Spinal Cord and Root Dysfunction

Question 1

If there is a problem at the cervical level of the spinal cord, what is involved?

Answer 1

ARMS

-UMN if central

Question 2

If there is a problem at the thoracic level of the spinal cord, what is involved?

Answer 2

Arms are not involved/minimally involved

-UMN if central

Question 3

If there is a problem at the lumbar level of the spinal cord, what is involved?

Answer 3

LEGS

- NO UMN involvement

Question 4

What is the ‘ASIA’ chart?

Answer 4

Describes a persons functional impairment as a result of their spinal cord damage

Question 5

What kind of pain would be experience in a cervical disc prolapse?

Answer 5

Arm pain

Neck pain

Question 6

Thoracic disc prolapses are common

Answer 6

FALSE - they are rare

Question 7

What kind of pain would you get if you had a thoracic disc prolapse?

Answer 7

Thoracic

Question 8

Describe a thoracic disc prolapse.

Answer 8

Usually central and causing a myelopathy

Question 9

What kind of pain would someone with a lumbar disc prolapse experience?

Answer 9

Leg pain

Question 10

Spinal claudication is usually intermittent

Answer 10

TRUE

Question 11

When is spinal claudication worse?

Answer 11

On mobilising

Question 12

When is spinal claudication better?

Answer 12

At ease or when bending forward

Question 13

Where can pain from spinal claudication often be?

Answer 13

At the back of the thighs and calves

Question 14

There is no altered sensation in spinal claudication

Answer 14

FALSE

Question 15

What is spinal claudication?

Answer 15

A common symptom of lumbar spinal stenosis (LSS), causing impingement or inflammation of the nerves emanating from the spinal cord

Question 16

Claudication can be?

Answer 16

Spinal or Vascular

Question 17

Cauda equina should always be treated as an ________

Answer 17

EMERGENCY

Question 18

What is critical in cauda equina syndrome?

Answer 18

TIME

Question 19

What is the principle concern in cauda equina?

Answer 19

Urinary function

Question 20

Describe the leg pain in cauda equina.

Answer 20

Usually bilateral

Question 21

Describe the sensory loss in cauda equina.

Answer 21

Perianal sensory loss to a pin prick

Question 22

At what spinal cord level does cauda equina syndrome usually occur?

Answer 22

S2-S4

Question 23

What level of the spinal cord is cauda equina?

Answer 23

T12-L1

Question 24

What can cauda equina syndrome be defined as?

Answer 24

Painless urinary retention with urinary incontinence (overflow)

Question 25

What may men get with cauda equna?

Answer 25

Erectile dysfunction :(

Question 26

List all the RED FLAGS of spinal cord dysfunction.

Answer 26

``` Bilateral leg pain Thoracic back pain Weight loss, night sweats, fever Night pain Sphincter disturbance Perianal sensory loss Age <20 or >55 History of carcinoma Progressive neurological deficit Trauma Immunocompromise ```

Question 27

What is the colloquial phrase used to describe cervical myelopathy?

Answer 27

'Numb, clumsy, hands'

Question 28

Cervical myelopathy is usually BILATERAL

Answer 28

TRUE - but one side may be more affected than the other

Question 29

Where do people with cervical myelopathy get paraesthesia?

Answer 29

Finger-tips

Question 30

What do people with cervical myelopathy have problems with?

Answer 30

Fine motor tasks

Question 31

What tests should be done in someone with suspected cervical myelopathy?

Answer 31

Hoffman’s and Lhermitte’s sign

Question 32

What are the risk factors for failed back syndrome?

Answer 32

* BMI * Diabetes * Smoking

Question 33

What is failed back syndrome?

Answer 33

Chronic pain following back surgeries with recurrent and residual compression of the spinal cord - nerve injury

Question 34

What 4 things can a patient get as a result of failed back syndrome?

Answer 34

* Infection * Fibrosis * Arachnoiditis * Depression, anxiety

Question 35

What is syrinx?

Answer 35

A fluid filled cavity within the spinal cord

Question 36

Neck and back pain is often __________

Answer 36

DEGENERATIVE

Question 37

There is lots of benefits of surgery for people with neck/back pain

Answer 37

FALSE

Question 38

How should a patient with neck/back pain be managed?

Answer 38

Conservative - physio, analgesia

Question 39

What is tone like in an UMN problem?

Answer 39

Increased

Question 40

What is tone like in a LMN problem?

Answer 40

Decreased

Question 41

Is there atrophy in an UMN problem?

Answer 41

No - there may be some late on

Question 42

Is there atrophy in a LMN problem?

Answer 42

Yes - early

Question 43

Are there fasciculations in an UMN problem?

Answer 43

NO

Question 44

Are there fasciculations in a LMN problem?

Answer 44

YES

Question 45

What is a fasciculation?

Answer 45

A brief spontaneous contraction affecting a small number of muscle fibres, often causing a flicker of movement under the ski

Question 46

Describe reflexes in an UMN problem.

Answer 46

Brisk

Question 47

Describe reflexes in a LMN problem.

Answer 47

Decreased/absent

Question 48

Describe plantars in UMN problems.

Answer 48

Up-going

Question 49

Describe plantars in a LMN problem.

Answer 49

Down-going

Question 50

Describe clonus in UMN problems.

Answer 50

Present

Question 51

Describe clonus in LMN problems.

Answer 51

Absent

Question 52

What is clonus?

Answer 52

Muscular spasm involving repeated, often rhythmic, contractions.