Diseases of spinal cord Flashcards
What are disorders of the spinal cord called?
Myelopathies
What are diseases of the nerve root called?
Radiculopathies
Diseases of the UMN are called _____
Myelopathies
Diseases if LMNs are called _____
Radiculopathies
What are the signs of UMN lesion?
Weakness
Increased tone (spasticity)
Increased reflex
Positive Babinski reflex
What are signs of LMN lesions?
Weakness
Decreased reflexes
Decreased tone
Flexor plantar
What syndrome is associated with Hemicord lesion?
Brown - Sequard syndrome
What sensory loss will be observed with radiculopathy?
Dermatomal sensory loss
If there is C5 lesion, what symptoms will be observed?
Wasting of muscles innervating C5
UMN lesion symptoms will be observed in the lower limbs.
Brisk reflexes
Increased tone (spasticity)
Sensory level
What are some of the acquired causes of myelopathy?
Inflammation
Infective
Vascular
Metabolic
In ischaemic myelopathy, where is the infract commonly observed?
Anterior spinal artery
Thoracic spine
What are some of the causes of spinal cord ischaemia?
Artheromatous disease Thromboembolic disease Arterial dissection Systemic hypotension Vascultis
What ares of the s & s’s of spinal cord stroke?
Pain in back, radiating
Weakness - paraparesis
Numbness
Urinary symptoms
What treatment can be administered in cases of spinal cord stroke?
Reduce vascular risk factors:
Maintain BP
Antiplatelet therapy
What is demyelinating myelitis usually caused by?
Multiple sclerosis
What area of the spinal cord does MS affect?
White matter tracts in spinal cord
What eye related condition is associated with MS?
Optic neuritis
What treatment can be given in MS myelitis?
Steroids
Supportive therapy
What is a metabolic cause of myelitis?
Vit B12 deficiency
How is VitB12 absorbed from the gut?
By intrinsic factor complex
What is pernicious anaemia?
Autoimmune condition whereby ABs are produced against Intrinsic factor preventing B12 absorption
How can VitB12 deficiency affect the NS?
Myelopathy
Peripheral neuropathy
Brain
Eye/optic nerve
What are the different parts of the intervertebral disc called?
Annulus fibrosis
Nucleus pulposus
What are the different ligaments associated with the vertebral column?
Anterior longitudinal ligament
Posterior longitudinal ligament
Ligamentum falvum
What type of fibres are present in ventral/dorsal rami?
Mixed - sensory & motor
What type of fibres are present in spinal nerve?
Mixed
What type of fibres are present in dorsal root?
Sensory
What type of fibres are present in ventral root?
Motor
Where does the spinal cord extend from/to?
C1-L2
What are the signs of an UMN lesion? Weakness Atrophy Reflexes Tone Fasciculations Babinski
Present Absent Increased Increased Absent Present (extensor)
What are the signs of an LMN lesion? Weakness Atrophy Reflexes Tone Fasciculations Babinski
Present Present Decreased Decreased Present Absent (Flexor)
Where are LMNs found?
Ventral horn of spinal cor
If the spinal cord is lesioned at C5, what will be observed?
Myelopathy (UMN Lesion)
Signs of UMN lesion will be observed in the legs
If there is a lesion of the nerve root at L4 what will be observed?
Radiculopathy (LMN lesion)
Numbness in L4 dermatome
Reduced knee jerk reflex
Weakness in ankle dorsiflexion
What is a disc prolapse?
An acute herniation of the IV disc causing compression of the spinal roots or cord
If there is central IV disc prolapse in the lumbar region what will be observed?
CES
If there is central IV disc prolapse in the CERVICAL region what will be observed?
Cervical myelopathy
Where are the most common areas in the spine for disc prolapse?
Cervical & lumbar (most mobile)
If there is lateral herniation of IV disc what will be observed ?
Radiculopathy
What symptoms will be experienced in disc prolapse?
Numbness & weakness in nerve distribution
Acute pain down leg/arm
What treatment can be administered for disc prolapse?
Rehabilitation -physio
Nerve root injection
Lumber/ cervical discectomy
What are the 3 red flag signs of Cauda Equina?
Bilateral sciatica
Urinary dysfunction
Saddle parasthesia
What treatment is required for CES?
Emergency lumber discectomy
What is Cauda equine syndrome?
Disc herniation in lumbar region results in compression of the roots
What is cervical spondylosis?
Degenerative disease of the cervical spine resulting in spine & nerve root compression
In what disease is spinal claudication observed? (pain down both legs)
Lumber spinal stenosis
What are the different types of spinal tumours?
Intramedullary
Intradural
Extradural
What are some of the causes of intramedullary tumour?
Astrocytoma
Ependymoma
What are some of the causes of intradural tumour?
Meningioma
Neurofibroma
Lipoma
What are some of the causes of extradural tumour?
Metastasis to bone (lung, prostate & breast)
Primary bone tumours
What are the different spinal infections?
Osteomyelitis
Discitis
Epidural Abscess
What are the 3 main presenting complaints of epidural abscesses?
Back pain
Pyrexia
Focal neurological - weakness/ numbess
What bacterial orgs cause epidural abscesses?
E. coli
S. aureus
Streptococcus
What are the risk factors for epidural abscess?
IV DUs
Alcoholics
Chronic kidney disease
Diabetes
What is the treatment for epidural abscess?
Surgical decompression
IV ABIs
What is osteomyelitis?
Infection of the vertebral body
What are the risk factors for osteomyelitis?
Diabetes IVDU CKD Alcoholism AIDs
