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Neurology > Patho- Spinal cord disease > Flashcards

Patho- Spinal cord disease Flashcards

1
Q

What are the two main conditions affecting the spinal cord?

A

Compression

Lesions

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2
Q

What areas of the spinal cord can be lesioned?

A

Cord
Roots
Brain stem

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3
Q

What damage can occur to a dorsal root?

A

Sectioning

Compression

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4
Q

What does sectioning a dorsal root do?

A

Complete sensory loss from dermatome

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5
Q

What are some symptoms of dorsal root compression?

A

Pain in the myotomes supplied
Tingling in the dermatome supplied
Pain worse on movement
Pain worse on increased ICP- Cough etc

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6
Q

What can cause dorsal root compression?

A

Herniated disc

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7
Q

What symptoms does lesioning the posterior column of the spinal cord cause?

A 
Tingling
Electric-shock-like sensations
Clumsiness
Numbness
Band-like sensations
Lateralized but vague
Stamping gait
Lhermitte’s sign- electric shock down legs
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8
Q

What symptoms can a Spinothalamic tract lesion cause?

A

Contralateral pain and temp loss

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9
Q

How much of the spinal cord can be lesioned?

A

Partial- hemi

Complete

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10
Q

What is a chronic spinal cord lesion?

A

Compression

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11
Q

What forms can an acute spinal cord lesion take?

A

Complete transection
Brown-sequard syndrome
Central Cord Syndrome

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12
Q

What can cause an acute spinal cord lesion?

A

Trauma

Tumour

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13
Q

What are some symptoms of complete spinal cord transection?

A

All sensory and motor affected below lesion

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14
Q

What can complete spinal cord transection cause?

A

Spinal shock- Flaccid areflexic paralysis

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15
Q

What causes Brown-sequard syndrome?

A

Hemisectioning

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16
Q

What are some symptoms of Brown-sequard syndrome?

A

Contralateral pain and temp loss

Ipsilateral weakness/paralysis and loss of proprioception

17
Q

What can cause central cord syndrome?

A

Generally hyperextension of neck in already stenosis or spondylosis spine.

18
Q

What are some symptoms of central cord syndrome?

A

Cape-like sensory loss
Upper limb weakness
Lower limb strength preserved

19
Q

What parts of the brain stem can be lesioned?

A

Pons
Thalamus
Cortex (not BS)

20
Q

What can cause pons lesions?

A

MS

21
Q

What is the symptom of pons lesion?

A

Full contralateral sensory loss

22
Q

What can cause thalamus lesion?

A

Infarct

23
Q

What are some symptoms of thalamus lesions?

A

Hemiparesis and sensory loss: Weankness tends to improve but chronic pain remains

24
Q

What can a cortex lesion cause?

A

Sensory loss
Side neglect
Apraxia
No patho pain

25
Q

What can cause spinal cord compression?

A 
Tumor
TB
Disc herniation
Abscess
Bleeding
B12 deficiency
Syringomyelia and syringobulbia
26
Q

What is Syringomyelia and syringobulbia?

A

Fluid filled cavity in spinal cord (myelia) or the brain stem (bulbia)

27
Q

What is Syringomyelia and syringobulbia associated with?

A

Arnold-Chiari Malformation

28
Q

What is the pathology of Syringomyelia and syringobulbia?

A

ACM cerebellar down into foramen magnum

29
Q

What areas can be affected by Syringomyelia and syringobulbia?

A

Spinothalamic
Anterior horn
Lateral corticospinal tracts

30
Q

What are some symptoms of Syringomyelia and syringobulbia?

A

Develop 20-30
Upper limb pain worse on coughing
Spinothalamic sensory loss- Pain and temp
Loss of upper limb reflexes

31
Q

What are some signs of spinal cord compression?

A

UMN signs
Progressive spastic paresis -Para or tetra depending on level
Radicular pain at level affected- Can be absent
Sensory loss from all levels below
Sphincter disturbance

32
Q

What are the UMN signs?

A 
Muscle weakness
Hyper-reflex
Rigidity
Clonus
Babinski sign
33
Q

How do you treat spinal cord compression?

A 
Medical emergency!!!
MRI
CSF for infection or tumor
Decompress immediately
Can use radio for tumor
34
Q

How do you manage para/tetraplegia?

A 
Treat issues:
Bladder
Bowels
Skin
Limb
35
Q

How do you manage bladder issues in para/tetraplegia?

A

Catheterise

Reflexes can return with time

36
Q

How do you manage bowel issues in para/tetraplegia?

A

Manuel evacuation

37
Q

How do you manage skin issues in para/tetraplegia?

A

Turning to avoid pressure sores

Cleaning to prevent infection

38
Q

How do you manage limb issues in para/tetraplegia?

A

Physio to prevent contractures

Baclofen for contractures

Neurology (30 decks)

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