B7-015 Myelopathies Flashcards

1
Q

because of bilateral symmetric symptoms and signs, [….] mimic diffuse toxic metabolic processes

A

midline structural processes

(usually more dangerous and require more urgent treatment)

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2
Q

the dorsal (posterior) horn contains […] neurons

A

sensory

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3
Q

the ventral (anterior) horn contains […] neurons

A

motor (includes LMN)

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4
Q

the first order sensory neuron lives in the

A

dorsal root ganglia

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5
Q

LMN lives in the

A

anterior horn

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6
Q

white matter tracts in the spinal cord [3]

A

posterior funiculus
lateral funiculus
anterior funiculus

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7
Q

the long tracts reside in the […] matter

A

white

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8
Q

what areas of the cord have larger anterior horns?

A

cervical and lumber

(contain more motor neurons to innnervate limbs)

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9
Q

what area of the cord has a lot of white matter?

A

cervical

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10
Q

spinal cord ends at

A

L1

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11
Q

UMN live in the

A

corticospinal tract

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12
Q

lives in the posterior faniculus

A

DC/ML

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13
Q

the first order neuron of the DC/ML

A

dorsal root ganglion

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14
Q

the second order neuron of the DC/ML

A

nucleus gracilis/cuneatus

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15
Q

the third order neuron of the DC/ML

A

thalamus

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16
Q

ways to test the DCML

A

proprioception (move joint)
tuning fork

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17
Q

ways to test spinothalamic

A

pain with pinprick
using a cool metal tool for temperature

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18
Q

what nutrient deficiency can affect the posterior columns and corticospinal tract?

A

B12 or copper

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19
Q

[…] competes with copper for absorption

A

zinc

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20
Q

first order neuron of the spinothalamic system

A

dorsal root ganglion

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21
Q

second order neuron of the spinothalamic system

A

dorsal horn

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22
Q

third order neuron of the spinothalamic system

A

thalamus

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23
Q

label the three systems

A
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24
Q

hemisection of the spinal cord will cause ipsilateral […] and contralateral […]

A

ipsilateral: proprioceptive loss and weakness (DC/ML and corticospinal)

contralateral: pain and temperature loss (spinothalamic)

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25
what information can tell you which spinal cord lesion the deficit is at? [3]
level of weakness level of reflex change level of numbness
26
deltoid, infraspinatus, and biceps weakness
C5
27
weakened biceps and pectoralis weakness
C5
28
wrist extensor and biceps weakness
C6
29
biceps and brachioradialis reflex weakness
C6
30
triceps weakness and reflex weakness
C7
31
iliopsoas and quadriceps weakness
L4
32
patellar reflex weakness
L4
33
foot dorsiflexion big toe extension foot eversion weakness
L5
34
weakness of foot plantar flexion
S1
35
weak Achilles reflex
S1
36
jaw jerk reflex [where is the lesion?]
lesion is above brainstem
37
nipple line
T4
38
umbilicus
T10
39
abrupt transition from C4 to T2
cervical mantle
40
where do loss of pain and temperature typically occur?
several levels below the lesion
41
supply the posterior columns of the spinal cord
posterior spinal arteries **rare to get infarct here**
42
supply the anterior 2/3 of the spinal cord
anterior spinal artery **infarct will affect this area usually**
43
bilateral weakness bilateral pain/temperature loss spared proprioception
infarction of spinal cord at anterior spinal artery
44
bilateral upper extremity pain/temp loss LMN findings in arms UMN findings in legs spared proprioception
cervical central cord syndrome
45
"cape-like" loss of sensation
central cord syndrome
46
external compression of the spinal cord tends to only effect the
corticospinal tract
47
spared pain/temperature spared proprioception UMN signs in arms and legs
external compression of the cervical spinal cord
48
the reason for selective vulnerability in toxic metabolic processes is
unknown
49
upper and lower extremity weakness upper and lower extremity proprioception loss pain/temperature spared [3]
B12 deficiency copper deficiency Friedrich's ataxia **subacute combined degeneration**
50
UMN and LMN weakness
ALS
51
diseases affecting anterior horn cell causing LMN weakness [2]
spinal muscular atrophy (werndig-hoffman) poliomyelitis (WNV)
52
diseases affecting posterior columns only causing proprioceptive loss [3]
tabes dorsalis (tertiary syphilis) B6 (pyroxidine) intoxication paraneoplastic
53
[...] is almost always preserved with spinal cord infarction
dorsal column
54
chronic progressive sensory ataxia + Romberg sign absent DTRs
tabes dorsalis
55
can be secondary to aortic aneurysm repair
anterior spinal artery occlusion
56
congenital degeneration of the anterior horn
spinal muscular atrophy (Werdnig-Hoffmann)
57
floppy baby marked hypotonia (flaccid paralysis) tongue fasciulations **symmetric** weakness
spinal muscular atrophy (Werdnig-Hoffmann)
58
poliomyelitis affects the [...]
anterior horn
59
acute LMN signs **asymmetric** weakness symptoms of viral meningitis
poliomyelitis
60
CSF shows: elevated WBCs slight elevation of protein no change in glucose
poliomyelitis
61
caused by autosomal recessive mutation in SMN1
spinal muscular atrophy (Werdnig-Hoffmann)
62
LMN signs associated with ALS [4]
flaccid limb weakness fasciculations atrophy bulbar palsy (dysarthia, dysphagia, tongue atrophy)
63
UMN signs associated with ALS
spastic limb weakness hyperreflexia clonus psuedobulbar palsy (dysarthia, dysphagia, emotional lability)
64
what nervous system functions are spared in ALS [2]
sensory bowel/bladder deficits
65
demyelination of: spinocerebellar tracts lateral corticospinal tracts dorsal columns
subacute combined degeneration **SCD**
66
subacute combined degeneration is caused by [...] deficiency
B12
67
ataxic gait impaired vibration/sensation + Romberg UMN signs
subacute combined degeneration
68
presents with UMN signs above the lesion and LMN signs at level of lesion loss of pain/temperature below lesion dorsal columns spared
anterior spinal artery occlusion
69
ependymomas can cause
central cord syndrome