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Neuro_week3 > Assessment of spine and spinal cord > Flashcards

Assessment of spine and spinal cord Flashcards

1
Q

define paresthesia

A

abnormal sensation = burning, pricking, tingling tickling

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2
Q

define dysesthesia

A

impairment of sensation short of anesthesia

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3
Q

define paresis

A

partial loss of movement or impaired movement

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4
Q

define dermatome

A

cutanoeus area served by individual sensory root

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5
Q

define myotome

A

muscles innerv by individual motor root

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6
Q

define radiculopathy

A

sensory and/or motor dysfunction due to injury to a nerve root from lateral herniation

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7
Q

define myelopathy

A

disorder resulting in spinal cord dysfunction from central herniation

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8
Q

spinothalamic tract
function
cross

A

function = pain and temp (cold/hot)

cross = 2-3 segments above root entry level in anterior cord

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9
Q

posterior column
function
cross

A

function = vibration, position, 2-point discrim

cross = medulla (brain stem)

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10
Q

corticospinal tract
function

cross

A 
function = motor
cross = lower medulla (brain stem)
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11
Q

where nerve roots exit

c1-7

A

exit above same numbered vertebra

c7 above c7

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12
Q

where nerve roots exit

c8

A

c8 exits below c7 vertebra

t1 below t1

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13
Q

where nerve roots exit

t1-s5

A

exit below same number vertebra

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14
Q

know cord level each vertebral body overlies

upper cervical

A

vertebra number overlies cord segment of same number

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15
Q

know cord level each vertebral body overlies

lower cervical

A

vertebra number overlies cord segment number + 1

c6 bone = c7 cord

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16
Q

know cord level each vertebral body overlies

upper thoracic

A

vertebra number overlies cord segment number + 2

T4 bone = T6 cord

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17
Q

know cord level each vertebral body overlies

lower thoracic/lumbar

A

vertebra number overlies cord segment number +2/3

t11 bone, L1-2 cord

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18
Q

know cord level each vertebral body overlies

lower edge of l1 vertebral body

A

overlies cord tip (conus medullaris)

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19
Q

where is conus medullaris

what does it supply

A

s2-s5 = supplies bladder, rectum, genitalia

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20
Q

what happen if lesion conus medullaris

A

late pain in thighs and butt, pelvic floor weakness

symmetric saddle anesthesia
early bladder dysfunction, bowel, sex

21
Q

cauda equina formed by

what happens if lesion

A

Lumbar sacral roots within lumbosacral cistern

early root pain radiating to legs (conus = late), leg weakness, decr DTR, patchy, asymm “saddle

late bladder dysfunction (conus = early), bowel, sex dysfunction

22
Q

if lesion extramedullary (outside cord)

if lesion intramedullary (inside cord)

A

early pain
UMN signs

early bladder dysfunction

23
Q

extaspinal blood supply includes

A

paired posterior spinal arteries (supplies posterior column)

single anterior artery (supplies spinothal and corticospinal tracts and watershed T1-T4 or L1)

24
Q

intraspinal blood supply includes

A

gray matter require more blood than white

25
Q

define radiculopathy pain

A

variable- shooting, burning, tingling, numb

radiates into dermatome or myotome

26
Q

exam for radiculopathy

localization

exercabation

A

possible LMN signs
localization based on root of muscles/dermatome

exacerbation by neck flex/ext/rot, shoulder movement, cough

27
Q

exam for radiculopathy

relieving factors

A

rest, immob, graded therapy, NSAIDs +/- muscle relaxant

28
Q

common causes of radiculopathy

direction of herniated disc

posterior herniation causes –>

A

compression by DJD –> bony prolif or herniated disc near intervertebral foramen

other = herpes zoster, cancer, lymphoma

discs herniated laterally

posterior herniation –> myelopathy

29
Q

describe lhermitte’s symptom

due to

A

neck flxion –> “electric shock” sensation down back and/or arms

due to posterior column disease (MS, disc, B12 deficiency, mass)

30
Q

LMN vs UMN signs

A

LMN = atrophy, fasciculations, decr tone, decr DTR

UMN = spasticity, hyperreflexia, babinski

31
Q

voiding controlled by

A

higher cortical centers developing as continence and achieved in childhood

32
Q

define incontinence

A

neuro pathways that innerv bladder interrupted or when problem with pelvic floor/sphincter

assoc with spinal cord damage

33
Q

bladder controlled by

neurons terminate where?

A

1) areas of brain/brainstem sending axons down cord medial to LCST
2) terminate on preganglionic parasympathetic at S2-S4
3) synapse on postgangl parasymp near bladder
4) innerv detrusor (smooth muscle) for voiding

34
Q

muscle spindles, nociceptors, and receptors in detrusor and bladder wall have cell bodies where?

involved in what?

A

DRG at S2-S4

involved in reflex arc and ascend nervous system via AL path and dorsal column

35
Q

what happens when bladder fills?

A

1) muscle spindle of detrusor/bladder stretched
2) incr firing –> incr neuronal firing of symp preganglionic neurons in IML cell column from T11-L1

3) constriction of internal urethral sphincter
decr firing of pregangl symp at S2-S4 to inhib contract of detrusor

4) then activates higher centers in bain
5) inhib of symp tone and activ of parasymp contraction of detrusor

36
Q

if PNS LMNs injured

if sensory afferents affect

if intact sensory with damaged motor

A

weakness, atrophy, hyporeflexia
bladder does not contract = overflow incontinence

no sensation of full bladder

urge to void but detrusor can’t contract

37
Q

where can LMN injury occur

A

preganglionic neuron at S2-S4
sacral root of cauda equina, pelvic nerve
pelvic plexus
2ndary postgangl, parasymp neuron innerv detrusor

38
Q

if UMN lesions injuured

A

to affect bladder, must be bilateral
detrusor flaccid –> urinary retention –> flaccid bladder

over time, get spasticity and bladder hyper contracts causing freq and urgency (activ parasymp motor neuron with little stretch and cause spastic bladder)

39
Q

c5 sensory
motor
reflex

A 
sensory = shoulder, upper lat arm
motor = deltoid, infraspinatus, bicep

reflex = biceps

40
Q

c6
sensory
motor
reflex

A 
sensory = 1st and 2nd digits of hand 
motor = wrist extension, biceps

reflex = biceps, brachioradialis

41
Q

c7
sensory
motor
reflex

A 
sensory = 3rd digit
motor = triceps
reflex = triceps
42
Q

L4
sensory
motor
reflex

A 
sensory = knee, medial leg
motor = psoas, quad
reflex = patellar
43
Q

L5
sensory
motor
reflex

A 
sensory = dorsal foot, great toe
motor = foot dorsiflex, big toe ext, foot eversion/inversion

reflex = none

44
Q

S1
sensory
motor
reflex

A

sensory = lat foot, small toe, sole of foot

motor = foot plantarfelx
reflex = achilles
45
Q

dermatomes for
nipple line
xyphoid
umbilicus

A 
nipple = T4
xyphoid = T6
umbilicus = T10
46
Q

Lhermitte’s sign

A

with cervical stonosis and flex head —> shock extend down spine and compression
of spinal cord acutely (cervical myelopathy)

47
Q

spurling’s sign

A

turn head towards nerve root (foramen
narrows) —> shock sensation along
the tract of nerve root

48
Q

Lasegue’s sign

A

in lumbosacral spine, narrowed neural foramen and raise
leg and dorsiflex ankle —> stretch sciatic nerve, shooting
pain in distrib of nerve root of sciatic nerve

49
Q

dysestheia vs paresthesia

A

dysesthesia is more unpleasant

Neuro_week3 (23 decks)

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