Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

In order Cuccurullo > Ch 5 - EDX: Radiculopathy > Flashcards

Ch 5 - EDX: Radiculopathy Flashcards

1
Q

What is a Radiculopathy?

A

Pathologic process affecting the nerves at the root level

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

What is the presentation of Radiculopathy?

A

Pure sensory > sensorimotor complaints> pure motor complaints

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

Why are sensory complaints MC in Radiculopathy?

A

Larger size of sensory fibers rendering more prone to injury

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

Describe NCS of Radiculopathy.

A

Typically normal due to sparing of DRG

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

What is the MCC of radiculopathy <50 yo?

A

Herniated nucleus pulposus (HNP)

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

What is the MCC of radiculopathy >50 yo?

A

Spinal stenosis

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

What are uncommon causes of radiculopathy?

A

“Hi Madam”
H—Herpes zoster
I—Inflammatory: TB, Lyme disease, HIV, syphilis, cryptococcus, and sarcoidosis
M—Metastasis
A—Arachnoiditis: Myelogram, surgery, steroids, and anesthesia
D—Diabetes mellitus
A—Abscess
M—Mass: Meningioma, neurofibroma, leukemia, lipoma, cysts, and hematoma

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

What is the clinic presentation of a C5 radiculopathy?

A

Reduced reflex: Biceps
Weakness: Elbow flexion
Numbness: lateral arm

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

What is the clinic presentation of a C6 radiculopathy?

A

Reduced reflex: Brachioradialis
Weakness: Elbow flexion
Numbness: lateral arm

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

What is the clinic presentation of a C7 radiculopathy?

A

Reduced reflex: Triceps
Weakness: Elbow extension
Numbness: middle finger

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

What is the clinic presentation of a C8 radiculopathy?

A

Reduced reflex: None
Weakness: Finger flexion
Numbness: medial forearm

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

What is the clinic presentation of a T1 radiculopathy?

A

Reduced reflex: None
Weakness: Finger abduction
Numbness: medial elbow

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

What is the clinic presentation of a L4 radiculopathy?

A

Reduced reflex: Patellar tendon
Weakness: Knee extension
Numbness: Anterolateral thigh/medial ankle

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

What is the clinic presentation of a L5 radiculopathy?

A

Reduced reflex: Lateral hamstring
Weakness: Hallux extension
Numbness: Posterolateral thigh/calf and dorsal foot

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

What is the clinic presentation of a S1 radiculopathy?

A

Reduced reflex: Achilles tendon
Weakness: Plantar flexion
Numbness: Posterior high/calf and lateral ankle

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

Describe the SNAP in Radiculopathy.

A

Normal if the lesion is located proximal to the DRG

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

Describe the CMAP in Radiculopathy.

A

Normal or reduced amplitude as lesion is distal to the motor neuron cell body.

Normal if the injury is purely demyelinating, incomplete, or reinnervation has occurred

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

Describe H-reflex in Radiculopathy.

A

Possibly abnormal in an S1 radiculopathy but not pathognomonic

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

Describe F-waves in Radiculopathy.

A

Not sensitive or specific for a radiculopathy. Muscles have more than one root innervation, which can result in a normal latency.

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

What are the optimal # of muscles to needle for EMG when screening for radiculopathy?

A

6 including paraspinals

If 1 is ABN, then more muscles should be evaluated

21
Q

What is found on EMG in Radiculopathy?

A

FIBs or PSWs should be found in two different muscles innervated by two different peripheral nerves originating from the same root

22
Q

When would radiculopathy not be found on EMG?

A

Lesion is demylinating, purely sensory, postreinnervation, or missed by random sampling

23
Q

What is the clinical finding of C3/C4 radiculopathy?

A

HA
Innervate posterior and lateral scalp
C2 and C3 nerves become greater and lesser occipital nerves

24
Q

Which muscles are involved in a C5 radiculopathy?

A 
Rhomboids
Deltoid
Biceps
Supraspinatus
Infraspinatus
Brachialis
BR
Supinator
Paraspinals
25
Q

Which muscles are involved in a C6 radiculopathy?

A 
Deltoid
Biceps
BR
Supraspinatus
Infraspinatus
Supinator
PT
FCR
EDC
Paraspinals
26
Q

Which muscles are involved in a C7 radiculopathy?

A 
PT
FCR
EDC
Triceps
Paraspinals
27
Q

Which muscles are involved in a C8 radiculopathy?

A 
Triceps
FCU
FDP
Abductor
digiti minimi
First dorsal
interossei
PQ
Abductor
pollicus
brevis
Paraspinals
28
Q

Which muscles are involved in a L2/3/4 radiculopathy?

A 
Iliopsoas
Iliacus
Gracilis
Adductor longus
Vastus medialis
TA
Paraspinals
Difficult to distinguish
between radiculopathy
and alternate lesions
due to only two
peripheral nerves
29
Q

Which muscles are involved in a L5 radiculopathy?

A 
Gluteus maximus
Gluteus medius
TFL
TA
MG
Medial hamstring
TP
Peroneus longus
Paraspinals
30
Q

Which muscles are involved in a S1 radiculopathy?

A 
Gluteus maximus
Gluteus medius
TFL
MG
Medial
hamstring
PL
TP
Paraspinals
31
Q

What is the etiology of a S2/3/4 radiculopathy?

A

Iatrogenic
Cauda equina
Spinal stenosis

32
Q

Which muscles are involved in a S2/3/4 radiculopathy?

A 
Abductor hallucis
Abductor digiti quinti
Needle exam of
the external anal
sphincter
Monitor:
Bulbocavernosus
reflex, anal wink,
external sphincter
tone, and bowel and
bladder function
33
Q

Which nerves innervate the Pectoralis major?

A

Medial and lateral pectoral nerves

34
Q

Which nerves innervate the Brachialis?

A

Musculocutaneous and Radial nerve

35
Q

Which nerves innervate Flexor digitorum profundus?

A

Median (AIN) and Ulnar nerves

36
Q

Which nerves innervate the Lumbricals?

A

Median and Ulnar nerves

37
Q

Which nerves innervate Flexor pollicis brevis?

A

Median and Ulnar nerves

38
Q

Which nerves innervate Pectineus?

A

Femoral and obturator nerves

39
Q

Which nerves innervate Adductor magnus?

A

Sciatic (tibial portion) and Obturator nerves

40
Q

Which nerves innervate Biceps femoris?

A

Sciatic (tibial portion) and Sciatic (peroneal portion) nerve

41
Q

Describe EDX findings in Radiculopathy at time of injury.

A

Decreased recruitment
Decreased recruitment interval
Prolonged F-wave
Abnormal H-reflex (S1 radiculopathy)

42
Q

Describe EDX findings in Radiculopathy 4 days after injury.

A

~50% Dec CMAP compared to opposite side in severe cases

43
Q

Describe EDX findings in Radiculopathy 1 week after injury.

A

ABN spontenous activity in paraspinals 1st

Normal if reinnervated or posterior rami spared

44
Q

Describe EDX findings in Radiculopathy 2 weeks after injury.

A

ABN spontaneous activity beginning in the limbs

45
Q

Describe EDX findings in Radiculopathy 3 weeks after injury.

A

ABN activity present in the paraspinals and limbs

46
Q

Describe EDX findings in Radiculopathy 5-6 weeks after injury.

A

Reinnervation begins

47
Q

Describe EDX findings in Radiculopathy 6 mo to 1 yr after injury.

A

Inc amplitude from reinnervated motor unit

Reinnervation complete

48
Q

Describe EDX findings in Radiculopathy if repeated every 3-4 mo.

A

Serial EMG could be performed in intervals to monitor for reinnervation

49
Q

Describe EMG of Radiculopathy

A

Pure sensory injury: negative EMG

In order Cuccurullo (91 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions