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6- Neuro Diag > Ch8 8 Spinal Nerve Roots > Flashcards

Ch8 8 Spinal Nerve Roots Flashcards

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1
Q

List the spinal nerve roots distribution

A 
8  cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
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2
Q

Spinal cord ends at which level

A

L1-L2

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3
Q

What structure is formed at the end of spinal cord

A

cauda equina

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4
Q

Define: area of skin innervated by a single nerve

A

dermatome

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5
Q

Define: muscles innervated by a single nerve root

A

myotome

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6
Q

Sclerotogenous pain aka

A

referred pain

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7
Q

Def: Neuropathy

A

peripheral nerve disorder

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8
Q

Def: Radiculopathy

A

nerve root level disorder

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9
Q

Mononeuropathy distribution can be due to

A

Trauma
Local infection
Local Toxicity

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10
Q

Polyneuropathy distribution can be due to

A

Nutritional deficiency
Systemic infection
Autoimmunity
Systemic toxicity

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11
Q

What Causes radiculopathy?

A
  1. compressive, mechanical
  2. metabolic
  3. reflexive
  4. inflammatory
  5. infectious
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12
Q

Evaluation of radiculopathy steps

A
  1. muscle testing
  2. tendon reflexes
  3. dermatome sensory testing
  4. Valsalva and orthopedic testing
  5. nerve conduction (velocity testing)
  6. radiography
  7. MRI
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13
Q

Radiculopathy location

A

at the spine or lateral canal (in the IVF)

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14
Q

Radiculitis location

A

out side the lateral canal (but before the plexi)

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15
Q

Radiculopathy/Radiculitis symptoms

A
  • Burning or tingling dermatomal pain
  • Loss of reflexes
  • Motor strength loss
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16
Q

Causes of Mechanical Injury

A
  1. disc lesion (MC C6 C7 L6 S1 nerve roots – C5, C6, L4, L5 discs)
  2. laceration
  3. neoplastic
  4. traction- whiplash injury
  5. degeneration - stenosis
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17
Q

Def: mild temporary interruption of nerve transmission

A

Neurapraxia

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18
Q

what results from injury or chronic compression?

A

Wallerian degeneration

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19
Q

Spondylosis is degenration due to

A

osteophytes, spinal stenosis

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20
Q

Spondylolysis is a

A

a Fracture/break in continuity

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21
Q

Spondylolisthesis is

A

displacement/shifted vertebra

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22
Q

Cervical stenosis signs & symptoms

A

LMNL and radicular signs in upper extremities

UMNL in lower extremities

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23
Q

Lumbar stenosis signs & symptoms

A

bilateral leg pain, and weakness with walking (LMNL sign)

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24
Q

what’s the difference between ALS vs Cervical stenosis:

A

cervical stenosis Pts still have sensory signs

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25
leg pain or discomfort is called
Claudication
26
Neurological Claudication- gets worse and better with
position
27
Vascular Claudication- gets worse when
Pt walks more
28
Claudication testing
stationary bike test | if pain occurs after paddling, then it’s due to a vascular issue
29
how to test for Medial and Lateral Disc Bulge
Kemp test | (medial: away, Lateral: toward)
30
Central disc protrusion that affects multiple nerve roots bilaterally is called
Cauda Equina Syndrome
31
Cauda Equina Syndrome is caused by
- Central (median) disc lesion - Canal stenosis - Vertebral fracture - Luxation - tumor
32
Cauda Equina Syndrome management:
refer out immediately (medical emergency)
33
Cauda Equina Syndrome
Bilateral involvement of multiple levels (s1, s2, s3): - urinary and fecal incontinence - impotence - loss of tendon reflexes - muscle atrophy - saddle anesthesia - foot drop - bilateral sciatica
34
vascular compromise to peripheral nerves is due to
Diabetic Neuropathy
35
Diabetic Neuropathy symptoms
``` Stocking glove sensory loss Charcot (neurogenic) joint Autonomic loss motor loss diabetic reinopathy ```
36
Def: Stocking glove sensory loss
- numbness - pain, and paresthesia - vibration loss
37
Autonomic loss includes
- hypo-tension - arrhythmia - alter bowl, bladder, and sexual function
38
Metal Toxicity symptoms | working around metal
- tingling in the extremities - unsteady gait - muscle tremor, pain, or tics - headache - general pain - fatigue
39
Reflex Sympathetic Dystrophy Syndrome "RSDS" | must have 1 symptom from the 3 of the following
1. sensory: hypersthesia or allodynia 2. vasomotor: temperature or skin asymmetry 3. pseudomotor: edema or symmetric sweating 4. moto/trophic: weakness, dystonia, hair nail or skin changes
40
whats the difference between RSDS 2 types?
one include nerve injury, and the other doesn’t
41
RSDS Type 1
- complex regional pain syndrome - less specific - rapid severe swelling - long term pain, along peripheral nerve fowwlowing minor injury (allodynia) - sever sympathetic reaction - includes regional osteoporosis
42
RSDS Type 2
- causalgia - involves specific nerve damage - begins with a nerve injury - more specific - follows the nerve distributions
43
Raynaud Disease is effect on peripheral vessels
causes peripheral vasospasm
44
Raynaud is associated with
migraines
45
Raynaud is more common with (which population)
women
46
Raynaud happens due to ____ exposure
cold
47
Raynaud color stages
white, blue, red
48
Raynaud can be diagnosed with _____ test
Allen's
49
Guillian Barre Syndrome aka
Inflammatory polyneuropathy | acute idiopathic polyneuritis
50
Guillian Barre Syndrome characteristic
1. post Epstein Barr infection 2. PNS demyelination 3. sensory loss 4. weakness comes next LMNL signs
51
Guillian Barre Syndrome is more common in what ages
30-50
52
Guillian Barre Syndrome prognosis
90% self healing
53
Myasthenia Gravis is disorder of
neuromuscular junction
54
in Myasthenia Gravis, autoimmune attack
acetylcholine receptor
55
Myasthenia Gravis MC in what population?
young women or old men
56
Myasthenia Gravis MC symptoms
weakness of eyes (ptosis), lips, face , and hands | thymoma or enlarged thymus
57
in Myasthenia Gravis weakness get worse with
repeated use of muscle or later in day
58
why the weakness get worse though the day with MG patients
Pt is loaded with Ach, by afternoon, Pt is depleted of Ach
59
what MG Pts are given?
anti-Ach esterase | edrophonium chloride
60
MG sensory findings
No sensory findings
61
MG Treatment
thymectomy, immunosuppressants, and anti-Ach drugs
62
Test to detect MG
tensilon
63
Eaton Lambert syndrome
1. presynaptic disorder of inadequate Ach 2. usually with underlying cancer 3. symptoms as myasthenia gravis
64
Polio is caused by
viral infection
65
Polio is spread through
fecal oral
66
Polio attack
affects anterior horn cells
67
Polio Signs
muscle wasting and deformity
68
Polio prevention includes
``` Salk vaccine (dead virus) Sabin vaccine (live virus) ```

6- Neuro Diag (10 decks)

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