Neuro

Question 1

Signs of Cranial cervical spinal cord (C1-C5) damage

Answer 1

Grey Matter in cervical region: Difficult to detect cervical musculature and sensory signs- decreased sensation from region of body innervated by the damaged segments

White Matter: All 4 limbs signs will be prominent in ipsilateral limbs
1) Damage to descending UMN axons (Paresis to paralysis in all four limbs, reflexes are normal to increased all four limbs, normal to increased muscle tone in all four limbs, disuse muscle atrophy
2) Sensory abnormality in all 4 limbs: abnormalities in postural reactions, damage to ascending somatosensory pathways- reduced rxns superficial and then deep

Question 2

Signs of Cervicothoracic enlargement (C6-T2) damage

Answer 2

Grey matter signs: thoracic limbs- LMN signs (paresis to paralysis of thoracic limbs, decreased to absent muscle tone, decreased to absent reflexes of thoracic limbs, rapid denervation atrophy of thoracic limb muscles, UMN signs for pelvic and pudendal nerves, abnormalities in posutral reactions and somatic sensation from region of body innervated by damaged segments

White Matter Signs: Pelvic limb (ipsilateral to damage) UMN: paresis to paralysis of pelvic limbs, muscle tone is increased in pelvic limbs, reflexes are normal to increased in pelvic limbs, disuse atrophy of pelvic limbs. sensory abnormalities: damage to postural reactions reduce nociceptive reactions

Damage to T1-T2 can show Horner’s syndrome

Question 3

Signs of Thoracolumbar spinal cord (T3-L3) damage

Answer 3

Grey matter: thoracolumbar region 1) LMN signs- difficult to detect trunk musculature and 2) sensory abnormalities- may be associated with hyperesthesisa on palpation of axial musculature

White matter: pelvic limbs- UMN signs- paresis to paralysis of pelvic limbs, muscle tone is normal to increased, reflexes are normal to increased in pelvic limbs, disuse muscle atrophy of pelvic limbs, UMN signs for pelvic and pudendal nerves 2) Damage to proprioceptive pathways produce abnormalities in pelvic postural reactions, damage to ascending somatosensory systems reduce reactions to superficial and finally deep nociceptive pathways for trunk and pelvic limbs

Question 4

Signs of lumbosacral enlargement (L4-S2) damage

Answer 4

Thoracic limbs normal
Grey matter signs- pelvic limbs
1) LMN signs- paresis to paralysis of pelvic limbs, decreased to absent muscle tone of pelvic limb muscles, decreased to absent reflexes of pelvic limbs, rapid atrophy of pelvic limb muscles, damage to sacral segments would produce LMN signs for pelvic and pudendal nerves
2) Sensory signs- dorsal horn damage, abnormalities in postural reactions, somatic sensation from region of pelvic limbs innervated by damaged segments, damage to somatosensory systems can reduce reactions to superficial and finally deep nociceptive pathways for pelvic limbs

White matter signs: tail
1) UMN signs- paresis to paralysis of tail muscles, muscle tone is normal to increased in tail musculature
Damage to ascending somatosensory systems can reduce reactions to superficial and then deep pathways for tail

Question 5

Signs of Cauda equina damage

Answer 5

Both Sensory and motor to partial sciatic nerve, urinary bladder, external anal sphincter, and tail
1) LMN signs: Sciatic nerve (partial as S2), Pudendal nerve (S1-S3)- perineum sensory and external anal sphincter muscle, pelvic nerve (S1-S3) preganglionic parasympathetic innervation to pelvic viscera, urinary bladder will be atonic, slight pressure on urinary bladder will cause overflow, caudal nerve (Cd1-5) motor and sensory innervation to tail
2) Sensory Signs- cutaneous sensation will be disrupted for dermatomes innervated by damaged cauda equina dorsal roots

White Matter signs: no UMN signs- this damage to dorsal and vental roots only