Cervical Spondylosis + Myopathy

Question 1

Cervical spondylosis

Answer 1

Degeneration of annulus fibrosis

+/- osteophytes

Narrows spinal canal

Question 2

Signs of cervical spondylosis

Answer 2

Limited painful neck movement

Crepitus

Tingling down spine

Question 3

Radiculopathy definition

Answer 3

Root compression

(rather than cord compression)

Question 4

Signs of root compression

Answer 4

Pain / electrical sensation in arms at level of compression

Dull reflexes

LMN weakness

Question 5

Dynatome definition

Answer 5

Area of pain / pins and needles

From trapped nerve root

Question 6

C3 and 4 dynatome

Answer 6

Neck pain

Trapezius pain

Question 7

C5 dynatome

Answer 7

Pain in shoulders + down front of arms

Question 8

C6 dynatome

Answer 8

Carpal tunnel

Question 9

C7 dynatome

Answer 9

Pain in dorsal arm + middle finger

Question 10

C8 dynatome

Answer 10

Pain in ring and little fingers + medial lower arm

Question 11

C5 motor deficit

Answer 11

Deltoid

Supraspinatus

Question 12

C6 motor deficit

Answer 12

Biceps

Brachioradialis

Question 13

C7 motor deficit

Answer 13

Triceps

Finger extenders

Question 14

C8 motor deficit

Answer 14

Finger flexors

Small muscles of hand

Question 15

Mx of cervical spondylosis

Answer 15

Firm neck collar

Transforaminal steroid injection

Surgical root decompression

Anterior spinal fusion

Question 16

Types of surgical root decompression

Answer 16

Laminectomy

Laminoplasty

Question 17

Laminectomy

Answer 17

Remove portion of bone

Question 18

Laminoplasty

Answer 18

Cut bone and insert bridging plate + screws

Question 19

Features of myopathy vs neuropathy

Answer 19

Myopathy:

Slower onset

Symmetrical

Proximal weakness

Preserved tendon reflexes

Question 20

Muscular dystrophy definition

Answer 20

Group of genetic diseases

Question 21

Muscular dystrophy classical features

Answer 21

Progressive degeneration and weakness of specific muscle groups

Variation in muscle fibre size

Deposition of fat

Question 22

Causes of muscular dystrophy

Answer 22

Duchenne’s muscular dystrophy

Becker’s muscular dystrophy

Facioscapulohumeral muscular dystrophy

Question 23

Duchenne’s muscular dystrophy inheritance

Answer 23

X linked recessive

30% spontaneous mutation

Question 24

Pathology of Duchenne’s muscular dystrophy

Answer 24

Non functional dystrophin produced

Question 25

Age of presentation of Duchenne's muscular dystrophy

Answer 25

~ 4 yrs

Question 26

Sx of Duchenne's muscular dystrophy

Answer 26

Clumsy walking Difficulty standing Respiratory failure Pseudohypertrophy of calves

Question 27

Ix for Duchenne's muscular dystrophy

Answer 27

Raised creatine kinase 40x

Question 28

Prognosis of Duchenne's muscular dystrophy

Answer 28

Some survive beyond 20 yrs

Question 29

Mx of Duchenne's muscular dystrophy

Answer 29

No specific Rx Home ventilation Genetic counselling

Question 30

Becker's muscular dystrophy definition

Answer 30

Same mutation as Duchenne's but produces partially functioning dystrophin

Question 31

Presentation of Becker's muscular dystrophy

Answer 31

Later age Similar but milder sx to Duchenne's Better prognosis

Question 32

Another name for Facioscapulohumeral muscular dystrophy

Answer 32

Landouzy-Dejerine

Question 33

Facioscapulohumeral muscular dystrophy inheritance

Answer 33

Autosomal dominant

Question 34

Facioscapulohumeral muscular dystrophy age of presentation

Answer 34

~ 12-14 yrs

Question 35

Sx of Facioscapulohumeral muscular dystrophy

Answer 35

Face, shoulder, upper arm weakness Foot drop Scapular winging Scoliosis

Question 36

Features of Facioscapulohumeral muscular dystrophy facial weakness

Answer 36

Can't puff out cheeks

Question 37

Features of Facioscapulohumeral muscular dystrophy upper arm weakness

Answer 37

Difficulty raising arms Asymmetrical Deltoid sparing

Question 38

Myotonic disorder definition

Answer 38

Cause tonic muscle spasms

Question 39

Histology of myotonic disorders

Answer 39

Long chains of central nuclei within muscle fibres

Question 40

Main type of myotonic disorder

Answer 40

Dystrophia myotonica

Question 41

Dystrophia myotonica inheritance

Answer 41

Autosomal dominant

Question 42

Dystrophia myotonica pathology

Answer 42

Chloride channelopathy

Question 43

Dystrophia myotonica onset

Answer 43

25 yrs

Question 44

Sx of Dystrophia myotonica

Answer 44

Distal onset weakness Facial weakness Muscle wasting

Question 45

Other features of Dystrophia myotonica

Answer 45

Male frontal baldness DM Cataracts Reduced cognition

Question 46

Prognosis of Dystrophia myotonica

Answer 46

Most pts die in middle age

Question 47

Mx of Dystrophia myotonica

Answer 47

Mexiletine Phenytoin Acetazolamide Genetic counselling

Question 48

Types of myotonic disorder caused by Na channelopathy

Answer 48

Paramyotonia congenita Adynamia episodica hereditaria

Question 49

Causes of acquired myopathies of late onset

Answer 49

Often part of systemic disease

Question 50

Systemic disease causes of acquired myopathies of late onset

Answer 50

Hyperthyroidism Malignancy Cushing's Hypo- or Hypercalcaemia

Question 51

Most common cause of inflammatory myopathy

Answer 51

Inclusion body myositis

Question 52

Age of onset of inclusion body myositis

Answer 52

\> 50 yrs

Question 53

Pathology of inclusion body myositis

Answer 53

Peripheral tauopathy Tau protein aggregates

Question 54

Sx of inclusion body myositis

Answer 54

Weakness of quads, finger flexors or pharynx Affects ventral extremities most

Question 55

Histology of inclusion body myositis

Answer 55

Ringed vacuoles Intranuclear inclusions

Question 56

Rx of inclusion body myositis

Answer 56

Nothing really

Question 57

Drug causes of myopathy

Answer 57

Alcohol Statins Steroids Chloroquine