Lec 05: Disorders of the Spinal Cord Flashcards
What is the anatomical extent of the spinal cord?
craniocervical junction (basi-occiput) to nerve roots in the cauda equina
What are the two most mobile segments of the spine?
cervical and lumbar
Most degenerative spinal diseases are found in which segments of the spine?
cervical and lumbar
What are the transitional regions of the spine?
cervicothoracic, thoracolumbar, lumbosacral
Which type of vertebra has the smallest vertebral body?
cervical
What is the trend in vertebral body size in relation to position?
As we go down, there is increasing size of the bodies because of increasing weight.
Which cervical vertebra does not have a body?
C1
Which cervical vertebra is the strongest?
C2
The odontoid process articulates with?
ring of the atlas (C1)
What is the purpose of the transverse atlantal ligament?
connects the dens to the ring of the atlas, preventing transverse displacement of the atlas
Which vertebral segment is the least mobile?
thoracic
Cervical facets have what angle?
45 degrees
Thoracic facets have what angle?
60 degrees
Lumbar facets have what angle?
90 degrees
What movements are allowed by the lumbar vertebra?
flexion and extension only
Which vertebral segment does not have any muscles anteriorly?
thoracic
What is the strongest vertebral ligament?
ALL - only ligament that limits extension
Which vertebral ligament has pain nerve endings?
PLL
The adult spinal cord ends at what level?
L1
What are the three levels of the spinal MRI?
cervical, thoracic, and lumbosacral
What are the characteristics of Central Cord syndrome?
more extensive motor weakness in the UE than in the LE, typically in patients with hyperextension injuries (UE fibers are located more centrally)
What are the characteristics of Anterior Cord syndrome?
motor function deficits, loss of detailed sensation
What are the characteristics of Posterior Cord syndrome?
position sense deficit
What are the characteristics of Brown-Sequard syndrome? (injury to the lateral half of the spinal cord)
motor paralysis and loss of proprioception are greater ipsilaterally, pain and temperature sensory loss are greater contralaterally
What are the characteristics of Conus Medullary syndrome?
combined lower and upper motor neuron deficits, flaccid paralysis (LMN), hyperreflexia (UMN)
What is spinal shock?
transient loss of all neurologic function below the level of the spinal cord injury
What is the difference between spinal shock and complete cord syndrome?
cord syndromes do not manifest until after 72 hours
What are possible spine pathology mimickers?
nerve entrapment syndromes, soft tissue injuries
What is the difference between vascular and neurogenic claudication?
vascular claudication - immediate relief upon resting (for surgery)
neurogenic claudication - relief in certain positions
What is the most common extramedullary tumor?
Schwanomma
(T/F) A meningioma commonly presents anteriorly.
T
What is the usual location of an ependymoma?
conus medullaris
What is a syrinx?
CSF pocket within the spinal cord
(T/F) A low-grade astrocytoma is easier to surgically remove than a high-grade astrocytoma.
F
When is the posterior approach in surgery used?
lumbar and thoracic tumors
What is the difference between a meningocoele and a myelomeningocoele?
meningocoele - csf and meninges in herniation but no neural elements
myelomeningocoele - w/ spine
What are the 4 stages of disc herniation?
incomplete: degeneration, prolapse
complete: extrusion, sequestration
