Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neurology > 2(E): Spinal Cord Disease > Flashcards

2(E): Spinal Cord Disease Flashcards

(103 cards)

Start Studying
1
Q

What does degenerative disc disease refer to

A

Group of disorders including:

  • Disc protrusion
  • Disc herniation
  • Disc sequestration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is disc protrusion

A

Where nucleus pulpous presses on annulus fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is disc prolapse (herniation)

A

Tear in annulus fibrosis leading to protrusion nucleus pulposus that can compress spinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is disc sequestration

A

Extrusion nucleus pulposus and seperation fragment, that enters spinal canal, may compress spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What age group does IV disc prolapse most commonly occur

A

30-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In which gender does IV disc prolapse occur

A

Male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the most common sites of disc prolapse

A

L5/S1

L4/L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is classical history of disc prolapse

A

Individual strains back (eg. lifting) then has back pain which is worse on coughing, sneezing, lifting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe pain in IV Disc prolapse

A

Lumbago - electric shock type pain

Sciatica - bilateral shooting pain down the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain sensory and motor symptoms in IV Disc Prolapse

A

Pareasthesia of the nerve root affected (Nerve root affected tends to be one under disc that has prolapsed)

Muscle weakness
Loss deep tendon reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What worsens pain in disc prolapse

A

Coughing

Sneezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What improves pain in disc prolapse

A

Short walks

Change in position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What deficit will be present in L4-L5 disc prolapse

A

L5 radioculopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What sensation is impaired in L4-L5 disc prolapse

A

Dorsum Foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What movement is lost in L4-L5 disc prolapse

A

Toe Extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What test is positive in L5 radiculopathy

A

Sciatic stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What sensation is impaired in L5-S1 disc prolapse

A

Dorsum Foot

Back of calf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What motor deficits are there in L5-S1 prolapse

A

Calf-pain

Weak plantar flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What test is positive in S1 radiculopathy

A

Sciatic stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What investigaiton is ordered for possible disc prolapse

A

MRI Spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If caudal equine present in disc prolapse what is done

A

Refer to neurosurgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If no cauda equina in IV disc prolapse, what is done

A
  • Analgesia
  • Rest, Early Mobilisation
  • Physiotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is cauda equina syndrome

A

Compression cauda equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What spinal level does the cauda equina start

A

L1-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Give 5 causes of cauda equina syndrome
- Disc Prolapse - Traumatic - Malignancy - Infection (Pott's Disease, Discitis) - Ankylosing spondylitis (Due to chronic inflammation) - Iatrogenic
26
What are three groups of cauda equina
1. cauda equina syndrome with retention (CESR) 2. cauda equina syndrome incomplete (CESI) 3. cauda equina syndrome suspected (CESS)
27
How does cauda equina syndrome with retention (CESR) present
- Back pain - LL weakness - Bilateral loss reflexes - Saddle anaesthesia - Loss anal tone - Loss badder control
28
Incomplete How does cauda equina syndrome
Same as CESR, except there is altered urinary sensation - opposed to loss of bladder control. This can cause painful then painless retention
29
How does cauda equina syndrome suspected present
- Back pain - LL pain - Variable neurological symptoms
30
Will cauda equina present with UMN or LMN signs and symptoms
LMN
31
What are symptoms of cauda equina
- Back pain - Bilateral sciatica - LL weakness - LL parasthesia - Saddle anaesthesia - Impotence - Bowel and bladder dysfunction
32
What are signs of cauda equina
- Loss anal tone - Urinary retention: palpable bladder - Hypo-reflexia
33
What examination is required in cauda equina
PR Exam: assess anal tone
34
What imaging is ordered in cauda equina
Bladder USS | Whole-spine MRI (Gold-standard)
35
How is cauda equina managed
Neurosurgical review: Dexamethasone Spinal decompression
36
What is spinal cord compression
Compression of spinal cord
37
What is the most common cause of spinal cord compression
Metastatic spinal cord compression
38
What cancers cause metastatic spinal cord compression
BLTKETCHUP ``` Breast Lung Thyroid Kidney Prostate ```
39
Aside from metastatic spinal cord compression, what else can cause spinal cord compression
- Infection (abscess) - Traumatic - vertebral fracture, facet joint dislocation - Neoplastic - myeloma
40
Why is disc herniation a rare cause of spinal cord compression
As disc herniation typically occurs in lumbar region which causes cauda equina, opposed to spinal cord compression
41
In general, what increases risk of spinal cord compression
Factors that cause stenosis of the spinal canal - these can be degenerative or inflammatory
42
What inflammatory conditions predispose to spinal cord compression
RA, Ankylosing spondylitis
43
What degenerative conditions predispose to spinal cord stenosis
Osteophyte (OA) | Ligamentum Flavum Hypertrophy
44
Is spinal cord compression UMN or LMN lesion and explain why
LMN at the level of the lesion - due to compression of anterior horn cells UMN below the lesion - due to compression of descending corticospinal tract
45
What is often first stage of spinal cord compression
Back pain
46
When is back pain worse in spinal cord compression
Coughing Sneezing Lying Down
47
Explain sensation and proprioception
Sensation and proprioception impaired
48
Explain reflexes at level of the lesion
Hypo-reflexia
49
Explain reflexes at levels below the lesion
Hyper-reflexia
50
What other features will be present in spinal cord compression
Myoclonus | Upgoing babinski reflex
51
What are late symptoms of spinal cord compression
Autonomic symptoms: bowel or urinary incontinence/retention = carry a poor prognosis
52
How is spinal cord injury divided
Complete SCI | Incomplete SCI
53
Define complete SCI
No preservation of sensory motor function more than 3 nerve roots below level of the lesion
54
Why is it defined as 3 nerve roots below the lesion?
Less than 3 nerve roots could indicate nerve root pathology
55
Define incomplete SCI
Residual motor or sensory function in more than 3 nerve roots below the lesion
56
What is often spared in incomplete SCI
Sacral sparing
57
Give 5 examples of incomplete SCI
- Anterior Cord Syndrome - Posterior Cord Syndrome - Brown-Sequard Syndrome - Central cord Syndrome - Cauda Equina
58
Who classified spinal cord injury
American Spinal Injury Association (AISA)
59
What did AISA classify spinal cord injury into
A-E
60
What is AISA Grade A
Complete SCI
61
What is AISA Grade B
Incomplete: | Sensory, but not motor, is preserved
62
What is AISA Grade C
Incomplete Injury: | >50% Muscles are MRC <3
63
What is AISA Grade D
Incomplete Injury: | >50% Muscles are MRC >3
64
What is AISA Grade E
Normal: Motor and Sensory function are normal
65
What is the most common incomplete SCI
Central cord syndrome
66
What mechanism of injury causes central cord syndrome
Hyperextension in presence of osteophytes (OA)
67
Why is central cord syndrome more prevalent
Centre of the spinal cord is a watershed area - and is more susceptible to oedema
68
What are symptoms of central cord syndrome
- Cape-like sensory loss of pain and temperature | - Arm weakness > Leg weakness
69
Why does weakness occur in arms over legs in central cord syndrome
As coricospical tract is organised so region representing arms is more medial to that of legs
70
What causes anterior cord syndrome
Infarct anterior spinal artery (ASA)
71
Where does anterior spinal artery arise from
Vertebral artery
72
What typically causes anterior cord syndrome
Herniated disc
73
What sensory loss is present in anterior cord syndrome
Loss of pain and temperature
74
Why are proprioception, vibration and fine touch in tact in anterior cord syndrome
As these are transmitted by dorsal column pathway which are located in posterior cord. Spinothalamic pathway travels in anterior cord
75
What motor deficit is present in anterior cord syndrome
Paraplegia. Unless above C7 - then quadriplegia
76
What is prognosis of anterior cord syndrome
Poor prognosis. Only 10-20% recover motor function
77
What is Brown-Sequard syndrome
Lateral compression of spinal cord
78
What are ipsilateral symptoms in brown sequard syndrome and why does it happen
- Loss vibration, proprioception, fine touch - Ipsilateral paralysis = Due to damage to corticospinal tract and DCP which have already decussated in the medulla
79
What are contralateral symptoms in brown sequard syndrome and why does it happen
Loss pain, temperature and crude touch = due to damage to spinothalamic tract that decussates at the spinal cord
80
Why is light touch preserved in brown-sequard
As transmitted via anterior spinothalamic tract
81
What is posterior cord syndrome also called
Contusion Cervicalis Posterior
82
What causes contusion cervicalis posterior
Infarct PCA
83
Where does PCA arise
Posterior inferior cerebellar artery (PICA)
84
How does posterior cord syndrome present
- Loss sensation and burning in neck, upper arms and torso | - Mild paresis of the upper limbs
85
What is first-line if suspecting spinal cord compression
MRI Spine
86
How is spinal cord compression managed
Urgent referral neurosurgery: - Dexamethasone - Decompressive laminectomy
87
When is decompressive laminectomy used
Disease at single spinal level
88
What is radiotherapy used
Disease at multiple levels (Malignancy)
89
What is the best prognostic indicator for SCC
Mobility status
90
What is a complication of complete spinal cord compression
Spinal shock
91
What causes spinal shock
Disruption sympathetic innervation
92
How does spinal shock present
- Hypotension. Hypothermia - Quadraplegia - Respiratory Inusfficiency - Anaesthesia below the level
93
How can spinal cord lesions be divided in terms of presentation
1. Motor 2. Motor and Sensory 3. Sensory
94
What are two purely motor spinal cord lesions
- MND | - Poliomyelitis
95
How does ALS (MND) present
Combination UMN and LMN signs
96
How does poliomyelitis present and why
LMN signs - due to disrupting anterior horn cells
97
What 3 conditions cause motor and sensory disruption spine
- Friedrichs ataxia - Syringomyelia - Subacute combined degeneration spinal cord
98
What causes subacute combined degeneration of the spinal cord
Vitamin B12 deficiency
99
How does subacute combined degeneration of spinal cord present
CST: bilateral paraparesis DCP: bilateral loss vibration and proprioception SCT: bilateral ataxia and tremor
100
What is syringomyelia
Collection CSF in spinal cord
101
How does syringomyelia present
- Cape like loss pain and temperature (due to spinothalamic tracts crossing being first affected) - Preservation proprioception, fine touch - Spastic weakness upper limbs
102
What is syringomyelia associated with
Chiari malformato
103
What is a purely sensory condition of spinal cord
Tabes dorsalis (Syphillis)

Neurology (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions