Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology > Principles of Spinal disease > Flashcards

Principles of Spinal disease Flashcards

1
Q

What does myelopathy mean?

A

Disease of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are the sensory tracts found in the spinal cord?

A

Dorsal and lateral funiculi - runs ipsilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where are the UMN tracts found in the spinal cord?

A

Lateral and ventral funiculi; runs ipsilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where are the LMN cell bodies found in the spinal cord?

A

Ventral horn grey matter; runs ipsilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are the spinal cord segments separated?

A
  • C1 to C5
  • C6 to T2
  • T3 to L3
  • L4 to S3
  • Caudal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the characteristic signs of sensory ataxia?

A
  • Loss of sense of limb/body position
  • Wide based stance
  • Increased stride length
  • Swaying/floating gait
  • Knuckling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of LMN paresis?

A
  • Muscle tone is decreased in limbs with a reflex arc containing the lesion
  • Spinal reflexes are decreased to absent in limbs with a reflex arc containing the lesion.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are you testing in a spinal reflex?

A

3 parts

  • Sensory
  • Central
  • Motor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the gait in a patient with LMN paresis

A
  • Stride length is normal to decreased
  • Stiffness
  • Bunny hopping
  • May or may not see collapse
  • May or may not see sensory ataxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the characteristics of UMN paresis?

A
  • Muscle tone is normal to increased in limbs caudal to the lesion
  • Spinal reflexes are normal to increased in limbs caudal to the lesion.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What will a lack of UMN inhibition cause?

A

Exaggerated reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the gait in a patient with UMN paresis

A
  • Stride length is normal to increased
  • Will see spasticity
  • May or may not see sensory ataxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If tetraparesis is present, what spinal cord segments can be affected?

A
  • C1 to C5

- C6 to T2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If paraparesis is present, what spinal cord segments can be affected?

A
  • T3 to L3

- L4 to S3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does -paresis mean?

A

Decreased voluntary movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does -plegia mean?

A

Absence of voluntary movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What signs will be seen in a L4-S3 myelopathy?

A
  • Normal forelimbs

- LMN signs in hind limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What signs will be seen in a T3-L3 myelopathy/

A
  • Normal forelimbs

- UMN signs in hind limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What signs will be seen in a C6-T2 myelopathy?

A

LMN signs in forelimbs

-UMN signs in hind limbs.

20
Q

What signs will be seen in a C1-C5 myelopathy?

A

UMN signs in all four limbs.

21
Q

What signs will be seen in generalized neuromuscular localization?

A

LMN signs in all for limbs

22
Q

What signs will be seen in a brainstem lesion?

A

UMN signs in all four limbs

23
Q

What classifies as an extrinsic myelopathy?

A
  • Extradural lesion

- Intradural-extramedullary lesion

24
Q

What classifies as an intrinsic myelopathy?

A
  • Diffuse intramedullary lesion

- Focal intramedullary lesion

25
Q

What is the most important prognostic indicator in spinal cord lesions?

A

Perception of deep pain.

26
Q

What is prognosis of myelopathies dependent on?

A
  • Diagnosis

- Function (neuro-exam)

27
Q

What does DAMNITV stand for?

A
  • Degenerative
  • Anomalous
  • Metabolic
  • Neoplastic, Nutritional
  • Infectious, Inflammatory, Idiopathic
  • Traumatic, Toxic
  • Vascular
28
Q

How do you build a list of differentials?

A
  • Onset
  • Progression
  • Localization
  • Symmetry
  • Presence of pain
  • Signalment
29
Q

Does Limb withdrawal indicate pain?

A

NO

30
Q

What are the most common places for disk herniation?

A

T11 - T1 (between the 11th and 12th thoracic vertebrae)

L2 - L3 (between the 2nd and 3rd lumbar vertebrae)

Thoracolumbar issues common in chrondrostrophoid breeds

Cervical (neck): (mostly dachshunds, beagles and poodles) - C2 - C3 (between the 2nd and 3rd cervical vertebrae)

31
Q

What is a Hansen Type I Disk disease?

A

In Hanson Type I disk herniation, the nucleus pulposus becomes dehydrated and mineralized.

It loses its gelatinous cushioning properties and suddenly extrudes, slapping right into the spinal cord and its tender surrounding ligaments.

The classic victim is a young dog of a breed that involves a long back and short legs, though any dog can be affected.

The damage to the spinal cord can range from mild inflammation to total destruction.

32
Q

What is a Hansen Type II Disk disease?

A

Here the degeneration is slower and the fibers of the annulus fibrosus become soft.

As the disk is compressed by the normal forces between the vertebrae, the annulus fibrosus bulges upwards and puts pressure on the spinal cord more slowly.

The classic victim here is an older large breed dog. German Shepherd dogs seem predispose

33
Q

What happens in disk herniation disease?

A

Disk herniation causes inflammation - then can show neurological deficits

Order of loss of function:
Loss of conscious proprioception - nerves located outside of sc
Voluntary motion nerves
nerves to feel superficial pain
nerves to feel deep pain perception
34
Q

What are the diagnostics for disk herniation?

A

After presented with spinal weakness
- work out if it is compressive or non-compressive spinal disease

  1. Neuro Exam (localise)
  2. Plain rads (calcified disks, disk space collapse)
  3. Advanced imaging - Myelography, CT, MRI
35
Q

Why is it important to work out if spinal disease is compressive or non-compressive?

A

Compressive can be corrected by surgery but non-compressive usually involves degenerative disease and is not suitable for surgery

36
Q

What other examples are there of compressive and non-compressive spinal lesions other than disk herniation?

A

Compression can also include - tumour, vertebral fracture/dislocation, disk infection

Non-compressive - spinal degeneration, spinal infection/inflamm, demyelination injuries, fibrocartilaginous embolism

37
Q

Are lesions in the thoracic area common?

A

No - ligaments connecting ribs to the back provide extra protection for sc

38
Q

What is Myelography?

A

Injecting iodine based dye around sc - myelogram (seeing compression)

CT taking over slowly

39
Q

What is the tx for disk herniation?

A

Surgery - very expensive + requires a long recovery period
(Best option is sx if dog cannot walk!)

Medical tx - Steroids, non-steroidal anti-inflammatories, muscle relaxants, and pain relievers

Placing ice packs for the inflamm!

Confinement

Physical therapy later on

40
Q

What are the surgery options for disk herniation?

A
  • Hemilaminectomy
  • Pediculectomy
  • Dorsal Laminectomy
  • Ventral Slot
  • Fenestration
41
Q

What is Hemilaminectomy?

A

Hemilaminectomy

  • Commonly performed in the thoracolumbar area.
  • the articular facets (where the two vertebrae connect) are removed, as is the vertebral bone adjacent to the spinal cord
42
Q

What is Pediculectomy?

A

Pediculectomy

  • Similar to hemilaminectomy except only the articular facets are preserved (less invasive/destabilizing)
  • removal of just pedicular bone - room for spinal cord
43
Q

What is Dorsal laminectomy?

A

Dorsal Laminectomy

  • most invasive of all the procedures + involves decompressing the spinal cord from the top
  • Removing the dorsal spinous process and lamina - entire top of vertebrae allowing room for swollen sc
44
Q

What is Ventral slot?

A

Ventral Slot

  • Neck disks
  • A slot is drilled in the vertebral bodies of the bones on either side of the disk creating a small window over the disk space
  • Mineralized disk material can be removed + room for the swollen spinal cord to decompress
45
Q

What is Fenestration?

A

Fenestration

  • Preventive procedure often performed on the disk spaces near the herniated space.
  • It involves making a slit over the annulus fibrosus and removal of any mineralized nucleus pulposus
  • For some patients, this is the only surgery needed but it is not truly a decompressive surgery

Neurology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions