Patho- Spinal cord disease

Question 1

What are the two main conditions affecting the spinal cord?

Answer 1

Compression

Lesions

Question 2

What areas of the spinal cord can be lesioned?

Answer 2

Cord
Roots
Brain stem

Question 3

What damage can occur to a dorsal root?

Answer 3

Sectioning

Compression

Question 4

What does sectioning a dorsal root do?

Answer 4

Complete sensory loss from dermatome

Question 5

What are some symptoms of dorsal root compression?

Answer 5

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

Question 6

What can cause dorsal root compression?

Answer 6

Herniated disc

Question 7

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

Answer 7

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

Question 8

What symptoms can a Spinothalamic tract lesion cause?

Answer 8

Contralateral pain and temp loss

Question 9

How much of the spinal cord can be lesioned?

Answer 9

Partial- hemi

Complete

Question 10

What is a chronic spinal cord lesion?

Answer 10

Compression

Question 11

What forms can an acute spinal cord lesion take?

Answer 11

Complete transection
Brown-sequard syndrome
Central Cord Syndrome

Question 12

What can cause an acute spinal cord lesion?

Answer 12

Trauma

Tumour

Question 13

What are some symptoms of complete spinal cord transection?

Answer 13

All sensory and motor affected below lesion

Question 14

What can complete spinal cord transection cause?

Answer 14

Spinal shock- Flaccid areflexic paralysis

Question 15

What causes Brown-sequard syndrome?

Answer 15

Hemisectioning

Question 16

What are some symptoms of Brown-sequard syndrome?

Answer 16

Contralateral pain and temp loss

Ipsilateral weakness/paralysis and loss of proprioception

Question 17

What can cause central cord syndrome?

Answer 17

Generally hyperextension of neck in already stenosis or spondylosis spine.

Question 18

What are some symptoms of central cord syndrome?

Answer 18

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

Question 19

What parts of the brain stem can be lesioned?

Answer 19

Pons
Thalamus
Cortex (not BS)

Question 20

What can cause pons lesions?

Answer 20

MS

Question 21

What is the symptom of pons lesion?

Answer 21

Full contralateral sensory loss

Question 22

What can cause thalamus lesion?

Answer 22

Infarct

Question 23

What are some symptoms of thalamus lesions?

Answer 23

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

Question 24

What can a cortex lesion cause?

Answer 24

Sensory loss
Side neglect
Apraxia
No patho pain

Question 25

What can cause spinal cord compression?

Answer 25

``` Tumor TB Disc herniation Abscess Bleeding B12 deficiency Syringomyelia and syringobulbia ```

Question 26

What is Syringomyelia and syringobulbia?

Answer 26

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

Question 27

What is Syringomyelia and syringobulbia associated with?

Answer 27

Arnold-Chiari Malformation

Question 28

What is the pathology of Syringomyelia and syringobulbia?

Answer 28

ACM cerebellar down into foramen magnum

Question 29

What areas can be affected by Syringomyelia and syringobulbia?

Answer 29

Spinothalamic Anterior horn Lateral corticospinal tracts

Question 30

What are some symptoms of Syringomyelia and syringobulbia?

Answer 30

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

Question 31

What are some signs of spinal cord compression?

Answer 31

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

Question 32

What are the UMN signs?

Answer 32

``` Muscle weakness Hyper-reflex Rigidity Clonus Babinski sign ```

Question 33

How do you treat spinal cord compression?

Answer 33

``` Medical emergency!!! MRI CSF for infection or tumor Decompress immediately Can use radio for tumor ```

Question 34

How do you manage para/tetraplegia?

Answer 34

``` Treat issues: Bladder Bowels Skin Limb ```

Question 35

How do you manage bladder issues in para/tetraplegia?

Answer 35

Catheterise | Reflexes can return with time

Question 36

How do you manage bowel issues in para/tetraplegia?

Answer 36

Manuel evacuation

Question 37

How do you manage skin issues in para/tetraplegia?

Answer 37

Turning to avoid pressure sores | Cleaning to prevent infection

Question 38

How do you manage limb issues in para/tetraplegia?

Answer 38

Physio to prevent contractures | Baclofen for contractures