LEC-9 Spinal Diseases Flashcards
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.
Areflexic, have flaccid muscle tone, loss of bladder and bowel control
Subacute combined degeneration of the spinal cord is most commonly caused by ________________.
Vitamin B12 deficiency
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.
Dorsal columns and corticospinal tracts
Subacute combined degeneration of the spinal cord usually involves the ______________ and ______________.
Posterior columns and corticospinal tracts
Something that affects the spinal cord and causes UMN symptoms on an exam is referred to as a _____________.
Myelopathy
(T/F) The most common site of a tumor that affects the spinal cord is within the spinal cord itself.
False. The most common site of a tumor that affects the spinal cord is in the bone surrounding the cord, causing extradural compression.
The most common tumor that metastasizes to bone in women is (breast/lung/colorectal) cancer.
Breast cancer
The most common tumor that metastasizes to bone in men is (lung/prostate/colorectal) cancer.
Prostate cancer
Initial treatment of a tumor compressing the spinal cord is administration of ____________.
Steroids, to control the inflammation
Tumors arising from the dura in the spinal cord are (common/rare).
Rare
A herniated disc typically herniates to either the right or left side, impinging upon the ______________ as it exits the intervertebral foramen.
Nerve root
(T/F) Disc disease or spinal stenosis of the lumbar spine exhibits both upper motor neuron and lower motor neuron symptoms.
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.
Copper deficiency presents very similarly to B12 deficiency, along with bone marrow problems such as:
I. Thrombocytopenia (low platelets)
II. Neutropenia (low white cells)
III. Anemia (low red cells)
Onset of copper deficiency symptoms tends to be (acute/chronic).
Acute
_____________ 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.
Transverse myelitis
Transverse myelitis occurring simultaneously with inflammation of the optic nerve is referred to as ______________.
Devic’s disease
The most common first symptom of transverse myelitis is (pain/weakness/sensory loss).
Pain
Spinal tap in a patient with virally mediated or post viral transverse myelitis will show an elevation of ____________ and ___________.
White cells and protein
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.
Fewer white cells and less protein in transverse myelitis caused by MS
Poliomyelitis selectively attacks the _____________ of the spinal cord.
Anterior horn
Patients suffering from poliomyelitis have (upper motor neuron/lower motor neuron) symptoms.
Lower motor neuron
Poliomyelitis attacks the anterior horn of the spinal cord, so lower motor neurons are affected.
A patient experiencing sensory ataxia and severe, fleeting pains following a syphilis infection is most likely to have _____________.
Tabes dorsalis
Tabes dorsalis causes the preferential demyelination of the ______________ and _______________ of the spinal cord.
Dorsal columns and dorsal root ganglia
HIV may cause a myelopathy that mimics the pathology of B12 deficiency in that it selectively targets the _______________ and _____________.
Corticospinal tracts and dorsal columns
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.
Thoracic section; spastic paraparesis
Anterior Spinal Cord syndrome is due to occlusion of the ________________ artery.
Anterior spinal artery
Anterior Spinal Cord syndrome affects the _____________ and ______________ tracts.
Spinothalamic and corticospinal
Occlusion of the anterior artery affects everything within the anterior 2/3rds of the spinal cord.
(T/F) A spinal fluid examination revealing red blood cells is characteristic of Brown Sequard syndrome.
False. A spinal fluid examination revealing red blood cells is characteristic of arteriovenous malformations and venous angiomas.
____________ 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.
Friedreich’s ataxia
________________ involves a hemisection and complete loss of one side of the spinal cord.
Brown-Sequard syndrome
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) __________________.
Syringomyelia
The cavity is known as a syrinx.
The presence of a syrinx in the spinal cord usually destroys the _____________________, affecting signals for (pain/proprioception/muscle activity).
Anterior white commissure; pain
(T/F) Posterior expansion of a syrinx is unusual, so dorsal columns are generally spared.
True.
______________ is an X-linked recessive spinal cord dysmyelination disease. It causes frameshifts and genetic mutations, resulting in abnormal peroxisomal fatty acid beta oxidation.
Adrenomyeloneuropathy
