LEC-9 Spinal Diseases

Question 1

A patient with an acute injury to the spinal cord will initially be (hyper-reflexic/areflexic), have (flaccid/spastic) muscle tone, as well as loss of _____________ and ____________ control.

Answer 1

Areflexic, have flaccid muscle tone, loss of bladder and bowel control

Question 2

Subacute combined degeneration of the spinal cord is most commonly caused by ________________.

Answer 2

Vitamin B12 deficiency

Question 3

Subacute combined degeneration of the spinal cord due to B12 deficiency commonly targets the ______________ and ____________ of the cord, causing lower extremity weakness and upper motor neuron symptoms.

Answer 3

Dorsal columns and corticospinal tracts

Question 4

Subacute combined degeneration of the spinal cord usually involves the ______________ and ______________.

Answer 4

Posterior columns and corticospinal tracts

Question 5

Something that affects the spinal cord and causes UMN symptoms on an exam is referred to as a _____________.

Answer 5

Myelopathy

Question 6

(T/F) The most common site of a tumor that affects the spinal cord is within the spinal cord itself.

Answer 6

False. The most common site of a tumor that affects the spinal cord is in the bone surrounding the cord, causing extradural compression.

Question 7

The most common tumor that metastasizes to bone in women is (breast/lung/colorectal) cancer.

Answer 7

Breast cancer

Question 8

The most common tumor that metastasizes to bone in men is (lung/prostate/colorectal) cancer.

Answer 8

Prostate cancer

Question 9

Initial treatment of a tumor compressing the spinal cord is administration of ____________.

Answer 9

Steroids, to control the inflammation

Question 10

Tumors arising from the dura in the spinal cord are (common/rare).

Answer 10

Rare

Question 11

A herniated disc typically herniates to either the right or left side, impinging upon the ______________ as it exits the intervertebral foramen.

Answer 11

Nerve root

Question 12

(T/F) Disc disease or spinal stenosis of the lumbar spine exhibits both upper motor neuron and lower motor neuron symptoms.

Answer 12

False. Disc disease or spinal stenosis of the lumbar spine will only exhibit lower motor neuron symptoms. The spinal cord ends at approximately T12-L1, so upper motor neurons do not extend down far enough to elicit those symptoms.

Question 13

Copper deficiency presents very similarly to B12 deficiency, along with bone marrow problems such as:

Answer 13

I. Thrombocytopenia (low platelets)
II. Neutropenia (low white cells)
III. Anemia (low red cells)

Question 14

Onset of copper deficiency symptoms tends to be (acute/chronic).

Answer 14

Acute

Question 15

_____________ is an acute inflammation of the spinal cord that may be virally mediated, occur after a viral infection, or result from an exacerbation of multiple sclerosis.

Answer 15

Transverse myelitis

Question 16

Transverse myelitis occurring simultaneously with inflammation of the optic nerve is referred to as ______________.

Answer 16

Devic’s disease

Question 17

The most common first symptom of transverse myelitis is (pain/weakness/sensory loss).

Answer 17

Pain

Question 18

Spinal tap in a patient with virally mediated or post viral transverse myelitis will show an elevation of ____________ and ___________.

Answer 18

White cells and protein

Question 19

In transverse myelitis caused by exacerbation of multiple sclerosis, there tends to be (more/fewer) white cells and (more/less) protein than in transverse myelitis caused by viral infection.

Answer 19

Fewer white cells and less protein in transverse myelitis caused by MS

Question 20

Poliomyelitis selectively attacks the _____________ of the spinal cord.

Answer 20

Anterior horn

Question 21

Patients suffering from poliomyelitis have (upper motor neuron/lower motor neuron) symptoms.

Answer 21

Lower motor neuron

Poliomyelitis attacks the anterior horn of the spinal cord, so lower motor neurons are affected.

Question 22

A patient experiencing sensory ataxia and severe, fleeting pains following a syphilis infection is most likely to have _____________.

Answer 22

Tabes dorsalis

Question 23

Tabes dorsalis causes the preferential demyelination of the ______________ and _______________ of the spinal cord.

Answer 23

Dorsal columns and dorsal root ganglia

Question 24

HIV may cause a myelopathy that mimics the pathology of B12 deficiency in that it selectively targets the _______________ and _____________.

Answer 24

Corticospinal tracts and dorsal columns

Question 25

HTLV-1 myelopathy, an infection endemic common to tropical climates, primarily targets the ____________ section of the spinal cord. This causes (spastic/flaccid) paraparesis and urinary troubles.

Answer 25

Thoracic section; spastic paraparesis

Question 26

Anterior Spinal Cord syndrome is due to occlusion of the ________________ artery.

Answer 26

Anterior spinal artery

Question 27

Anterior Spinal Cord syndrome affects the _____________ and ______________ tracts.

Answer 27

Spinothalamic and corticospinal

Occlusion of the anterior artery affects everything within the anterior 2/3rds of the spinal cord.

Question 28

(T/F) A spinal fluid examination revealing red blood cells is characteristic of Brown Sequard syndrome.

Answer 28

False. A spinal fluid examination revealing red blood cells is characteristic of arteriovenous malformations and venous angiomas.

Question 29

____________ is an autosomal recessive disease in which the white matter of the spinal cord slowly demyelinates due to a mutation in the gene that encodes a mitochondrial iron-binding protein known as frataxin.

Answer 29

Friedreich’s ataxia

Question 30

________________ involves a hemisection and complete loss of one side of the spinal cord.

Answer 30

Brown-Sequard syndrome

Question 31

The presence of a cavity near the central canal of the cord and usually occurring at levels of the cervical spinal cord is referred to as a(n) __________________.

Answer 31

Syringomyelia

The cavity is known as a syrinx.

Question 32

The presence of a syrinx in the spinal cord usually destroys the _____________________, affecting signals for (pain/proprioception/muscle activity).

Answer 32

Anterior white commissure; pain

Question 33

(T/F) Posterior expansion of a syrinx is unusual, so dorsal columns are generally spared.

Answer 33

True.

Question 34

______________ is an X-linked recessive spinal cord dysmyelination disease. It causes frameshifts and genetic mutations, resulting in abnormal peroxisomal fatty acid beta oxidation.

Answer 34

Adrenomyeloneuropathy