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CORE Neuro > Neuro spine CORE - Sheet1 > Flashcards

Neuro spine CORE - Sheet1 Flashcards

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1
Q

one of the main arteries that supplies that anterior spinal artery

A

Artery of Adamkiewicz

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2
Q

where does the Artery of Adamkiewicz arise in 75% of people

A

comes off the left side of the aorta between T8 and T1 - supplies the lower 2/3 of the cord

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3
Q

posterior spinal artery usually arises from one of these two

A

vertebral arteries or posterior inferior cerebellar

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4
Q

conus medullaris usually terminates at

A

around L1 (below L2-3 is abnormal)

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5
Q

Torg-Pavlov ratio for congential stenosis

A

vertebral body width to cervical canal diameter <0.85

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6
Q

definition: focal herniation

A

herniated disc comprising less than 90 degrees of disc circumference

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7
Q

definition: broadbased herniation

A

herniated disc comprising 90-180 degrees of disc circumference

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8
Q

definition: protrusion

A

distance between the edge of the disc herniation is < the distance between the edges of the base

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9
Q

definition: extrusion

A

edges of the disc are greater than the distance of the base

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10
Q

Scheuermann’s

A

> 3 levels of Schmorl’s nodes in the spine of a teenager resulting in kyphotic deformity

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11
Q

limbus vertebra

A

fracture mimic - herniated disc material between the non-fused apophysis and adjacent vertbral body

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12
Q

Modic 1 signal

A

“edema” - T1 dark, T2 bright

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13
Q

Modic 2 signal

A

“fat” - T1 bright, T2 bright

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14
Q

Modic 3 signal

A

“scar” - T1 dark, T2 dark

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15
Q

how long to stop coumadin before LP

A

4-5 days

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16
Q

how long to stop plavix before LP

A

7 days

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17
Q

how long to hold LMW heparin before LP

A

12 hours

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18
Q

how long to hold heparin before LP

A

2-4 hours - document normal PTT

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19
Q

how long to hold NSAIDs/Aspirin before LP

A

no need

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20
Q

early sign of failed back surgery syndrome

A

epidural abscess

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21
Q

late signs (3) of failed back surgery syndrome

A
  1. epidural fibrosis/scar (enhances) 2. recurrent disc herniation 3. arachnoiditis
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22
Q

how long is nerve root enhancement normal after back surgery?

A

6 weeks - after that it’s arachnoiditis (infectious or inflammatory)

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23
Q

conjoined nerve roots?

A

s/p spine surgery - 2 adjacent nerve roots share an enlarged common sleeve

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24
Q

definition/mechanism: Jefferson

A

burst fracture of C1/axial loading

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25
definition/mechanism: Hangman
bilateral pedicle/pars fx of C2 - hyperextension
26
definition/mechanism: Teardrop
anterior/inferior teardrop shaped fx fragment - can be flexion or extension
27
definition/mechanism: Clay-Shoveler's
avulsion of spinous process at C7 or T1 - hyperflexion
28
definition/mechanism: Chance
horizonal fracture through the thoracolumbar spine
29
odontoid fracture: type 1
upper part of odontoid - maybe stable
30
odontoid fracture: type 2
fracture at base of odontoid - unstable
31
odontoid fracture: type 3
fracture through dens into the body of C2 - unstable, but better prognosis for healing
32
os odontoideum is associated with what funny named syndrome?
Morquio's
33
clinical scenario for hangman's fracture
"direct blow to face" - chin hits dashboard in MVA
34
clinical scenario for flexion teardrop
"ran into wall"
35
clinical history for extension teardrop
"hit from behind"
36
anterior cord function
motor, pain, temperature
37
dorsal cord function
proprioception and vibration
38
cord syndrome associated with flexion teardrop
anterior cord syndome - loss of motor, pain + temp (immediate paralysis)
39
mechanism of bilateral facet dislocation
severe hyperflexion - disruption of posterior ligament complex
40
syndromes associated with atlantoaxial instability
Down + juvenile RA
41
most important factor for outcome in spinal cord trauma
prescence of hemorrhage (low T2)
42
brown sequard
one half motor/other half sensory - seen in rotation or penetrating trauma
43
central cord syndrome
upper extremity deficit worse than lower
44
who gets central cord syndrome
old lady with spondylosis or younger person with bad extension injury
45
what is a terminal ventricle?
development variant - stupid looking cyst at the end of your cord
46
spina bifida aperta
open neural defect with tissue exposed through a defect in bone and skin
47
spina bifida occulta
closed neural defect - covered with skin
48
lipomyelomeningocele is 100% associated with
tethered cord (myelomeningocele may or may not)
49
terminal myelocystocele
herniation of the terminal syrinx into a posterior meningocele via a posterior spinal defect
50
fibrolipoma of the filum terminale
linear T1 bright structure in the filum terminale - incidental
51
diastematomyelia
sagital split in the cord
52
most common spinal vascular disorder
Type 1 (85%) - dural AVF
53
Spinal AVM/F: type 1
dural AVF with a single coiled vessel
54
Spinal AVM/F: type 2
intramedullary nidus - from ant or post spinal artery
55
Spinal AVM/F: type 3
juvenile, very rare/complex/terrible
56
Spinal AVM/F: type 4
intradural perimedullary - occur near conus
57
Foix alajouanine syndrome
myelopathy associated with dural AVF - "45 yo with LE weakness and sensory deficits"
58
2 ways of showing Pagets in the spine
1. enlarged "ivory" verebrae (ddx mets) 2. picture frame vertebrae (sclerotic border)
59
if H-shaped vertebrae aren't from sickle cell
Gauchers
60
most common bacterial discitis/osteo
Staph A
61
"calcified psoas abscess"
TB
62
"Gibbus deformity"
TB - desctructive focal kyphosis
63
TB tends to ..... the disc space
spare
64
what unusual infection favorst the lower L-spine and SI joints
brucellosis
65
MS lesions are usually
short segment, in the C-spine (white matter)
66
transverse myelitis lesions are usually
long segment, involving both sides of cord, expanded/swollen cord
67
ADEM lesions are usually
seen after viral illness in a kid, CN enhancement
68
NMO/Devics lesions are usually
long segment, involving full transverse diameter of the cord, involve optic nerves (duh)
69
Subacute combined degeneration
bilateral symmetrically increased T2 signal in the dorsal columns - "inverted V"
70
deficiency in subacute combined degeneration
B12
71
HIV vacuolar myelopathy
spinal cord atrophy, high T2 posterior columns
72
"owl eye appearance" of anterior spinal cord
anterior spinal artery ischemia - usually long segment/restricts diffusion
73
"empty thecal sac sign"
arachnoiditis - nerves roots adhere peripherally, giving appearance of empty sac
74
what causes Guillain Barre
campylobacter (or s/p surgery, lymphoma, SLE)
75
enhancing "onion bulb" nerve roots
CIDP - chronic form of guillain barre
76
3 intramedullary tumors
1. astrocytoma 2. ependymoma 3. hemangioblastoma
77
4 extramedullary/intradural tumors
1. schwannoma 2. meningioma 3. neurofibroma 3. drop mets
78
4 extradural "tumors"
1. disc disease (most common) 2. bone tumors 3. mets 4. lymphoma
79
astrocytoma vs. ependymoma: location
astrocytoma - c-cord, eccentric; ependymoma - lower cord, central, hemorrhagic
80
most common intramedullary mass in adults
ependymoma
81
ependymoma in the conus
myxopapillary form
82
most common extramedullary/intradural tumor
schwannoma
83
2 syndromes with multiple schwannomas
NF-2 and Carney complex
84
most common primary tumor to drop mets
medulloblastoma
85
most common systemic tumor to drop mets
breast ca (followed by lung and melanoma)
86
"lytic expansile lesion in the sacrum with no rim of sclerosis"
giant cell tumor

CORE Neuro (4 decks)

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