Chapter 27. Paraplegia and Spinal Cord Syndromes Flashcards
Question 27-1: Tibialis anterior. Select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E. C7 F. L3 G. L4 H. L5 I. SI
Answer 27-1: G.
The tibialis anterior is responsible for foot
dorsiflexion, and innervated predominantly by
L4, although there is some contribution from
L5,
Question 27-2: Deltoid. Select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E. C7 F. L3 G. L4 H. L5 I. SI
Answer 27-2: C.
The deltoid is responsible for arm abduction,
and receives its major innervation from C5.
Question 27-3: Gastrocnemius. Select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E. C7 F. L3 G. L4 H. L5 I. SI
Answer 27-3: I.
The gaslrocnemius receives its major
innervation from S I, although there are a few
fibers from L5
Question 27-4: Brachioradialis. Select the root which is most responsible for its innervation. A. C3 B. C4 C. C5 D. C6 E. C7 F. L3 G. L4 H. L5 I. SI
Answer 27-4: D.
Brachioradialis is responsible for flexion of
the forearm. Major Innervation is from C6
Question 27-5:
Which of the following statements regarding dennatomal sensory innervation are true?
1. Digit 5 of the hand is supplied by C8
2. In the upper chest, the C4 and T2 dermatomes are contiguous
3. The nipple is at the T41evel
4. The umbilicus is at the TIO level
Select: A = 1,2. 3. B = 1,3. C = 2. 4. D = 4 only. E=AII
Answer 27-5: E.
All of the statements are true. Digit 5 is
innervated by C8, digit 3 is innen’ated by C7.
and digit I (thumb) is innervated by C6. The
nipple (H) and umbilicus (TIO) levels are
good points to remember
Question 27–6:
A lesion of the L2 nerve root would be expected to produce which of the following findings?
1. Sensory loss in the upper thigh
2. Weakness of knee extension
3. Weakness of hip flexion
4. Loss or diminution of knee reflex
Select: A= 1,2,3. B= 1,3. C=2, 4. D = 4 only. E=AIl
Answer 27-6: B.
L2 lesion often produces no sensory loss, but
when present, results in sensory loss in the
upper thigh. Hip flexion is also affected.
However. knee extension is not affected, since
little or no innervation to the quadriceps is .
supplied by L2, most of the innervation is by
L3. Similarly, the knee reflex would not be
affected by lesion of L2, rather by lesion of L3
and a contribution of L4
Question 27-7:
Anterior spinal artery syndrome is associated with which of the following fIndings?
1. Dysfunction of autonomic pathways
2. Dysfunction of the spinothalamic tracts
3. Dysfunction of the corticospinal tracts
4. Dysfunction of the dorsal columns
Select A = 1,2,3. B= 1,3. C=2,4. D=4 only. E=AII
Answer 27-7: A.
These three pathways are among the most
important pathways affected by the anterior
spinal artery syndrome. The dorsal colunms
are spared
Question 27-8:
Which of the following symptoms may develop due to a lesion at the foramen magnum?
1. Occipital pain
2. Downbeat nystagmus
3. Spastic weakness
4. Lower motor neuron weakness of the arms
Select: A = 1,2,3. B = 1,3. C = 2,4. D = 4 only. E = All
Answer 27-8: E.
All of these can develop with a lesion at the
foramen magnum, Occipital pain, spastic
weakness, downbeat nystagmus are expected.
However, lower motor neuron weakness of
cervical-innervated muscles can develop, and
the cause may be damage to the descending
contributions to the anterior spinal artery or a
syrinx
Question 27-9:
Which of the following clinical features suggest conus medullaris lesion rather than cauda equina lesion?
1. Mild synunenic weakness
2. lack of sphincter disturbance
3. Sudden onset
4. Severe bilateral pain
Select: A= 1,2.3. B -1, 3.C=2.4. D=4 only. E= All
Answer 27-9: B.
Conus medullaris and cauda equina lesions
can be difficult to distinguish although there
are some general guidelines. In comparison to
cauda equina lesions, conus medullaris lesions
usually have a more acute onsel, produce
milder weaknl’SS which is more symmetric,
have early sphincter and sexual dysfunction,
and have less pain
