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Neurology > PDF - Spinal Cord > Flashcards

PDF - Spinal Cord Flashcards

1
Q

Another name for LMNs?

A

Anterior horn cells

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2
Q

Weakness in LMN lesions?

A

Can present immediately but atrophy can takes weeks - months to develop

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3
Q

What do c5 and C6 innervate?

A

Deltoids and biceps

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4
Q

What do C7/8 Innervated?

A

Triceps

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5
Q

What innervates Tricep?

A

C7/8

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6
Q

What innervates biceps?

A

C5/6

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7
Q

What innervates deltoid?

A

C5/6

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8
Q

What do C8/T1 innervate?

A

Flexor digitorum

Interoseii

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9
Q

What innervates the Flexor digitorum?

A

C8/T1

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10
Q

What innervates the Interossei?

A

C8/T1

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11
Q

What do L2-4 innervate?

A

Quadriceps

Iliopsoas (hip flexor)

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12
Q

What innervates the Quadriceps?

A

L2-4

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13
Q

What innervates the Iliopsoas (hip flexor)?

A

L2-4

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14
Q

What does L4/5 innervate?

A

Tibialis anterior (foot dorsiflexor)

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15
Q

What innervates the tibialis anterior (foot dorsiflexor)?

A

L4/5

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16
Q

What innervates the Gastrocnemius (foot plantar flexor)?

A

S1/2

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17
Q

What does S1/2 innervate?

A

Gastrocnemius (foot plantar flexor)

18
Q

LMN signs?

A
  1. Severe atrophy w/ milder weakness
  2. Fasciculations
  3. Decreased Tone
  4. Decreased stretch reflexes
  5. No babinski
  6. No clonus
19
Q

UMN signs?

A
  1. Severe weakness w/ mild atrophy
  2. Never fasciculations
  3. increased tone / spasticity
  4. Increased reflexes
  5. Positive Babinski
  6. Possible Clonus
20
Q

What is radicular pain?

A

Lightning, stabbing, shooting or electrical pain in dermatomal distribution of a dorsal root

21
Q

Causes radicular pain?

A
  1. Inflammation: Herpes zoster

2. Extramedullary compression

22
Q

Difference in intra/extramedullary compression of cord?

A

Extra: Radicular pain
Intra: No pain or diffuse pain

23
Q

Rx Radicular pain?

A
  1. Analgesics
  2. Nerve blocks
  3. Antidepressants: duloxetine / amitriptyline
  4. Anticonvulsants: gabapentin / carbamazepine
24
Q

Presentation spinothalamic lesion?

A

Pain and temperature deficit in contralateral body

25
Q

What does a A suspended pattern of pain / temp deficit with sacral sparing indicate?

A
  • Intramedullary spinothalamic lesion within spinal cord
  • Disrupts decussating spinothalamic fibers
  • Since sacral fibers of spinothalamic are most lateral, they may be spared
26
Q

What does sensory deficit for pain and temperature up to a level with sacral involvement indicate?

A

Extramedullary lesion arising from outside spinal cord, and typically compressing it: IE, tumor

27
Q

What is a transection?

A

“Transverse myelopathy”

- Complete or nearly complete lesion encompassing cross-sectional extent of spinal cord

28
Q

Presentation spinal shock?

A

Weakness may be accompanied by decreased muscle tone and muscle stretch reflexes, with expected UMN signs gradually emerging weeks to months later

29
Q

What can extensive involvement of anterior horn cells at C3, C4 and C5 may cause?

A

impaired phrenic nerve function causing respiratory failure

30
Q

What is a brown sequard lesion?

A
  • Lesion impacting half of spinal cord
  • Contralateral deficit to pain and temperature
  • Involvement of the dorsal or posterior columns produces ipsilateral deficit of vibration / position sense
31
Q

What is syringomyelia?

A

Spinal cord lesion from a syrinx, or cavity, within center of spinal cord
- Dermatomal deficit of pain / temp sparing sacrum
“a suspended sensory level with sacral sparing”
- Vibration / proprioception spared

32
Q

Presentation anterior spinal artery occlusion?

A
  1. Paraplegia with UMN signs in lower limbs
  2. Thoracic level sensory loss, w/o sacral sparing, to pain and temp
  3. Vibration / position remain normal
  4. Back / radicular pain = common initial symptoms
33
Q

Risks spinal artery occlusion?

A
  1. AAA repair
  2. Aortic dissection
  3. Atherosclerosis
34
Q

What is this:

  1. Paraplegia with UMN signs in lower limbs
  2. Thoracic level sensory loss, w/o sacral sparing, to pain and temp
  3. Vibration / position remain normal
  4. Back / radicular pain = common initial symptoms
A

Anterior spinal artery occlusion

35
Q

Cause Posterolateral syndrome?

A

“Subacute combined degeneration”

  1. B12 deficiency (most common)
  2. Copper deficiency
  3. HIV
36
Q

Presentation Subacute combined degeneration?

A
  1. Vibration / position are reduced in lower limbs
    - Unsteadiness when patient stands or walks in dark
  2. Spastic paraparesis from involvement of corticospinal tract
  3. Pain / temp not affected
37
Q

What is this:

  1. Vibration / position are reduced in lower limbs
    - Unsteadiness when patient stands or walks in dark
  2. Spastic paraparesis from involvement of corticospinal tract
  3. Pain / temp not affected
A

“Subacute combined degeneration”

38
Q

What is ALS?

A

Degenerative disease where upper / LMNs are selectively and progressively destroyed, for unknown reasons
- Lesions occur diffusely, in cortex / stem, as well as
cord

39
Q

What is not present in ALS?

A
  1. Sensory impairment
  2. Bowel / bladder incontinence
  3. Radicular pain
40
Q

Cause Tabes dorsalis?

A

Syphilis

41
Q

Presentation Tabes Dorsalis

A
  1. Radicular pains in lower limbs
  2. Impairment of vibration / position sense in lower limbs
  3. Eventual loss of all sensation in lower limbs, where reflexes are lost
  4. Strength remains intact
42
Q

What is the following:

  1. Radicular pains in lower limbs
  2. Impairment of vibration / position sense in lower limbs
  3. Eventual loss of all sensation in lower limbs, where reflexes are lost
  4. Strength remains intact
A

Tabes Dorsalis

Neurology (37 decks)

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