19. Neurological Exam/SC Syndromes Flashcards
Signs for UMN lesion
No atrophy
Inc tone and spasticity
Inc DTRs
+Babinski
Sign LMN lesion
Atrophy/flaccid paralysis
Dec. or absent DTR
-Babinski
Nerve level for deltoid
C5
Nerve level for biceps
C6
Nerve level for triceps
C7
Nerve level for intrinsic hand muscles
C8
Nerve level for Hip flexors
L2/L3
Nerve level for Quads
L4
Nerve level for plantarflexors
L5
Nerve level for everything on back of leg
S1
What is the name of the artery that supplies T9-L2 region?
Artery of Adamkiewicz
Which forces cause spinal cord trauma to the cervical region? Thoracolumbar region?
Compression and hyperextension
Compression and hyperflexion
Symptoms of acute spinal shock during first few weeks (3 symptoms)
- Flaccid paralysis
- Red. DTR
- Smooth muscle hypofunction
Symptoms of spinal shock when it becomes chronic (after several weeks)
Inc reflexes and tone
Involuntary spasms
Hyperactive bladder and bowel with involuntary emptying
What is effected with central spinal cord syndrome? Which are spared?
Anterior horn cells –> LMN –> weak, atrophic limbs
Dorsal columns and LCST are spared
What is the most common type of spinal cord tumor?
Metastatic (extradural)
Where do metastatic cancers to the SC come from?
Breast, lungs, and prostate
What are the three infections of the spinal cord?
Epidural abscess by S. aureus
Poliomyelitis by polio virus
Neurosyphilis by T. pallidum
Epidural abscess organism, mechanism, common mechanism of spread, symptoms, treatment
S. aureus
Skin infection –> osteomyelitis –> abscess
Hematogenous is how it spreads
Fever and spinal cord compression are the symptoms
Treatment: Lg abscesses = surgery, abx
Sm abscess = abx, percutaneous drainage
Poliomyelitis involves which cells, symptoms, pathology,
Lower alpha motor neurons are involved
Pathology: diffuse chromatolysis with acidophilic nuclear inclusions –> PMNs invade –> neuonophagia
Symptoms:
Anterior horn cells - limb weakness, atrophy, hyporeflexia
Thx region - kyphoscoliosis, resp difficulty
Cranial nerve nuceli - dysarthria, dysphagia
Neurosyphilis what is involved, signs, symptoms
Demylinating disease of dorsal columns - Romberg sign and gait ataxia
Hyporeflexia
Bladder hypotonicity
What nutritional disease causes damage to SC? What happens? Tx?
Vit B12 deficiency causes demylination of LCST and posterior columns
UMN weakness
Loss of vibration, proprioception, and touch sensations
Tx: B12 supplements
Friedreich’s Ataxia is what type of disease? Symptoms
Demyelination
Posterior columns, Cerebellum (ataxia), DRG (hyporeflexia), LCST (weakness, Babinski)
Als involves which system, presentation
Pure motor system involvement
Prominent weakness of one limb, spasticity of another limb, tongue atrophy, problems with speech
What is cervical spondylosis? Clinical triad of spondylosis. Pathogenesis
Myelopathy due to degenerative arthritis
Triad: Neck pain, LMN (arm pain, upper extremity signs), UMN (Spastic weakness and ataxia in legs)
Canal diameter reduced due to disc herniation, spondolytic ridging, congenital narrowing –> cord compression
Syringomyelia
Due to cavitation of central portion of the cord
Vestigial canal forms, used to be central spinal canal
From obstruction of central canal, dilates –> syringomyelia
Tracts effected: STT, Anterior horn cells
