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MSK > Spinal Symposium > Flashcards

Spinal Symposium Flashcards

(46 cards)

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1
Q

Dermatome

A

-a dermatome is an area of skin that is mainly supplied by a single spinal nerve

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2
Q

Myotome

A

-a myotome is the group of muscles that a single spinal nerve innervates

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3
Q

C5 movement

A

-shoulder abduction (deltoid)

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4
Q

C6 movement

A

-elbow flexion/wrist extension (biceps)

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5
Q

C7 movement

A

-elbow extension (triceps)

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6
Q

C8 movement

A

-long finger flexors (FDS/FDP)

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7
Q

T1 movement

A

-finger abduction (interossei)

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8
Q

L2 movement

A

-hip flexion (iliopsoas)

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9
Q

L3, L4 movement

A

-knee extension (quadriceps)

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10
Q

L4 movement

A

-ankle dorsiflexion (Tibialis anterior)

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11
Q

L5 movement

A

-big toe extension (extensor hallucis longus)

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12
Q

S1 movement

A

-ankle plantar flexion (gastrocnemius)

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13
Q

Complete spinal cord injury presentation

A
  • no motor or sensory function distal to lesion
  • no anal squeeze
  • no sacral sensation
  • ASIA Grade A
  • no chance of recovery
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14
Q

Incomplete spinal cord injury presentation

A
  • some function is present below site of injury

- more favorable prognosis overall

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15
Q

ASIS classification A

A

A - Complete. No sensory or motor function preserved in sacral segments S4-S5

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16
Q

ASIS classification B

A

B - Incomplete. Sensory but not motor function preserved below the neurological level and extending through sacral segments S4-S5

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17
Q

ASIS classification C

A

C - Incomplete. Motor function preserved below the neurological level; majority of key muscles have a grade <3

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18
Q

ASIS classification D

A

D - Incomplete. Motor function preserved below the neurological level; majority of key muscles have a grade >3

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19
Q

ASIS classification E

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A

E - Normal motor and sensory function

20
Q

Quadriplegia

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A
  • Partial or total loss of use of all four limbs and the trunk
  • Loss of motor/sensory function in cervical segments of the spinal cord
  • Respiratory failure due to loss of innervation of the diaphragm
  • Spasticity
21
Q

Paraplegia

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A
  • Partial or total loss of use of the lower-limbs
  • Impairment or loss of motor/sensory function in thoracic, lumbar or sacral segments of the spinal cord
  • Spasticity if injury of spinal cord (i.e. above L1)
  • Bladder/ Bowel function affected
22
Q

Central cord syndrome

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A
  • Older patients (arthritic neck)
  • Hyperextension injury
  • Central cervical tracts more involved
  • Weakness of arms > legs
  • Perianal sensation & lower extremity power persevered
23
Q

Anterior cord syndrome

Study These Flashcards
A
  • Hyperflexion injury
  • Anterior compression fracture
  • Damaged anterior spinal artery
  • Fine touch and proprioception preserved
  • Profound weakness
24
Q

Brown–Sequard Syndrome

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A
  • Hemi-section of the cord
  • Penetrating injuries
  • Paralysis on affected side (corticospinal)
  • Loss of proprioception and fine discrimination (dorsal columns)
  • Pain and temperature loss on the opposite side below the lesion (spinothalamic)
25
Spinal shock
- Transient depression of cord function below level of injury - Flaccid paralysis - Areflexia - Last several hours to days after injury
26
Neurogenic shock
- Hypotension - Bradycardia - Hypothermia - Injuries above T6 - Secondary to disruption of sympathetic outflow
27
Surgical fixation of spinal cord injury
- Unstable fractures - Vast majority fixed from posteriorly - Pedicle screws preferred method
28
Long term management of spinal cord injury
- Physiotherapy - Occupational therapy - Psychological support - Urological /Sexual counselling
29
Intervertebral disc joint type
-secondary cartilaginous
30
Intervertebral disc prolapse
- Annulus fibrosus - Tough outer layer - Nucleus pulposus - Gelatinous core - Annulus may tear and nucleus prolapse - Can cause cord / nerve root compression - Disc prolapses are usually posteriolateral
31
Nerve root pain management
- Physiotherapy - Strong analgesia - Referral after 12 weeks - Imaging - MRI
32
Disc problems
- Bulge (generalised) – common, majority asymptomatic - Protrusion (annulus weakened but still intact) - Extrusion (through annulus but in continuity) - Sequestration (dessicated disc material free in canal)
33
Cauda equina syndrome aetiology
- central lumbar disc prolapse (commonest) - tumours - trauma or spinal stenosis - infection (epidural abscess) - iatrogenic (spinal surgery or manipulation, spinal epidural injection)
34
Cauda equina syndrome clinical features
-Injury or precipitating event -Location of symptoms (bilateral buttock & leg pain + varying dysaethesiae + weakness) –Bowel or bladder dysfunction (urinary retention +/- incontinence overflow) –PR exam - saddle anaesthesia (perianal loss of sensation), loss of anal tone & anal reflex –High index of suspicion in spinal post-op patients with increasing leg pain in presence of urinary retention
35
Cauda equina radiological investigations
- MRI | - CT myelogram if MRI contraindicated
36
Cauda equina syndrome treatment
- operative | - within 48 hours
37
Cervical and lumbar spondyosis
- Common - Degenerative change at facet joints, discs, ligaments, etc. - If severe, can compress whole cord causing myelopathy - UMN signs in limbs (increased tone, brisk reflexes, etc.)
38
Ligaments around vertebrae
- Anterior Longitudinal Ligament (ALL – along the front of the vertebral bodies – broad, strong) - Posterior Longitudinal Ligament (PLL – along the backs of the vertebral bodies, i.e. front of the spinal canal; narrower) - Ligamentum Flavum (between laminae) - Interspinous and Supraspinous Ligaments (between spinous processes) - Intertransverse Ligament (between transverse processes)
39
Spinal Claudication
- Usually bilateral - Sensory dysaesthesiae - Posterior weakness (drop foot – tripping) - Takes several minutes to ease after stopping walking - Worse walking down hills because the spinal canal becomes smaller in extension, better walking uphill or riding bicycle
40
Lateral recess stenosis treatment
- Nerve root injection - Epidural injection - Surgery
41
Central stenosis treatment
- Epidural steroid injection | - Surgery
42
Foraminal stenosis
- Nerve root injection - Epidural injection - Surgery
43
ASIS B
B - Incomplete. Sensory but not motor function preserved below the neurological level and extending through sacral segments S4-S5
44
ASIS C
C - Incomplete. Motor function preserved below the neurological level; majority of key muscles have a grade <3
45
ASIS D
D - Incomplete. Motor function preserved below the neurological level; majority of key muscles have a grade >3
46
ASIS E
E - Normal motor and sensory function

MSK (24 decks)

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