CERVICAL+THORACOLUMBAR COLUMN: 31, 32 Flashcards
5 SIGNS of animal with spinal cord disease
(1) reduction or loss of voluntary movement
(2) spinal reflex abnormalities
(3) alterations in muscle tone
(4) muscle atrophy
(5) sensory dysfunction
describe a “two engine gait”
difference in stride length between thoracic and pelvic limb (C6-T2 lesion)
a cervical lesion will always determine a worst motor disfunction in the thoracic limbs compared to pelvic limb. T or F
F, descending upper motor neuron tracts to the pelvic limbs are more peripherally located in the spinal cord; animal presents with ambulatory paresis that apparently affects only the pelvic limbs, could represent mild cervical spinal cord dysfunction
What is a central spinal cord syndrome?
Animal will present with more profound motor dysfunction in the thoracic limbs than in the pelvic limbs:
The disparity is often due to a lesion affecting the central aspect of the spinal cord, which would affect the white matter deeper in the spinal cord
reduced flexor withdrawal (thoracic limb) reflex always indicate a lesion between C6 and T2. T or F
F: can be in up to 34 % of dogs C1-C5 lesion.
Spinal location associated with Horner Syndrome
C6-T2 (more commonly T1-T3)
describe briefly the paramedial approach to the cervical column
1) right sternocephalicus muscle is spearated to right sternohyoideus
2) exposure longus colli muscles and longus capitis muscle
Name in sequence the muscles encountered during lateral approach to the cervical column:
1) cutis
2) platysma
3) expose brachiocephalicus and trapezius
4) incision parallel to brach. fibers
5) exposure in the cranial cervical region of splenius and serratus ventral
6) blunt division and ventral retraction serratus ventralis
7) exposure longissumus crevicis
8) ventral retraction longissimus cervicis
during a C1 C2 ventral approach a ventral incision is performed in the median line between the ………… muscle and …………muscle.
-trachea retracted to left
-Muscle retraction + carotid artery + internal jugular vein + vagosympathetic trunk right side
sternohyoideus muscle
sternothyroideus
the main movement between the occipital bone and the atlas is later-lateral. T or F
F, flexion and extension (yes joint)
the main movement between the atlas and the axis is rotational. T or F
T
Name the 4 legaments that attacches the ATLAS to occipital bone and axis
1) apical ligament (basioccipital)
2) alar ligamenys (occipital)
3) dorsal atlantoaxial (spine axis)
4) transverse ligament (dens axis)
agle beween atas and axis predictive of instability
< 162°
when DORSAL surgical approach for ATL-AX instability is contraindicated?
dorsal deviation of the dens
angle and length of ideal transarticular corridor between atlas and axis
40° mediolateral
20° ventrodorsal
7 mm median
Failure rate ventral vs dorsal techniques for ATL-AX stabilization
ventral: 44%
dorsal: 48%
does C5 contribute to brachial plexus?
Usually no (just C6-T2), however 24% dogs also C5
partial lesions to brachial plexus are more commonly cranial. T or F
F: more commonly caudal.
name in order the 6 types of injury to nerves
1) neuroapraxia
2) axonotmesi
3)neurotmesi (disruption axons+endoneurium)
4) neurotmesi (previous + perineurium)
5) neurotmesi, complete severed nerve
6) nerve avulsion
3 types of brachial plexus injuries
1) cranial portion (C6-C7, some times also C5)
2) caudal portion (T1-T2)
3) all brachial plexus
clinical signs associated with cranial brachial plexus injury
1) atrophy supraspinatus
2) atrophy infraspinatus
-loss shoulder movement
-loss elbow FLEXION
clinical signs associated with caudal brachial plexus injury
involves RADIAL NERVE! (92% of cases)
1) paralisys triceps
2) loss cutaneous trunci reflex)
3) Horner
-loss extend elbow
-loss extend carpus
common site for cervical vertebral disc extrusion
C2-C4 80%
C2-C3 44-59%
protrusion are more common in cervical column than thoracolumbar column. T or F
F. more common extrusions!
prevalence of nerve root signature in cervical extrusions
22-50%. really common. Uncommon tetraplegia.
the degree of spinal cord compression evident on MRI is undependent to both clinical signs and prognosis in cervical Hansen Type 1 extrusions. T or F
F. dependent to clinical signs, undependent to prognosis.
conservative treatement is recommended for:
a) neck pain only
b) recurrent neck pain
c) neck pain+concurrent neuro deficits
a only
ideal ventral slot dimensions
33% vertebral bodies length, 50% width (preferrably and 33%)
hypoventilation will occur more commonly in dogs with lesions between C…. and C…., especially undergoing. ……….decompressive laminectomy
2 and 4
dorsal
risk of recurrence in cases of cervical extrusion treated conservatively
36+%
name the two major patophisiological categories of cervical spondylomielopathy
osseous associated
disc associated
most commonly involved IVD spaces in wobbler syndrome
C5-C6, C6-C7
signalment and patogenesis of osseous associated wobbler
Young, large breed dogs.
-combination of vertebral malformation + osteoarthritic changes to zygoapophyseal joint
what is the difference between vertebral instability and dinamic compression?
a) instability: abnormal displacement secondary to normal load
b) dynamic lesion: lesion that worsten or improve depending on column position
differences between large breed and giant breed wobbler
GIANT: 3.8 years mean, 80% multiple sites compression. most common C6-C7, then C5-C6 (90%)
LARGE: 6.8 years mean, 50% multiple compression . most common C6-C7, C5-C6, C4-C5 (80%)
