3.2 Flashcards
does spinal shock have anything to do with perfusion/cardiac issues
no; strictly to motor and sensory issues
in spinal shock, below SCI we see loss of
all reflexes
sensation
motor function
What reflex is lost of shock phase of spinal shock
Bulbocavernosus reflex
Autonomic Dysreflexia generally occurs when there SCI at what level
T6 and above
below the injury in autonomic Dysreflexia, what nervous system is in charge
sympathetic domination
above the injury in Autonomic Dysreflexia, what nervous system is in charge
parasympathetic domination
most common cause of Autonomic Dysreflexia
UTI/urinary retention
second most common cause of Autonomic Dysreflexia
fecal impaction
central cord syndrome is often due to
hyperextension injury or syringomyelia
what is the most common incomplete spinal cord injury
central cord syndrome
what tracts are commonly damaged in central cord syndrome
lateral corticospinal (bilaterally)
anterior gray horn (bilaterally)
sympathetic fibers
what is typically spared in central cord syndrome
dorsal column
motor deficit in central cord syndrome is great in what extremities
upper extremities > lower extremities
how do we describe the sensory deficit distribution in central cord syndrome
shawl distribution
anterior cord injury is commonly due to
blowout vertebral body burst fracture (flexion)
anterior spinal artery injury or occlusion
anterior cord syndrome usually spares what tract
dorsal white column
Posterior cord syndrome is commonly due to
syphillis
Frederick’s ataxia
multiple sclerosis
B12 deficiency
posterior spinal stenosis
Brown sequard syndrome is commonly due to
penetrating trauma
micturition reflex
increased parasympathetic
decreased sympathetic
detrusor muscle contracts
internal sphincter opens
decreased motor input to external sphincter–> external sphincter opens
what area in the brain allows us to STORE our urine
pontine storage center
what area in the brain allows us to urinate
pontine micturition center
what type of incontinence do we see in spinal shock
overflow incontinence due to detrusor hyporeflexia
what type of incontinence do we see after spinal shock has resolved
urge incontinence due to detrusor hyperreflexia
what type of incontinence do we see in MS
urge incontinence due to detrusor hyperreflexia
what type of incontinence do we see in PD
urge incontinence
what type of hypersensitivity rxn is acute disseminated encephalomyelitis
type 4
large difference between ADEM and MS
ADEM - single event of demyelination in a child
MS - progressive and recurrent bouts of demyelination in young adults
are symptoms for ADEM sudden or gradual
sudden
what is a required feature of acute disseminated encephalomyelitis
encephalopathy
what is the study of choice for evaluating most acute head injuries
CT head without contrast
do we have degeneration of white matter or gray matter in multiple sclerosis
white matter
What is the most common form of multiple sclerosis
relapsing-remitting disease (episodic exacerbations)
what are the most common presenting symptoms in MS
sensory disturbances
weakness
visual disturbances
what pain syndrome is commonly seen in multiple sclerosis
trigeminal neuralgia
what is Uhthoff’s phenomena that we often see in MS
worsening of symptoms with heat
what is Lhermitte’s sign in MS
neck flexion causes lightning shock type pain radiating from the spine down the leg
Marcus-Gunn pupil in MS patients with optic neuritis
during swinging flashlight test from unaffected eye to affected eye, the pupils dilate
What imaging is best for MS
T2 weighted MRI with FLAIR
How many areas of white matter involvement should you see in MS before making a diagnosis
at least 2
what will you see on LP for MS
increased IgG and oligoclonal bands
first line treatment for MS
IV high dose glucocorticoids
what part of the spinal cord is affected in poliomyelitis
anterior horns
what types of symptoms will be see in poliomyelitis
flaccid paralysis due to destruction of anterior horns
what is poliomyelitis caused by
poliovirus
most common transmission with poliomyelitis
fecal-oral transmission
how long can poliovirus shed in stool
up to 6 weeks
best way to test for poliovirus
stool sample
for conductive hearing loss, what would we expect
weber heard in affected ear
rinne: BC > AC in affected ear
for sensorineural hearing loss, what would we expect
weber heard in normal ear
rinne: normal bilaterally; AC > BC
Charcot’s triad in MS
nystagmus
staccato speech
intention tremor
in what section of the spine does transverse myelitis most commonly occur
thoracic region
what is progressive multifocal leukoencephalopathy caused by
polyomavirus JC
what does the polyomavirus JC attack
oligodendrocytes –> unable to reform myelin
are symptoms gradual or sudden in progressive multifocal leukoencephalopathy
gradual
UMN symptoms in ALS are due to
frontal and corticospinal
LMN symptoms in ALS are due to
spinal cord and brainstem
what type of shock do we commonly see in spinal cord injuries
neurogenic shock; this is a type of distributive shock
what NS is damaged and what NS dominates in neurogenic shock
Sympathetic - damaged
Parasympathetic - dominates
What is the triad we see in neurogenic shock
hypotension
bradycardia
hypothermia
Port wine stains are commonly associated with
Sturge Weber syndrome
where are port wine stains found in sturge weber syndrome
generally alone the trigeminal nerve distribution
3 main findings in sturge weber syndrome
port wine stains
leptomeningeal angiomatosis
ocular involvement (glaucoma)
