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differential physicalexam extremity management spinalcord barre causes cord guillain leg motor myotomes sensory algorithm arm caudaequina clinical comatose dislocation disorders
Cauda Equina Syndrome Overview Cauda Equina Syndrome: • Prevalence: 1:33,000-100,000 ppl/yr • Incidence: 1.5-3.4 million ppl/yr •
Cauda Equina Syndrome ... compression of nerve ... infarct • HIV ... region (S2-S4 dermatomes ... #causes #neurology
Spinal Cord Injury by Nerve Root Levels Spinal Root Sensory Motor Reflex C4 Acromioclavicular Joint Respiration None C5 Radial Antecubital Fossa Elbow Flexion Biceps Reflex C6 Dorsal Thumb Wrist Extension Brachioradialis Reflex C7 Dorsal
Spinal Cord Injury ... by Nerve Root Levels ... C6 Dorsal Thumb Wrist ... Anterior Medial Thigh Hip ... #Neurology #Spine
Lower Extremity Dermatomes and Myotomes Reflexes: • Knee - L2, L3, L4 • Ankle - S1
Conditions: • Cauda ... Equina Syndrome ... damage to peroneal nerve ... #Myotomes #diagnosis ... #neurology #sensory
Upper Extremity Dermatomes and Myotomes Motor Function Shoulder: • Abduction - C5,C6 (axillary) • Adduction - C6, C7,
Upper Extremity Dermatomes ... Pronation - C7, C8 Wrist ... spared in this injury ... #Myotomes #diagnosis ... #neurology #sensory
Meralgia paresthetica: Pathogenesis and Clinical Findings Compression/injury of Lateral Femoral Cutaneous Nerve (LFCN) -> Meralgia paresthetica •
Findings Compression/injury ... Femoral Cutaneous Nerve ... rarely follow dermatomal ... Straight Leg Raise Test ... MeralgiaParesthetica #MSK
Causes of Neuromuscular Weakness • Spinal Cord: Demyelinating Disease (MS), Epidural abscess, Infarction, Syringomyelia, Tetanus, Transverse
Neuromuscular Weakness • Spinal ... Demyelinating Disease (MS ... injury, Sarcoid ... #differential #diagnosis ... #neurology
Lesions of the Spinal cord - Spinal Cord Syndromes Spinal cord lesions can result in permanent neurologic
Syndromes Spinal ... result in permanent neurologic ... involvement Cauda ... #differential #diagnosis ... #neurology
Leg Pain - Differential Diagnosis Framework Bone/Joint Causes of Leg Pain: • Fracture • Arthritis • Gout/pseudogout
- Differential Diagnosis ... deficiency etc) • Spinal ... Herpes zoster - HIV ... Trauma • Crush injury ... lower #extremity #msk
Spinal Cord Disorders - Differential Diagnosis Framework Spinal cord neurological lesion: Clinical findings: • Symptoms and signs below
- Differential Diagnosis ... below the site of injury ... Lower roots -> Cauda ... MCTD, Sjogren syndrome ... #neurology #differential
Guillain-Barre Syndrome - Summary Acute AIDP that presents with rapidly progressive flaccid weakness Epidemiology: • 1-2 cases/100,000 per
Guillain-Barre Diagnosis ... of intrathecal spinal ... cauda equina ... #diagnosis #management ... #treatment #neurology
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