Section 7 - Spinal Cord Flashcards
What is amyotrophic lateral sclerosis?
Lou Gehrig Disease. Abnormal reflexes (upper and lower motor neuron involvement). No sensory loss; progressive loss of all motor neurons. Particularly severe when muscles of respiration are affected.
What is myasthenia gravis?
Autoimmune abnormality where antibodies bind to the nicotinic acetylcholine receptors at neuromusclar jxn, blocking normal effects of acetylcholine to depolarize muscle and elicit response.
List symptoms of myasthenia gravis.
- Muscle weakness/compromise of ability to elicit skeletal muscle response - this waxes and wanes over time
- Diplopia, ptosis (both seen first; eye mm. affected first)
- Dysarthria (difficult/unclear speech)
- Dysphagia
What is syringomyelia?
Cavitation of central region of spinal cord. NOT the central canal.
A small syrinx damages:
Fibers crossing anterior white commissure (ALS); damage ALS tract destined bilaterally to specific spinal levels. (2 levels below, bilaterally).
A large syrinx damages:
Anterior white commissure AND anterior horn –> bilateral sensory loss at specific levels, weakness of extremity
What is a hydrosyringomyelia?
A cavitation of the central canal.
Non-communicating syringomyelia ______.
Communicating syringomyelia ______.
- Is separate from the central canal.
- Has a cystic structure connecting to the central canal.
What is Brown-Sequard Syndrome?
A hemisection of the spinal cord that reflects damage to lateral corticospinal tract, ALS, and dorsal columns.
List symptoms of Brown-Sequard Syndrome.
- Muscle weakness/paralysis ipsilaterally
- Loss of pain and thermal sensation contralaterally
- Loss of proprioception, vibratory, fine touch ipsilaterally
What is a radiculopathy?
Damage to nerve root, typical of disk/spine disease and impingement syndromes. Sharp, localized pain related to dermatome. (Single root might not cause big sensory loss, due to overlap of dermatomes).
What is a mononeuropathy?
Damage to defined peripheral nerve, often from trauma or entrapment (like carpal tunnel). Leads to paresthesia, pain, weakness in target tissue.
List some characteristic examples of a mononeuropathy.
- Tongue deviation (XII)
- Flexion/adduction, extension of fingers (ulnar)
- Foot dorsiflexion (fibular)
- Forearm pronation (median)
- Flexion of toes (tibial)
What is a polyneuropathy?
Damage in multiple peripheral nerves, so both motor and sensory.
What is glove and stocking sensory loss?
Lesions/neuropathy starts in lower extremity then begins in upper; moves from periphery to central locations (involving small diameter fibers first). Diabetes mellitus causes this.
- Lose sensation of temp/pain, then vibration/proprioception, weakness of extremities/hyporeflexia
What is a motor neuropathy, and what does it lead to?
- Loss of anterior horn motor neurons
- Flaccid weakness, muscle fasciculations, muscle atrophy
What is a sensory neuropathy, and what does it lead to?
- Loss of cell bodies in DRG
- Distal and proximal extremity affected
What is a lower-motor lesion?
- Skeletal mm. activity affected (the final common pathway)
- FLACCID paralysis, muscle ATROPHY, diminished or ABSENT deep tendon reflexes
What is an upper-motor lesion?
- Damage to cerebral hemispheres or lateral white columns of spinal cord
- SPASTIC paralysis, NO atrophy, HYPERACTIVE deep tendon reflex, Babinski’s sign
- Often caused by stroke, tumor, infection
What results from occlusion/spasm of anterior spinal artery (Central Cervical Cord Syndrome)?
- Bilateral weakness of extremities (mostly upper)
- Patchy loss of sensation below lesion
- Urinary retention
What is poliomyelitis?
Viral infection leading to spinal cord inflammation of gray matter
What are symptoms of poliomyelitis?
- Headaches
- Red/sore throat
- Slight fever
- Vomiting
- Abnormal reflexes
- Back/neck stiffness
What is tabes dorsalis?
Slow degeneration of sensory neurons in dorsal columns of spinal cord. Occurs as secondary demyelination due to untreated syphilis.
What are symptoms of tabes dorsalis?
- Weakness
- Diminished reflexes
- Paresthesias
- Hypoesthesias
- Progressive locomotor ataxia