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ADAMS > Diseases of the Spinal Cord > Flashcards

Diseases of the Spinal Cord Flashcards

1
Q

ASIA Impairment Scale

A

A. Complete: no sensory or motor function below the level of the lesion B. Sensory incomplete: sensory function is preserved but motor function is lost below the zone of injury
C. Motor incomplete (first grade): motor function is reduced in more than half of key muscles below the level of the lesion
D. Motor incomplete (second grade): motor function is reduced in fewer than half of key muscles below the level of the lesion
E. Normal: reflexes may be abnormal

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2
Q

estimated duration of spinal shock

A

1-6 weeks or longer

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3
Q

These terms refer to a transient loss of motor sensory function of the spinal cord that recovers within minutes or hours but may persist in mild form for days or more

A

Transient Cord Injury

Spinal Cord Concussiom

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4
Q 
central cord (schneider syndrome)
cruciate paralysis

location of fibers

A

The weakness is very selective, being practically limited to the arms, a feature that is attributable to the segregation within the pyramidal decussation of corticospinal fibers to the arms (being rostral) and to the legs (more caudally situated)

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5
Q

True or False

In Spinal Cord injury, bacteriuria alone warrants treatment with antibiotics

A

false, it should be accompanied with pyuria

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6
Q

An “early” type of radiation myelopathy (appearing 3 to 6 months after radiotherapy) is characterized mainly by spontaneous uncomfortable sensations in the extremities

A

Transient Radiation Myelopathy

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7
Q

most common sites of vertebral injuries

A

first and second cervical,
fourth to sixth cervical, and
eleventh thoracic to second lumbar vertebrae

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8
Q

It is a progressive myelopathy that follows, after a variable latent period, the radiation
of malignant lesions in the vicinity of the spinal cord.

A

Delayed Progressive Radiation Myelopathy

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9
Q

Imaging findings in Delayed Progressive Radiation Myelopathy

A

early: cord may be swollen, heterogeneous enhancement with gadolinium infusion

MRI: abnormal signal intensity , decreased in T1, increased in T2

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10
Q

Pathologic findings in Delayed Progressive Radiation Myelopathy (3)

A

irregular zone of coagulation necrosis involving white and gray matter
secondary degeneration in the ascending and descending tracts
vascular changes- necrosis of arterioles or hyaline thickening of their walls and thrombotic occlusion of their lumens

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11
Q

Prevention of radiation injury

dose and duration

A

dose of 6000cGy
given over a period of 30-70 days
each daily fraction is not greater than 200cGy and the weekly dose does not exceed 900cGy

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12
Q

factor that governs the damage to the nervous system is the

A

amount of current or amperage

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13
Q

part of spinal cord injured in cases of spinal atrophic paralysis (focal muscular atrophy after an electric shock)

A

gray matter/

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14
Q

Mortality rate when lightning strikes the head

A

30%

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15
Q

enteroviruses have the affinity to:

herpes zoster affinity to:

A

enteroviruses have the affinity to anterior horns of the SC and motor nuclei of the brainstem
herpes zoster affinity to dorsal root ganglia

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16
Q

Elsberg syndrome

A

acute lumbosacral radiculitis with urinary retention from HSV type 2 and CMV infections

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17
Q

findings in vacuolar myelopathy in HIV

A

white matter of the spinal cord is vacuolated, by which is meant a ballooning within myelin sheaths of the long tracts

most severe in thoracic
segments with the posterior and lateral columns are
affected diffusely

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18
Q

characteristic finding in Sarcoid Myelitis

A

multifocal subpial nodular enhancement of the meninges adjacent to a lesion within the cord or nerve roots – picture that resembles neoplastic meningeal infiltration

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19
Q

Most frequent etiologic agent in Spinal Epidural abscess

A

Staphylococcus aureus followed by Steptococci, gram neg bacilli, anaerobic organisms

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20
Q

Most affected part of spine in vertebral bacterial osteomyelitis

A

lumbar region

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21
Q

the SC is a common target for three formms of schistosoma

A

most particularly S. mansoni
then
S. haematobium, S. japonicum

22
Q

treatment for Schistosomiasis

A

praziquantel

23
Q

CSF findings in Schostosomiasis

A

slightly elevated protein, WBC 5-500/cc

glucose is normal or minimally reduced

24
Q

True or False

CSf eosinophilia is a dependable diagnosis for Schistosomiasis

A

False

25
Q

Schistosoma parasite can be found in which part of the colon

A

rectosigmoid mucosa

26
Q

Infarction of the spinal cord may occur during hypotension and affect the most vulerable region of the spinal cord namely

A

thoracic

27
Q

TRUE or FALSE

In cardiac and aortic surgery, which requires clamping of the aorta for more than 30 mins, and aortic arteriography may also be complicated by infarction in the anterior spinal artery, more often the damage to central neuronal elements is greater than that to anterior and lateral funiculi

A

TRUE

28
Q

Spinal infarction sometimes follows the procedures e.g. cardiac and aortic surgery by up to ___ weeks

A

3

29
Q

In rare cases, infarction of SC is preceded by spinal transient ischemic attacks and has been emphasized in cases related to _____

A

cocaine use

30
Q

TRUE or FALSE
Most vascular malformations of the spinal cord do not cause hemorrhage but instead produce a progressive presumably ischemic myelopathy

A

TRUE

31
Q

most common location of spinal dural AV fistula

A

low thoracic cord or the conus

32
Q

other names for intramedullary AVM (2)

A

angioma racemosum venosum or dorsal extramedullary AVM

33
Q

prognosis for intramedullary AVM

severe disability
chair bound
surivival

A

severe disability of gait present within 6 months
in 50% of patients chair bound in 3 years
average survival 5-6 years

34
Q

Imaging features of spinal Dural AVF

A

enlargement of spinal cord
T2 bright signal of the swollen cord over several segments
peripherally located regions of T2 hypointense signals

35
Q

part of SC mostly affected in Caisson Disease

A

posterior column

36
Q

Most frequently observed myelopathy in general practice

A

Spondylitic Myelopathy

37
Q

The range acquired of narrowing of the canal that produces symptomatic cervical spondylosis is generally ____

normal canal diameter

A

7-12mm

Normal Canal Diameter 17-18mm

38
Q

True or False
The gait abnormality produced by spondylotic myelopathy may also be mistaken for that of NPH. A marked increase of imbalance with removal of visual cues (Romberg sign) is a feature of spondylosis but not of hydrocephalus, and short stepped and magnetic quality of walking that is characteristic of hydrocephalus is not seen in cervical myelopathy.

A

true

39
Q

regions mostly affected in ankylosing spondylitis

A

sacroiliac joints

lumbar spine

40
Q

Most Common Complications in Ankylosing Spondylitis

A

Spinal Stenosis and Cauda Equina Syndrome

41
Q

True or False

Surgical decompression and corticosteroid therapy are beneficial fro patients with arachnoidal diverticula

A

False

42
Q

Most HAZARDOUS complication of Ankylosing Spondylitis

A

Compression of the Cord

43
Q

The ligaments that attach the odontoid to the atlas and to the skull and the joint tissue are weakened by the destructive inflammatory process

A

Rheumatoid Arthritis of the Spine

44
Q

MND is considered a differential because of chronic wasting of one or both hands and forearms without sensory changes or long tract signs

from intermittent compression of the lower cervical cord and gradual deterioration of the motor neurons in the anterior grey matter

A

Cervical Dural Sac Myelopathy

Hirayama Disease

45
Q

Enlargement of vertebral bodies , pedicles, laminae in Paget Disease may result in narrowing of the Spinal Canal

High plasma alkaline phosphatase
medical managementL NSAID, calcitonin

A

Paget Disease of the Spine

Osteitis Deformans

46
Q

Most common primary extramedullary tumors of intraspinal neoplasms

A

neurofibromas
meningiomas

intradural>extradural

47
Q

predilection of neruofibromas

A

lumbar and thoracic region

48
Q

Most common primary intramedullary tumors of the spine

A

ependymomas 60%
astrocytomas 25%

astrocytoma is the MC intramedullary tumor excluding arising from filum terminale

49
Q

True or False
Spinal ependymomas are considered to be benign, intraspinal spread can occur and local recurrence after resection occurs in 10 percent of cases, even decaeds after surgery.

A

True

50
Q

Froin syndrome

A

xanthochromia and clotting of CSF from greatly elevated protein content

51
Q

Most common of all spinal tumors

A

extradural metastases

carcinoma, lymphoma, myeloma

52
Q

Classification of Syringomyelia

A

Type I syringomyelia with obstruction of the foramen magnum and dilatation of the central canal
A. with type I chiari mal
B. with other obstructive lesions

Type II Syringomyelia without obstruction of the forman magnum

Type III Syringomyelia with other diseases of the spinal cord

A. Sc tumors
B. traumatic myelopathy
C. Spinal arachnoiditis and pachymeningitis
D. Secondary myelomalacia from cord compression

Type IV Pure hydromyelia

ADAMS (29 decks)

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