Lesions of the spinal cord

Question 1

Monoplegia

Answer 1

Paralysis of one limb

Question 2

Diplegia

Answer 2

Paralysis of both upper or lower limbs

Question 3

Paraplegia

Answer 3

Paralysis of both lower limbs

Question 4

Hemiplegia

Answer 4

Paralysis of one side of body

Question 5

Quadriplegia

Answer 5

Paralysis of all four limbs

Question 6

Spinal shock

Answer 6

Loss of sensation accompanied with initial arreflexia, which recovers. Makes a UMN lesion look like a LMN lesion.

Question 7

Syringomyelia

Answer 7

Fluid filled cavitation in the center of the cord. Mostly in cervical cord. Loss of pain and temp, weakness of arm muscles with hyporeflexia. Can cause spasticity in legs.

Question 8

Syringobulbia

Answer 8

When syringomyelia goes into brainstem. Can present as vocal cord paralysis, nystagmus, tongue weakness.

Question 9

Transverse myelopathy

Answer 9

Complete spinal cord transection. Motor, sensory, autonomics below lesion disturbed.

Question 10

Brown Sequard Syndrome

Answer 10

Hemisection of spinal cord. Contralateral pain/temp loss, ipsilateral loss of touch,vibration. Ipsilateral weakness.

Question 11

Central cord syndrome

Answer 11

Cervical lesion that may be due to hyperextension of the neck. Motor weakness present in upper and lower limbs, patient more likely to lose pain/temp.

Question 12

Conus Syndrome

Answer 12

Bilateral saddle anesthesia, unirary retention/incontinence. Bulbocavernosus and anal reflexes are absent. Muscle strength largely preserved.

Question 13

Cauda Equina Syndrome

Answer 13

Severe lower back pain. Asymmetric leg weakness, sparing of bowel/bladder.

Question 14

Degenerated vs herniated disk.

Answer 14

Degenerated has less water content. Herniated means ruptured into canal.

Question 15

How to treat a disk herniation

Answer 15

Laminectomy, spinal fusion, microdiskectomy, chemonucleolysis

Question 16

Spinal stenosis

Answer 16

Can cause claudication of cauda equina.

Question 17

Tabes dorsalis

Answer 17

Tertiary neurosyphalis where the nerves of the dorsal columns deteriorate. Loss of position, vibration, touch. Also, painful. Loss of proprioception with pain? Syphalis.

Question 18

Pain with cough sneeze or bowel movement?

Answer 18

Epidural abscess causing spinal cord compression

Question 19

Three types of spinal turmors

Answer 19

Extradural (between meninges and spine bones)
Intradural extramedullary (within meninges)
Intramedullary (inside the cord)

Question 20

Spondylolisthesis

Answer 20

Where vertebrae are displaced anteriorly

Question 21

Wallenberg syndrome IMPORTANT

Answer 21

Patient presents with slurred speech, imbalance and numbness. No weakness. Posterior medullary lesion that spares the pyramids.

Question 22

Hallmark of brainstem syndromes?

Answer 22

Crossed signs: ipsilateral symptoms on the face, contralateral symptoms on the body. CNIII is midbrain, VI and VII are pontine, and IX, X, XI define medulla.