back pain has a lot of potential ___.

complications