WEEK 7 Neuro MSK Conditions Flashcards
(18 cards)
What is Myelopathy?
Compression on the spinal cord in the central canal
Usually occurs in the cervical spine and can lead to various neurological symptoms.
What are the management options for Myelopathy?
Conservative or surgical (fusion / stabilisation)
Surgical management may be necessary for severe cases.
What is Cauda Equina Syndrome (CES)?
Compression on the collection of nerves at the bottom of the spinal cord
It is a rare but serious condition, most commonly caused by herniation of a lumbar disc.
What are the common causes of Cauda Equina Syndrome?
- Herniation of a lumbar disc (45%)
- Stenosis
- Tumour
- Discitis
- Trauma
Understanding these causes is crucial for diagnosis and management.
What are the symptoms of Cauda Equina Syndrome?
- Retention of urine
- Loss of anal tone
- Saddle anaesthesia
- Bilateral leg pain and/or numbness
- Sexual dysfunction
These symptoms require urgent medical attention.
What is the time frame for urgent medical attention in CES?
48 hours for MRI and bladder scanning
Delays can lead to significant complications.
What could happen if CES symptoms are misdiagnosed?
There could be a massive payout of around £336,000
Highlighting the importance of accurate diagnosis.
What are the risk factors for Myelopathy?
- Older age
- Degenerative changes
- Stenosis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Trauma
- Upper cervical instability
Identifying these risk factors can aid in prevention and early diagnosis.
What are the signs and symptoms of Myelopathy?
- Gait disturbances
- Fine motor skill changes
- Possibly neck pain
- Bilateral symptoms (pain, weakness, P+N’s, paraesthesia)
- Hyperreflexia
- Bladder and bowel disturbances
These symptoms can vary widely among individuals.
What are spinal red flags associated with Myelopathy?
- Central/spinal cord compression
- Cervical arterial dysfunction (CAD)
- Malignancy
- Systemic inflammatory disorders
- Infections
- Fractures
- Cauda equina syndrome (CES)
Awareness of red flags is essential for timely intervention.
What causes Myelopathy?
- Central disc herniation
- Age-related changes
- Trauma and/or instability
- Spondylolisthesis
- Ligament thickening
- Rarely: infections, tumours, cysts
Understanding the causes helps in developing effective treatment strategies.
What is Radiculopathy?
A change in neurological function from nerve root compression, irritation, or sensitivity
Symptoms can be specific to the affected nerve root.
What are the signs and symptoms of Radiculopathy?
- Pain in dermatomal distribution
- Sensory symptoms (paraesthesia, anaesthesia, allodynia)
- Motor loss in the relevant nerve root (myotome)
- Reflex changes (reduced/hyporeflexia)
Symptoms vary depending on the affected nerve root.
What investigations are used for neural conditions?
- Myelopathy – full spine MRI
- Radiculopathy – MRI of local region (e.g., cervical)
- Peripheral nerve entrapment – EMG studies
Imaging and testing are critical for accurate diagnosis.
What is the management approach for peripheral neuropathies?
- Physiotherapy/non-invasive treatment first
- Education
- Activity modification
- ROM, strength, function
- Potentially surgery if conservative management fails
Early interventions often lead to better outcomes.
What is the role of anatomy in understanding peripheral nerve irritation?
Knowing your nerve anatomy will help you work out where the irritation is occurring
This knowledge is crucial for effective diagnosis and treatment.
What are common reflex levels tested in neurological assessments?
- Biceps: C5/6
- Brachioradialis: C5/6
- Triceps: C7
- Patella tendon: L3/4
- Achilles tendon: S1
Reflex testing helps assess nerve function and integrity.
What are the myotomes and their corresponding muscle tests?
- C2: Cervical flexors - Cervical flexion
- C3: Cervical extensors - Cervical extension
- C4: Cervical side flexors - Cervical side flexion
- C5: Deltoid - Shoulder abduction
- C6: Biceps - Elbow flexion
- C7: Triceps - Elbow extension
- C8: Forearm flexors - Flexes wrist and fingers
- T1: Small finger abductors - Abduction of fingers
- L2: Iliopsoas - Hip Flexion
- L3, L4: Quadriceps - Knee extension
- L4, L5, S1: Hamstrings - Knee Flexors
- L5: Tibialis anterior and extensor hallicus longus - Dorsiflexion of ankle and great toe
- S1: Gastrocneumius, soleus - Ankle plantar flexion
Understanding myotomes is essential for pinpointing neurological deficits.
