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Neuro MSK > SCI > Flashcards

SCI Flashcards

1
Q

which part of the SC is more protected d/t its blood supply?

A

posterior
posterior spinal artery has 2 branches and supplies 1/3 of SC

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2
Q

what part of the spinal cord is damaged in ALS?

A

anterior horn cells (motor neurons)
Wallerian degeneration

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3
Q

where does the spinothalamic tract cross?

A

anterior commissure of the SC immediately/1-2 levels above enter

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4
Q

if there is a stroke at the thalamus, where will pain & temp deficits be?

A

contralateral

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5
Q

where does the DCML cross?

A

caudal medulla
(internal arcuate fibers)

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6
Q

how will DCML be lost with a lesion at the SC?

A

ipsilateral

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7
Q

which structure does all sensory integration for the entire body (except face)?

A

ventral posterior lateral nucleus of thalamus

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8
Q

where does the corticospinal tract cross?

A

medulla (cervical medullary junction)
pyramids

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9
Q

which spinal levels do the parasympathetic NS?

A

cervical and sacral

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10
Q

which spinal levels do the sympathetic NS?

A

T1-L3

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11
Q

what sx are indicative of a SC lesion?

A

bilateral sx
B/B involvement
leg stiffness
neck or back pain
Lhermitte or Uhthoff
sensory level
tight band sensation across trunk/torso

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12
Q

tight band sensation across trunk/torso could indicate what condition?

A

transverse myelitis (–> MS)

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13
Q

what is the 2 most common complete SCI?

A

1 C5
2 C4

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14
Q

what spinal levels lead to quadriplegia?

A

C1-T2

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15
Q

what spinal levels lead to paraplegia?

A

T3 and down

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16
Q

what is the ASIA scale?

A

assesses the level of involvement of a SCI
assesses prognosis
should be done w/i 24-48 hours post SCI

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17
Q

what are the UE motor tests on the ASIA?

A

C5 elbow flexors
C6 wrist extensors
C7 elbow extensors
C8 finger flexors
T1 finger abductors

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18
Q

what are the LE motor tests on the ASIA?

A

L2 hip flexors
L3 knee extensors
L4 DF
L5 great toe extensors
S1 PF

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19
Q

what determines if a SCI is complete or not?

A

if there is voluntary anal contraction = not complete

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20
Q

how is motor testing performed on the ASIA scale?

A

all done in supine

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21
Q

what are the grades of SCI on the ASIA scale?

A

A = complete (S4-5 impaired)
B = sensory incomplete (no motor)
C = motor incomplete: <1/2 key mm functions & mm grade < 3
D = motor incomplete: at least 1/2 key mm functions & mm grade ≥ 3
E = normal

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22
Q

sx of spinal shock

A

immediate flaccidity & loss of sensory and autonomic function BELOW level of lesion
atonic bladder
loss of vasomotor control

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23
Q

how to determine if person is out of spinal shock?

A

anal wink/reflex returned

24
Q

autonomic dysreflexia occur in a SCI above ____ level

A

T5

25
Q

SCI sx after spinal shock

A

increased reflexes
spasticity below lesion level
pathological pyramidal reflexes
spastic bladder
paralyzed legs w/ contractures
autonomic dysreflexia (above T5)

26
Q

which spinal level SCI is dependent with verbal communication?

A

C1-C3

27
Q

what is autonomic dysreflexia?

A

exaggerated sympathetic response to noxious stimuli below lesion (for SCI above T5)

28
Q

sx of autonomic dysreflexia

A

hypertension
sweating
flushing
bradycardia

29
Q

autonomic dysreflexia is usually due to ___ injury of SCI

A

complete transverse

30
Q

risk of autonomic dysreflexia is increased after recovery from

A

spinal shock

31
Q

T/F: fertility is maintained in both F and M with SCI

A

F
just F

32
Q

leading causes of death of SCI pts

A

sepsis
pneumonia
respiratory failure

33
Q

when is the highest rate of lowered life expectancy after a SCI?

A

1st year

34
Q

what is the most common level for cervical spondylosis?

A

C5-C6

35
Q

cervical spondylosis causes ____ below the lesion and ___ at the level of the lesion

A

below - myopathy
@ - radiculopathy

36
Q

C spine injury has ___ deficits at the level of the lesion and ____ below

A

@ - UMN
below - LMN

37
Q

motor neuron injuries (ex: ALS) has ____ deficits at the level of the lesion and ____ below

A

@ - LMN
below - UMN

38
Q

what is a sign of permanent injury to the SC and requires surgery?

A

cord signal change

39
Q

what is the most common non-traumatic SCI?

A

cervical spondylotic myelopathy

40
Q

sx of cervical spondylotic myelopathy

A

pain
burning
weakness
numbness
tingling
B/B dysfunction !!
Lhermitte’s phenomenon !!
more fine motor involvement

41
Q

a positive Hoffman’s sign indicates a lesion where?

A

C spine

42
Q

what is the most common level to have a SC met?

A

thoracic

43
Q

what is the only SCI treated with steroids?

A

SC mets

44
Q

primary tumor sites that go to SC mets

A

lung
breast
prostate
kidney
thyroid
gut

45
Q

red flags of epidural abscess

A

fever
back pain
diabetes

46
Q

an epidural abscess will be ___ shaped

A

crescent

47
Q

subacute combine degeneration is a SC syndrome that involves the _____ and _____ tracts

A

posterior column and corticospinal

48
Q

posterolateral column syndrome is usually caused by _____ deficiency

A

B12

49
Q

what is the model disease for posterior column syndrome?

A

neurosyphilis (Tabes dorsalis)
*absent reflexes but preserved strength

50
Q

hemicord syndrome sx

A

ipsi UMN weakness below lesion
ipsi LMN weakness at lesion level
ipsi loss of vibration & proprioception
CONTRA loss of pain and temp 1-2 levels below
ipsi nerve root pain
ipsi impaired sweating

51
Q

NMO can lead to what kind of SCI?

A

central cord syndrome

52
Q

Chiari malformation can cause ___ which is a central cavitation of the SC

A

syringomyelia

53
Q

where is syringomyelia most common?

A

C spine

54
Q

syringomyelia will have a ____ distribution of weakness and reflex loss

A

cape
*in hands and arms

55
Q

anterior cord syndrome is usually due to

A

anterior spinal artery stroke

56
Q

what tracts are affected with anterior cord syndrome?

A

CST
STT

57
Q

conus medullaris & cauda equina syndrome presentation

A

preserved UE
impaired B/B function
absent reflexes

Neuro MSK (15 decks)

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