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Spinal cord compression > Basic neurology & disease > Flashcards

Basic neurology & disease Flashcards

1
Q

What does an afferent neurone do?

A

Carries information from sensory receptors into the CNS.

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2
Q

Where do afferent neurones enter the CNS?

A

Through dorsal root ganglia.

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3
Q

What does an efferent neurone do?

A

Carries motor signals from the CNS to effector muscles.

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4
Q

Where do efferent neurones leave the CNS?

A

Thought ventral root ganglia.

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5
Q

What is a ganglion?

A

A collection of neurones or cell bodies of neurones outside the CNS.

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6
Q

What do muscle spindles detect?

A

Muscle stretch.

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7
Q

What neurones do muscle spindles cause APs in?

A

1a afferent neurones.

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8
Q

What do 1a afferent neurones innervate?

A

Alpha motor neurones & inhibitory interneurones.

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9
Q

What do golgi tendons detect?

A

Muscle tension.

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10
Q

What neurones doe golgi tendons cause APs in?

A

1b afferent neurones.

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11
Q

What does two actions result from activation of the muscle spindle?

A

Excitation of alpha motor neurone projecting to the homonymous muscle > contraction of the homonymous muscle.

Excitation of the inhibitory interneurone > inhibition of the alpha motor neurone projecting to the heteronymous muscle > relaxation of the heteronymous muscle.

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12
Q

What are renshaw cells & what is their role?

A

Inhibitory neurones which release glycine onto alpha motor neurones to make the spinal reflex transient.

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13
Q

What does tetanus inhibit?

A

Glycine release.

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14
Q

Explain the myotactic reflex?

A

Stretch of a muscle > stretch of the muscle spindle > AP in 1a afferent neurone > activation of the alpha motor neurone projecting to the homonymous muscle > contraction of the homonymous muscle.

The 1a afferent neurone also activates the inhibitory interneurone projecting to the alpha motor neurone of the heteronymous muslce > relaxation of the heteronymous muscle.

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15
Q

Explain the inverse myotactic reflex?

A

Increased muscle tension > activation of the GTO > AP in 1b afferent neurone > excitation of inhibitory interneurone > inhibition of the alpha motor neurone projecting to the homonymous muscle > relaxation of the homonymous muscle.

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16
Q

What are synergistic muscles?

A

Muscles that contract together to produce the same movement.

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17
Q

What is the role of gamma motor neurones?

A

Ensure the muscle spindle is always kept under tension.

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18
Q

What are the most important tracts for voluntary movement?

A

Corticospinal tracts.

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19
Q

Where do corticospinal tracts originate?

A

Pyramidal cells of the motor cortex.

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20
Q

Where do corticospinal tracts decussate?

A

At the decussation of the pyramids in the medulla.

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21
Q

Where is the premotor area found & what is its role?

A

Found in the frontal lobe.

Required for the planning of movements & movements that require visual guidance.

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22
Q

Where is the primary somatosensory cortex found & what is its role?

A

Found in the parietal lobe.

Required for filtering out of irrelevant sensory information.

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23
Q

Where is the supplementary motor area found & what is its role?

A

Found in the frontal lobe.

Required for coordinating voluntary movements.

24
Q

What is anosognosia?

A

Unawareness of a disability.

25
Q

Damage to which area may result in anosognosia?

A

The posterior parietal cortex.

26
Q

What is apraxia?

A

Inability to produce a specific motor act even though sensory & motor pathways are intact.

27
Q

Damage to which areas result in apraxia?

A

Primary motor cortex.
Supplementary motor area.
Posterior parietal cortex.

28
Q

What are the two types of apraxia?

A

Ideomotor apraxia:
> Cannot execute a specific movement on request even though the movement is known.

Ideational apraxia:
> Cannot conceptualise the movement.

29
Q

What information does the lateral spinothalamic tract carry?

A

Pain & temperature.

30
Q

What information does the dorsal column carry?

A

Proprioception & soft touch.

31
Q

What are the classic signs of a UMN lesion?

A

Hyper-reflexia.
Spasticity.
Postivie babinski reflex.

32
Q

What are the classic signs of a LMN lesion?

A

Hypo-reflexia / areflexia.
Fasiculations.
Muscle atrophy.

33
Q

Where does the lateral spinothalamic tract decussate?

A

At the level is enters the spinal cord.

34
Q

What level does the dorsal column decussate?

A

At the level of the medulla.

35
Q

What is Brown-Sequard syndrome?

A

Lateral hemisection of the spinal cord.

36
Q

What are the signs of Brown-Sequard syndrome?

A

Loss of motor function on the ipsilateral side at the level of & below the lesion.
Loss of proprioception & soft touch on the ipsilateral side at the level of & below the lesion.
Loss of pain & temperature sensation on the contralateral side at the level of & below the lesion.

37
Q

What are the causes of spinal cord disease?

A 
Trauma.
Infection.
Demyelination (i.e. MS).
Compression.
B12 deficiency.
Anterior spinal artery infarction.
Inflammatory (i.e. SLE).
38
Q

What does paresis mean?

A

Weakness.

39
Q

What does plegia mean?

A

Paralysis.

40
Q

What does myelo mean?

A

Pathology of the spinal cord.

41
Q

What does radiculo mean?

A

Pathology of the nerve root.

42
Q

What does neuro mean?

A

Pathology of the peripheral nerves.

43
Q

What does myo mean?

A

Pathology of muscle.

44
Q

What are the functions of UMN pathways?

A

Dampening of the reflex arc.
Suppressing muscle over-activity & spasm.
Suppressing primitive reflexes (i.e. babinkski).

45
Q

What is a LMN?

A

anterior grey horn cell.

46
Q

What is a UMN?

A

Anything above the synapse of the anterior grey horn cell.

47
Q

What are the classic signs of muscle disease?

A

Proximal muscle weakness & pain.
Muscle wasting or hypertrophy.
Normal reflexes.
Raised CK.

48
Q

What is papilloedema & what does it suggest?

A

Swelling of the optic nerve - suggests raised ICP.

49
Q

What is dysarthia?

A

Difficulty with speech articulation.

50
Q

What pathways degenerate in motor neurone disease?

A

UMN:
> corticospinal tracts.
> corticobulbar tracts.

LMN:
> loss of anterior horn cell.

51
Q

What are the signs of motor neurone disease?

A

Hyper-reflexia.
Pseudobulbar palsy.
Fasiculations.
Elevated CK.

52
Q

What drugs can cause muscle disease?

A

Statins.
Steroids.
Anti-virals.
Chloroquine.

53
Q

What are the signs of polymyositis?

A

Proximal muscle weakness.

54
Q

What are the signs of dermatomyositis?

A

Promxial muscle weakness.
Rash over hands & face.
Mainly in adults with malignancy.

55
Q

What are the signs of inclusion body myositis?

A

Proximal leg muscle & long finger flexor weakness.

Mainly in the elderly.

56
Q

What is cauda equina syndrome?

A

Compression of the cauda equina.

57
Q

What are the symptoms of cauda equina syndrome?

A 
Bilateral sciatica.
Saddle & genitalia anaesthesia.
Sphincter & sexual dysfunction.
Loss of ankle reflexes.
Leg weakness & pain on raising.

Spinal cord compression (1 decks)

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