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Kaplan: Anatomy and Physiology Part III > Chapter 4: Spinal Cord (continued) > Flashcards

Chapter 4: Spinal Cord (continued) Flashcards

1
Q

The fasiculus cuneatus carries fibers from what spinal cord segments?

A

T5 and up

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2
Q

The DCML pathway is located in what part of the spinal cord?

A

dorsal columns

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3
Q

The fasiculus gracilis carries fibers from which spinal cord segments?

A

T6 and below

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4
Q

Where in the thalamus are the 3rd neurons of the DCML?

A

ventropostero-lateral nucleus VPL

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5
Q

What sensations are loss with damage to the DCML?

A
  • joint position sensation
  • vibratory and pressure sensations
  • 2 point discrimination
  • loss of ability to identify the characteristics of an object (asterognosis) (consistency, form, and shape)
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6
Q

How is Romberg sign tested?

A

asking the patients to place their feet together. If there is marked deterioration of posture (if patient sways) with eyes closed, this is a positive Romberg sign (DC lesion)

If patent has balance problems and tends to sway with eyes open = cerebellar damage

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7
Q

What sensations does the anterolateral pathway send?

A

pain, temperature, and crude touch sensations from the extremities and trunk

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8
Q

What is another name for the anterolateral system?

A

spinothalamic tract

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9
Q

Lissaur tract?

A

tract taken by anterolateral dorsal root fibers where they ascend or descend the spinal cord 1-2 segments down or up in the spinal cord

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10
Q

Where is the ventral white commissure located?

A

below the central canal of the spinal cord

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11
Q

Where do anterolateral system fibers cross the midline?

A

in the ventral white commisure

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12
Q

Where in the thalamus does the spinothalamic tract terminate?

A

in the VPL nucleus of the thalamus

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13
Q

Cells from the VPL that have received spinothalamic tract cords send pain and temperature information to which part of the brain?

A

primary somatosensory cortex in the postcentral gyrus

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14
Q

What sensory information does the spinocerebellar tract carry?

A

unconscious proprioceptive input from muscle spindles and GTOs to the cerebellum where this information is used to help monitor and modulate movements

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15
Q

What are the 2 major spinocerebellar pathways?

A
  • dorsal spinocerebellar tract
  • cuneocerebellar tract
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16
Q

The dorsal spinocerebellar tract carries information from what part of the body?

A

carries input from the lower extremities and lower trunk

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17
Q

The cuneocerebellar tract carries information from what part of the body?

A

carries proprioceptive input to the cerebellum from the upper extremities and upper trunk

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18
Q

Where are the cell bodies of the dorsal spinocerebellar tracts found?

A

in Clarke’s nucleus, which is situated in the spinal cord from T1 to L2

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19
Q

Where are the cell bodies of the cuneocerebellar tract found?

A

in the medulla in the external cuneate nucleus

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20
Q

What is the most common hereditary condition involving degeneration of the spinocerebellar pathways?

A

Friedreich ataxia

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21
Q

What are the areas of the spinal cord affected by Friedreich ataxia?

A

spinocerebellar tracts, dorsal columns, corticospinal tracts, an cerebellum

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22
Q

How to identify a cord section: If there is a large ventral horn?

A

C5 -T1 or L2 - S2

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23
Q

How to identify a cord section: If there is not a large ventral horn?

A

T1-L1, C1-C4

24
Q

How to identify a cord section: If both dorsal columns are present.

A

above T5

25
Q

How to identify a cord section: If both dorsal columns are not pressent?

A

below T5

26
Q

How to identify a cord section: If there is a lateral horn?

A

T1 - L2

27
Q

How to identify a cord section: If lateral horns are not present?

A

C1 - C8 or L3 - S5

28
Q

What is Brown-Sequard Syndrome?

A

hemisection of the cord causing lesion of each of the 3 main neural systems

29
Q

What is a hallmark sign of Brown Sequard syndrome?

A

patient presents with 2 ipsilateral signs and 1 contralateral sign

30
Q

What are the 3 Ps of Tabes Dorsalis?

A

paresthesias (pins-and-needles sensations), pain, polyuria

also will have Romberg sign

31
Q

Spastic bladder results from lesions found where in the spinal cord?

A

lesions of the spinal cord above the sacral spinal cord levels

32
Q

The pathogenesis for spastic bladder?

A

results from lesions of the spinal cord above the sacral spinal cord levels

33
Q

Pathology of polio?

A

results from a relatively selective destruction of lower motorneurons in the ventral horn by poliovirus

34
Q

Symptoms of polio

A

a. flaccid paralysis
b. muscle atrophy
c. fasciculations
d. areflexia

35
Q

What levels of the spinal cord is polio typically found?

A

lumbar levels

36
Q

What does ALS stand for?

A

amyotrophic lateral sclerosis

37
Q

What is another name for ALS?

A

Lou Gehrig disease

38
Q

What levels of the spinal cord does ALS typically affect?

A

begins at cervical levels of the cord and progress either up or down the cord

39
Q

ALS symptoms.

A

a. progressive spinal muscular atrophy (ventral horn)

b. primary lateral sclerosis (corticospinal tract)
- spastic paralysis in lower limbs
- increased tone and reflexes
- flaccid paralysis in upper limbs

c. Common in cervical enlargment

40
Q

What part of the spinal cord does occlusion of the ASA affect?

A

ASA (anterior spinal artery)

interrupts blood supply to the ventrolateral parts of the spinal cord

41
Q

What major tracts of the spinal cord are affected with occlusion of the ASA?

A

corticospinnal tracts and spinothalamic tracts

42
Q

What is syringomyelia?

A

a disease characterized by progressive cavitation of the central canal

43
Q

What spinal cord levels are typically affected when one has syringomyelia?

A

usually in the cervical spinal cord level

44
Q

Horner syndrome manifestation?

A

ptosis
miosis
anyhydrosis

45
Q

Symptoms of syringomyelia?

A

a. bilateral loss of pain and temperature at the level of the lesion

c. as disease progresses, there is muscle weakness; eventually flaccid paralysis and atrophy of the upper limb muscles due to destruction of ventral horns

46
Q

What is Tabes dorsalis a manifestation of?

A

neurosyphilis

47
Q

Pathology of Tabes dorsalis?

A

causes bilateral degeneration of the dorsal roots and secondary degeneration of the dorsal columns

48
Q

What are symptoms of Tabes Doralis?

A

a. “paresthesias, pain, polyuria”
b. associated with late-stage syphilis, sensory ataxia, positive Romberg sign: sways with eyes closed, Argyll Robertson pupils, suppressed reflexes
c. common at lumbar cord levels

49
Q

Pathology of atonic bladder?

A
  • results from lesions to the sacral spinal cord segments of sacral spinal nerve roots
  • loss of pelvic splanchnic motor innervation with loss of contraction of the detrusor muscle results in a full bladder with a continuous dribble of urine from the bladder
50
Q

Pathology of infantile bladder?

A
51
Q

Syringomyelia may present with what other condition?

A

Arnold-Chiari I malformation

52
Q

What is the buzz word for pain caused by syringomyelia?

A

“belt-like” or “cape like” loss of pain and temperature

53
Q

When is subacute combined degeneration typically seen?

A

in cases of B12 deficiency sometimes related to pernicious anemia

54
Q

Where is the myelin loss in subacute combined degeneration found?

A

patchy losses of myelin in dorsal columns and lateral corticospinal tract

55
Q

What are the symptoms of subacute combined degeneration?

A

a. vitamin B12, pernicious anemia

b. demyelination of the:
- dorsal columns (central and peripheral myelin)
- spinocerebellar tracts
- corticospinal tracts (CST)

c. upper thoracic or lower cervical cord.

56
Q

Symptoms of ASA occlusion?

A

a. DC spared
b. all else bilateral signs
c. common at mid thoracic levels
d. spastic bladder

57
Q

Brown Sequard Syndrome symptoms.

A

a. DC: ipsilateral loss of position and vibratory senses at and below level of the lesion

b. spinothalamic tract: contralateral loss of pain and temp 1-2 segments below lesion and ipsilateral loss at the level of the lesion

c. CST: ipsilateral paresis below the level of the lesion

d. LMN: flaccid paralysis at the level of the lesion

e. descending hypothalamics: ipsilateral Horner syndrome (if cord lesion is above T1)

Kaplan: Anatomy and Physiology Part III (13 decks)

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