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34 Cards in this Set
- Front
- Back
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Define Radiculopathy
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Irritation of a nerve root (radical) as it leaves the spinal canal.
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What are the generalized symptoms of radiculopathy? x4
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VARIABLE effects on:
Pain Weakness Diminished reflex Loss of dermatome sensation |
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T/F - Radiculopathy affects the UMN and LMN.
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False: Only the LMN
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Describe the peaks of incidence in radiculopathy.
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Decades 4-5 --> Disc herniation
Decades 8-9 --> Degenerative foraminal stenosis |
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Describe the prognosis of radiculopathies in younger cohorts.
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80% - 90% chance of spontaneous improvement
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Cervical radiculopathy:
- describe onset - common complaint |
Insidious onset
"shoulder pain" which is actually neck pain until proven otherwise. |
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Cervical radiculopathy:
- Pain location/intensity - Pain increases with what? - Pain decreases with what? |
Extremity > Axial
(80:20) Neck extension or Spurling's (neck rotation towards painful extremity) Placing hand on head. |
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What is Spurling's sign?
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Increased pain (along with possible loss of dermatome sensation) when rotating neck toward painful extremity.
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Irritation of nerve root C5 will affect the following how?
- Reflex - Muscle - Dermatome |
Biceps reflex
Deltoid muscle Lateral arm |
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Irritation of nerve root C6 will affect the following how?
- Reflex - Muscle - Dermatome |
Brachioradialis reflex
Biceps muscle Thumb and index |
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Irritation of nerve root C7 will affect the following how?
- Reflex - Muscle - Dermatome |
Tricep reflex
Tricep muscle Middle finger |
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Irritation of nerve root C8 will affect the following how?
- Reflex - Muscle - Dermatome |
none
Fingers (FDP) Ring finger and pinky |
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Irritation of nerve root T1 will affect the following how?
- Reflex - Muscle - Dermatome |
none
Interossei Medial arm |
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Irritation of nerve root C5 will affect the following how?
- Reflex - Muscle - Dermatome |
Biceps reflex
Deltoid muscle Lateral arm |
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Irritation of nerve root C6 will affect the following how?
- Reflex - Muscle - Dermatome |
Brachioradialis reflex
Biceps muscle Thumb and index |
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Irritation of nerve root C7 will affect the following how?
- Reflex - Muscle - Dermatome |
Tricep reflex
Tricep muscle Middle finger |
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Irritation of nerve root C8 will affect the following how?
- Reflex - Muscle - Dermatome |
none
Fingers (FDP) Ring finger and pinky |
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Irritation of nerve root T1 will affect the following how?
- Reflex - Muscle - Dermatome |
none
Interossei Medial arm |
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Lumbar radiculopathy:
- describe onset - common complaint |
Insidious onset
"Hip/butt pain" --> usually means back pain |
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Lumbar radiculopathy:
- Pain location/intensity - Pain increases with what actions? - Pain increases with what movement? |
Extremity > Axial
(80:20) Cough, sneeze, valsalva Forward flexion of leg |
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The straight leg raise test is for which nerve roots?
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L5 and S1
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What is Bragard's sign?
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Procedure used to determine whether source of lower back pain is nervous or muscular; leg is kept straight as if flexed forward at hip.
Confirms Straight Leg Raise Test. |
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In lumbar radiculopathy, an irritation of nerve root L4 does what to the following:
- Reflex - Muscle |
Patella reflex diminished
Quadricep weakness |
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In lumbar radiculopathy, an irritation of nerve root L5 does what to the following:
- Reflex - Muscle |
None
EHL/TA |
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In lumbar radiculopathy, an irritation of nerve root S1 does what to the following:
- Reflex - Muscle |
Ankle
Gastrocnemius |
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Are MRI's a screening tool for radiculopathy? Why or why not?
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Not a screening tool, because of VERY HIGH FALSE POSITIVE RATE.
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What is the best diagnosis tool for radiculopathy?
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History and Exam
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In treatment for radiculopathy, what would you want to do first?
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Nothing, but be cautious.
Gain additional history |
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What is the best option with radiculopathies?
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Time
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What is the surgical alternative for cervical radiculopathy?
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ACDF
(Anterior Cervical Dissection and Fusion) |
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What are the indications for ACDF? x5
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"Failure" of epidural steroids
6 weeks of pain without improvement Progressive weakness Unbearable pain Bowel/Bladder involvement |
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What is the surgical alternative for lumbar radiculopathy?
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Lumbar Microdissectomy
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What are the indications for Microdissectomy? x5
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"Failure" of epidural steroids
6 weeks of pain without improvement Progressive weakness Unbearable pain Bowel/Bladder involvement |
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What is Cauda Equina syndrome and what is it an indication for?
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Dull pain in upper sacral region with anesthesia or analgesia
accompanied by bowel and bladder disturbance Indicative of pressure on cauda equina may require lumbar microdissectomy |
