WorksheetsHorse tail
Total questions: 7
Worksheet time: 3mins
The cauda equina consists of which of the following..
All lumbar nerve pairs
First through fifth sacral nerve pairs
Coccygeal nerve
Cauda equina syndrome is solely traumatic
True
False
What is the most common presenting symptom in CES after back pain?
Urinary retention
Faecal incontinence
Leg pain
Perineal numbness
Sensorimotor changes
43yo male presents with atraumatic bilateral leg pain and weakness worsening over the last 8 months.
What of the following may you identify on examination
Up going babinski
Muscle atrophy
Fasiculations
Hyperreflexia
Lack of sensation to pin prick around the anus
55yo lady with siatica presents because of right leg pain. When asking if she has lost control of her bowels, she replies: "no, but it was odd, I didn't feel it come out the last time"
In decreasing frequency, what are the objective findings in CES?
Altered sensation in lower limb > lower limb weakness > saddle anaesthesia > absent ankle jerk > reduced anal tone
Saddle anaesthesia > altered sensation in lower limb > absent ankle jerk > lower limb weakness > reduced anal tone
Altered sensation in lower limb > lower limb weakness > absent ankle jerk > saddle anaesthesia > reduced anal tone
Lower limb weakness > altered sensation in lower limb > absent ankle jerk > saddle anaesthesia > reduced anal tone
Reduced anal tone > saddle anaesthesia > altered sensation in lower limb > lower limb weakness > absent ankle jerk
38 year old male with chronic back pain presents with acute worsening of his lower back pain after coughing last night and now the pain goes down both legs. His wife complains of his poor sexual performance this morning.
What is the most appropriate first step?
General reassurance, overnight ESSO admit for analgesia and morning physiotherapy review
Immediate MRI of the lumbar spine and discussion with neurosurgery
Pain relief and urgent radiographs of the lumbar spine
Caudal epidural steroid injection with GP follow up for OP MRI
When must surgical decompression be done to improve bladder and motor recovery?
< 24hrs of symptom onset
< 48hrs of symptom onset
< 60hrs of symptom onset
< 1 week of symptom onset
< 2 weeks of symptom onset
