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Neurology > Spinal Cord > Flashcards

Spinal Cord Flashcards

1
Q

Tract carrying PAIN TEMPERATURE CRUDE TOUCH AND CRUDE PRESSURE

A

ST

Lat ST= Temp—> Pressure

Anterior ST= —> Crude touch/pressure

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2
Q

Thalamus nucleus of ST and DC

A

VPL

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3
Q

Lemniscus of ST

A

Spinal

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4
Q

Brown sequard at T3 what will be the nature of lesion at ST3 and ST5 DC and CST (umn & lmn)

A

I/L at ST3

C/L at ST5

I/L DC

I/L T3 CST= LMN
I/L T5 CST = UMN

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5
Q

Dorsal column transmits?

VPFJ

A

Vibration
Proprioception
Fine touch
Joint position sense (x=RHOMBERGS SIGN)

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6
Q

Lemniscus of DC

A

Medial

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7
Q

Nucleus of LL in DC

A

GRACILIS

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8
Q

Fasciculus of UL in DC

A

F. CUNEATUS

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9
Q

Crossing of DC is at?

A

MEDULLA

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10
Q

Which lesion in Pb poisoning?

A

LMN ALWAYS

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11
Q

SPINAL SHOCK FEATURES and DURATION

A

Transient paradoxical LMN below the level of lesion.

Lasts 1-6wk (mc = 48-72 hrs)

All features of LMN except WASTING!!

Arreflexia
Flaccidity
Sensory loss+
Urinary retention+

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12
Q

Which is the first reflex to reappear in a spinal shock?

A

BULBOCAVERNOSUS»Flexor withdrawal

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13
Q

Hemiparesis group causes?

As per artery rupture

A

MCA rupture in CORTEX

MCA rupture in IC (Dense HEMIPARESIS)

In Cerebral Hge in PUTAMEN

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14
Q

Test for Hemiparesis

A

PRONATOR DRIFT TEST

-Hand on weak side will pronate and drift downwards

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15
Q

Cause of MONOPARESIS

A

NEUROPATHIES

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16
Q

Cause of PARAPARESIS

A

MYELOPATHIES (Spinal roots)

- Always check dermatomes to find lesion

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17
Q

BEEVOR SIGN?

A

Tell pt to get up from supine position

  • Umbilicus upwards??— Upper muscles normal and lower muscles weak—> lesion at T10 or below
  • Umbilicus normal??—Both muscles strong—> Lesion below T12

NO NEED TO DO BEEVOR TEST IF LESION IS ABOVE T10, the patient wont be able to get up only

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18
Q

Hemisectional anatomy of tracts and artery supply in spinal cord

A

DC- S L T C (notice medial LL and lateral UL—Gracillis and Cuneatus accordingly)

ST&CST - C T L S

Posterior= VERTEBRAL ARTERY (DC)
Anterior = ANT SPINAL ARTERY (ST&CST)
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19
Q

Features of Intramedullary pathology on tracts (SLTC CTLS CTLS)

A

Descending Sensory and Motor loss (ST&CST)

C= Shoulder—Elbow—wrist

BURNING PAIN**

SACRAL SPARING***

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20
Q

Extramedullary pathology symptoms

A

Early Sacral loss

Root/Radicular pain (Eg IVD slip)

ASCENDING S&M loss (ST&CST)

CSF PROTEINS+++ **

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21
Q

Syringomyelia age/sex and mcs

A

10-30y
M»F

C5-C8 pressing anteriorly (ST&raquo_space;CST)

  • CAPE LIKE SENSORY LOSS***
  • Loss of reflexes in the same area (LMN)
22
Q

Syringomyelia pathology

A

CSF filled cavity (SYRINX) expanding and pushing anteriorly

A/w CHIARI MALFORMATION 1 (>50%)
- Cerebellar tonsillar herniation—pushes central canal anteriorly

23
Q

Etiology if SYRINGOMYELIA

cT3

A

Congenital

TB

Trauma

Tumor

24
Q

Cf of Syringomyelia

A

DISSOCIATIVE ANESTHESIA c BURNING SENSATION-painless
(selective loss of pain and temp)

LMN PALSY @ Lesion

UMN PALSY below lesion

25
Q

Ixoc Syringomyelia

A

MRI BRAIN + SPINAL CORD***

To see total extent if dilatation

26
Q

Rxoc Syringomyelia

A

Laminectomy and decompression

Poor px

27
Q

Rx Chiari malformation

A

Sub occipital craniotomy

28
Q

Root values POEM

A

1-2 Buckle my shoe (AJ -S1S2)

3-4 Kick the door (KJ- L3L4)

5-6 Pick up the sticks (BJ- C5C6)

7-8 Lay them straight (TJ- C7C8)

9,10 Big fat hen (Beevors sign T10)

29
Q

UB higher controls

A

1) Paracentral Lobule (Frontal lobe)
- Social inhibition

2)PONS (Micturition centre)

3)Spinal cord— Symp = T11-L2 (Relax)
Parasym= S234 (Contract)

                   Sensory = S234 (Urge)
30
Q

Autonomous bladder

Lesion at s234

A

LMN lesion
Flaccid/ Hypotonic
No sensory/ parasymp supply
LARGE CAPACITY**

OVERFLOW INCONTINENCE **

31
Q

AutonomIc bladder

A

UMN lesion
Spastic bladder
Urge incontinence ++
Hypertonic

LOW CAPACITY

32
Q

Characteristics of INFANT BLADDER/ CORTICAL BLADDER

A

Lesion at Pc lobule— disinhibition

Cause : ACA infarct

33
Q

Reflex grading

A

+ hypo
++ normal
+++ brisk
++++ clonus

34
Q

Conus Medullaris vs Cauda Equina

A 
Inside                    Outside
S1-5 (V= L1,2)       S&L 1-5
KJ norm.                 KJ - 
Autonomic B.       Mixed B
Saddle An.              -
AJ B/L -                  AJ U/L -
Plantar+                Plantar U/L

CE- TB tumor trauma

35
Q

Lesion above and below t1 nature?

A

QUADRIPARESIS

PARAPARESIS

36
Q

Phrenic nerve roots

A

C345

37
Q

Intercoastal nerve roots

A

C678

38
Q

High cervical lesion features(c1-4)

A

Phrenic nerve gone
IC nerve gone

APNOEA

39
Q

Low cervical lesion features

A

Diaphragmatic breathing++

40
Q

Cervical lesion Features other than respiration

A

UMN
LMN

HORNER SYNDROME *
Rectal Sphincter tone DECREASE*
Priapism +++ *** (Dt autonomic transection)

41
Q

What is autonomic dysreflexia and its rx

A

Upper thoracic lesion—no sympathetic to HEART—Decreased HR—-Increased BP

Rx CLONIDINE
NIFEDIPINE

42
Q

Types of MNDs

A

ALS

SMA (Spinal Muscular Atrophy)- LMN

PLS (Primary Lat Sclerosis)-UMN

Adult Tay Sachs-LMN

Kennedy syndrome- LMN

Multifocal motor neuropathy c Conduction block- LMN

FAMILIAL SPASTIC PARAPLEGIA-UMN

43
Q

ALS pathology

A

SOD dysfunction— High radicles in nerves—Damage to whole nerve—UMN + LMN lesion

44
Q

ALS c/f

A

Whole CST + AHC gone :

No motor fn.
(AMYOTROPIC)

Fasciculations+ *** (Pathognomonic of AHC LESION)

SENSORY SYSTEM AND AUTONOMIC SYSTEM SPARED in all MNDs

Bladder
EYE**
Cognition

45
Q

Rx ALS

A

RILUZOLE
(inhibits glutamate release from adjacent nerve—Ca influx—combines with negative free radicles—No damage)

EDAVARONE
(Acts like SOD enzyme)

46
Q

Mccd in als

A

Resp failure

47
Q

Inclusion bodies in ALS

A

BUNINA BODIES

48
Q

Genetic etiology?

A

HEXANUCLEOTIDE REPEATS

FTD**

49
Q

SMA pathology

A

Lesion only in AHC

ONLY LMN weakness

50
Q

PLS pathology

A

Lesion only in CST

ONLY UMN weakness

51
Q

Rx SMA

A

Zolgenesma

NUSINERSEN

52
Q

LOu gehrig disease

A

ALS

Neurology (11 decks)

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