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FINALS - NEURO > spinal cord > Flashcards

spinal cord Flashcards

1
Q

function of spinothalamic tract

A

pain, temp, coarse touch, pressure

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2
Q

where do spinothalamic tracts desuccate + which side do they affect

A

spinal level - contralateral side

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3
Q

function dorsal columns

A

fine touch, vibration, proprioception

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4
Q

where do dorsal column tracts desuccate + which side do they affect

A

brainstem (medulla) - ipsilateral

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5
Q

where do UMN legions occur

A

above anterior horn - spinal cord and brain

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6
Q

symptoms UMN

A

hyperrefelxia, increased tone, no fasculations

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7
Q

where do LMN legions occur

A

ant horn, nerves + muscles

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8
Q

LMN symptoms

A

decreased tone, wasting, fasculations, hyporeflex

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9
Q

what tracts are affected in anterior spinal artery infarction

A

lateral spinothalamic + corticospinal

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10
Q

symptoms anterior spinal artery infarction

A

bilateral spastic paralysis // bilateral loss of pain + temp (vibration + proprioception intact)

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11
Q

symptoms complete cord transection

A

all motor and sensory levels affected below level, UMN signs appear later

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12
Q

what is neurogenic shock

A

cord transection–> interrupted autonomic tract –> increases parasymp / decreased symp –> vasodilation + reduced CO

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13
Q

what level does neurogenic shock usually occur

A

above T5

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14
Q

what is spinal shock

A

acute spinal cord injury –> sudden physiological response –> flaccid paralysis, loss of reflexes, bulbocavernous reflex absent

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15
Q

where does autonomic dysreflexia occur + what is it

A

above T6 // increased thoracic-sacral sympathetic outflow + inhibited parasympathetic

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16
Q

what can trigger autonomic dysreflexia

A

faecal impaction or urinary retention

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17
Q

symptoms autonomic dysreflexia

A

extreme hypertension, sweating, flushing, headache, agitation

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18
Q

complication autonomic dysreflexia

A

haemorrhagic shock

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19
Q

mx autonomic dysreflexia

A

remove stimuli + manage hypertension

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20
Q

what is brown sequared syndrome

A

hemi-section of spine (usually knife)

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21
Q

symptoms brown sequared

A

contralateral spinothalamic loss (pain, temp) // ipsilateral dorsal column (vibration + proprioception) + motor loss

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22
Q

symptoms of central cor lesions

A

bilateral upper limb weakness + cape like spinothalamic sensory loss (power and dorsal columns OK)

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23
Q

where do disc herniations usually occur

A

L4/5 or L5/S1

24
Q

sciatica symptoms

A

shooting pain buttocks –> knee // straight leg test +ive // absent ankle reflex!!

25
Q

L3/4 herniation symptoms

A

sensory loss anterior thigh (L3) or ant knee (L4) // wasting quads // reduced knee // positive femoral stretch

26
Q

L5 herniation symptoms

A

sensory loss posterior thigh + dorsum of foot –> weak foot and toe dorsiflexion // reflexes ok

27
Q

S1 herniation symptoms

A

posteriorlateral leg + lateral foot // weak plantar flexion // reduced ankle reflex

28
Q

nerve assoc with foot drop

A

common peroneal

29
Q

invx + mx disc herniation

A

MRI if no improvement 4-6 weeks // physio + analgesia

30
Q

what is CES

A

compression cauda equina S2-4

31
Q

causes CES

A

slippied disc (L4/5 or L5/S1) // tumour, trauma, infection

32
Q

symptoms CES

A

bilateral sciatica // urinary + rectal incontinence // back pain // saddle anaesthesia // decreased anal tone

33
Q

CES invx

A

PR + urgent MRI

34
Q

what is degenerative cervical myelopathy

A

degenerative narrowing of spinal canal –> cord compression

35
Q

causes degenerative cervical myelopathy

A

smoking, OA, occupation

36
Q

symptoms degenerative cervical myelopathy

A

neck pain // loss of fine motor function eg buttoning shirt // sensory numbness // autonomic incontinence // hoffmans sign: flick a finger the others twitch

37
Q

invx degenerative cervical myelopathy

A

MRI

38
Q

mx degenerative cervical myelopathy

A

urgent ortho referall –> decompressive surgery

39
Q

causes of cervical spondlylosis

A

wear + tear –> OA –> osteophytes

40
Q

symptoms cervical spondylosis

A

neck pain // radiculopathy: LMN signs eg hyporeflexia, muscle weakness // myelopathy: UMN signs

41
Q

invx cervical spondlysosis

A

neck Xray

42
Q

what causes subacute degeneration of the spinal cord

A

B12 deficiency

43
Q

symptoms subacute degeneration spinal cord

A

UMN signs in legs. eg brisk knee reflexes, absent ankle // lost joint position + vibration in fingers

44
Q

tracts affected subacute degeneration spinal cord

A

lateral dorsal column + corticospinal

45
Q

symptoms neoplastic spinal cord compression

A

1 = back pain // lower limb weakness, sensory changes // neurological signs

46
Q

what level of neoplastic spinal cord compression causes UMN vs LMN

A

above L1 = UMN // below L1 = LMN

47
Q

invx neoplastic spinal cord compression

A

MRI within 24 hours

48
Q

mx neoplastic spinal cord compression

A

high dose dexamethasone

49
Q

what is syringomyelia

A

collection of CSF in spinal cord

50
Q

tracts syringiomyeloma

A

spinothalamic + ventral horns (motor)

51
Q

causes syringomyelia

A

chiari malformation, trauma, tumoujr

52
Q

symptoms syringomyelia

A

cape like loss of temp (spinothal) eg burn hand and do not realise // weakness lower limbs // neuropathic pain // upgoing plantar // horners syndrome // scoliolosis

53
Q

invx syringiomyelia

A

spine + brain MRI

54
Q

symptoms of neurosyphillis + tract affected

A

dorsal columns –> loss of proprioception + vibration

55
Q

what inheritence is friedrechs ataxia

A

autosomoal recessive (GAA on chromosome 9)

56
Q

spinal tracts friedrechs ataxia

A

same as subacute degeneration (cortiical, spinocerebellar, dorsal columns)

FINALS - NEURO (16 decks)

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