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Emma H&N > Localization of Spinal Cord Lesions > Flashcards

Localization of Spinal Cord Lesions Flashcards

1
Q

LMN involvement means

A

LMN involvement means SPINAL CORD INVOLVEMENT or root or nerve

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2
Q

C4 dermatome

A

clavicle **

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3
Q

C5 dermatome

A

shoulder

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4
Q

C6 dermatome

A

thumb

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5
Q

C7 dermatome

A

middle finger

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6
Q

C8 dermatome

A

little finger

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7
Q

T4 dermatome

A

nipple line **

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8
Q

T10 dermatome

A

umbilicus **

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9
Q

L1 dermatome

A

inguinal crease **

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10
Q

L5 dermatome

A

lateral calf **

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11
Q

S4-S5 dermatome

A

perianal area **

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12
Q

biceps brachii myotome

A

C5 (C6)

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13
Q

triceps myotome

A

C7 (C6-C8)

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14
Q

intrinsic hand muscles myotome

A

C8, T1

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15
Q

quadriceps femoris myotome

A

L3 (L2-L4)

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16
Q

gastrocnemius myotome

A

S1

17
Q

spinothalamic tract crosses in ________

A

spinothalamic tract crosses in SPINAL CORD

18
Q

dorsal columns cross in _________

A

dorsal columns cross in medulla

19
Q

a lesion on one side of the spinal cord will cause loss of ____________________ on the side of the lesion, and loss of ______________ on side opposite the lesion

A

a lesion on one side of the spinal cord will cause loss of POSITION and VIBRATORY SENSE on the side of the lesion, and loss of PAIN and TEMPERATURE on side opposite the lesion

20
Q

Brown-Sequard Syndrome

A

Hemisection of spinal cord.

Deficits in dorsal column, spinothalamic, and corticospinal tracts.

Ipsilateral loss of position and vibration sense.

Contralateral loss of pain and temperature sense (slightly below level of lesion due to movement of spinothalamic fibers up thru lissauer’s tract before decussation).
Ipsilateral paralysis.

21
Q

a lesion in the central part of the spinal cord can affect ___________, leaving ______ and ______ tracts unaffected.

A

a lesion in the central part of the spinal cord can affect PAIN and TEMPERATURE, leaving DORSAL COLUMN and CORTICOSPINAL tracts unaffected.

22
Q

suspended sensory loss for pain and temperature means

A

spinal cord disease

only ventral white commisure is affected

23
Q

lesion of ventral white commisure

A

Only fibers that cross at level of lesion will be affected. (lose pain/temp at level of lesion)

Pain and temperature will be normal above and below the lesion.

24
Q

syringomyelia

A
  • affects ventral white commisure
  • suspended sensory loss for pain and temperature
  • starts small, gets bigger: next affected is burning fingers w/o realizing, LMN weakness
25
Q

ALS

A

Amyotrophic Lateral Sclerosis

  • motor disease only
  • combined UMN and LMN disease [LMN signs predominate, fasciculations]
  • affects corticospinal tract, LMNs
  • does NOT affect sensory
  • rare
  • elderly
  • progressive
  • 2-3 yr survival
  • death from infection
26
Q

ALS - LMN lesions vs UMN lesions

A

LMN lesions: fasciculations

UMN lesions: clonus, babinski sign

27
Q

variants of ALS

A

Spinal muscular atrophy - LMN

Primary lateral sclerosis - UMN

Bulbar ALS - LMN cranial nerves

28
Q

tabes dorsalis

A

Predominant DORSAL COLUMN deficits

  • loss of position/vibration sense
  • difficulty maintaining erect posture
  • Romberg sign
  • patchy loss of pain/temp
  • affects dorsal roots/ganglia

-form of tertiary neurosyphilis

29
Q

Romberg sign

A

Patient can stand with eyes open, but cannot stand with eyes closed

Seen with Tabes Dorsalis

30
Q

what is needed for balance?

A

2 of the following:

  • visual
  • vestibular
  • posterior column
31
Q

subacute combined degeneration posterolateral sclerosis

A

Dorsal columns and corticospinal tract deficits

  • Romberg sign
  • UMN signs
  • vitamin B12 deficiency
  • pernicious anemia
32
Q

poliomyelitis

A

Anterior horn cells affected.
LMN syndrome.
-viral infection with predilection for anterior horn cells
-acute febrile illness

33
Q

post-polio syndrome

A
  • new weakness years after acute polio (stress to system)

- often in same distribution as original weakness

34
Q

anterior spinal syndrome

A

Spinothalamic and Corticospinal affected.
Dorsal column preserved.

(due to loss of anterior spinal artery, providing blood to anterior 2/3 of spinal cord)

Loss of pain/temperature, motor function

35
Q

extrinsic cord compression

A

osteophytes, herniations, tumors, abcesses

  • commonly presents with pain (from root compression)
  • early involvement of sacral segments (from compression of lateral aspects of spinothalamic tracts and lateral corticospinal tracts)
  • localized LMN lesion from compression of ventral root

Emma H&N (49 decks)

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