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Spinal Cord > Spinal cord > Flashcards

Spinal cord Flashcards

1
Q

Which system tactile discrimination, Vibration, Pressure, proprioception

A

Dorsal Column/Medial Lemniscus system

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2
Q

Which tract discriminative pain and temperature

A

Lateral Spinothalamic

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3
Q

System controls fine movements or voluntary skilled motor activity innervation of voluntary muscles

A

Corticospinal System

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4
Q

Most common cause of spinal cord lesions

A

Trauma to the Spinal cord, complete or partial

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5
Q

Complete Spinal Cord injury

A

absence of sensory and motor function BELOW the lesion level

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6
Q

Incomplete

A

Partial loss of sensory and motor function BELOW the lesion. Most frequent than complete

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7
Q

Bilateral loss of tactile discrimination, vibration, pressure, proprioception, accompanied by ataxia
Pts with neurosyphilis

A

Dorsal column syndrome: bilateral loss of dorsal column. Pts with neurosyphilis

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8
Q

Ipsilateral loss of lateral corticospinal; and Ipsilateral loss of Dorsal column. Contralateral loss of spinothalamic tract

A

Brown-Sequard Syndrome
caused by MS, Stab wound, Tumor
Lateral cord lost

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9
Q

Dorsal column spared, BL loss of lateral corticospinal tracts, loss of ventral horn, loss of spinothalamic tracts

A

Anterior cord Syndrome
Infarct, ischemia trauma
2/3 of anterior cord lost

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10
Q

Loss of spinothalamic tracts; small lesion, 1st symptom tract across midline. BL loss of pain and temp
Loss of ventral Horn large lesion; flaccidity of upper limb
Etiology infarct ischemia trauma

A

Central Cord syndrome

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11
Q

rare, progressive congenital disorder; fluid filled cavity in Spinal cord

A

Central Cord syndrome

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12
Q

Degeneration of SC from severe vit B12 deficiency, pernicious anemia, AIDS Bilateral ataxia, bilateral spastic paralysis, bilateral loss of discriminative touch, pressure, vibration and proprioception

A

Posterolateral Cord Syndrome

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13
Q

Acute viral disease (poliomyelitis) causes bilateral flaccidity in muscles innervated by the affected SC levels

A

Ventral Anterior Horn syndrome

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14
Q

Area most vulnerable injury after impact accidents and most severe physiological effects

A

Acute spinal cord injury

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15
Q

Major cause of morbidity and mortality. Cervical and upper thoracic SCI, alveolar hypoventilation and inability to clear bronchial secretions

A

Acute SCI

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16
Q

Initially causes flaccid paralysis with loss of sensation below the level of injury, reduced vital capacity and arterial hypoxemia

A

Acute SCI

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17
Q

SC functions below the lesion are depressed or lost immediately after traumatic injury to SC
Lasts 1-3 wks

A

Spinal SHock

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18
Q

Lost or impaired; somatic and autonomic reflexes, autonomic regulation of BP, control of sweating and piloerection (erection of haris)

A

Spinal shock

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19
Q

Spinal condition causes the following constant threats; aspiration of gastric contents, pneumonia, and pulmonary embolism

A

Spinal Shock

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20
Q

Treatment of acute SCI; cervical fracture or dislocation

A

Halo thoracic device is more effective than neck collars

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21
Q

Method of intubating cervical fracture or dislocation

A

direct laryngoscopy with manual in line stabilization or awake ficeroptic laryngoscopy

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22
Q

In acute SCI; spinal fractures or dislocations what should be be avoided

A

Hypotension

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23
Q

Which neuromuscular muscle relaxant should be used in acute SCI

A

Nondepolarizing (Pancurium), Succycholine may be used (not in chronic SCI)

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24
Q

Medications used for chronic SCI

A

antidepressants, analgesics and baclofen for involuntary muscle spasms

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25
Spinal cord injury above with vertebra causes apnea
C5
26
Prevention of what condition in chronic SCI
Autonomic hyperreflexia
27
Which muscle relaxants could be used for chronic SCI
Nondepolarizing, do not use succylcholine (cause hyperkalemia)
28
EXAM question: What inititates Autonomic Hyperreflexia
surgery or visceral stimulation below the level of spinal cord injury
29
Patient with SCI at level T1 is being surgically interviened in the bladder and rectum, notice increase in BP and decrease in pulse, What condition is possible
Autonomic Hyperreflexia
30
Symptoms of autonomic hyperreflexia
Hypertension, bradycardia are hallmark, LOC, seizures, cardiac dysrhythmias, pulmonary edema
31
Which anesthesia should be given for autonomic hyperreflexia
Spinal or general; prevents AH. Topical or epidural anesthesia are not effective in prevention
32
Can Autonomic hyperrflexia manifest post op
Yes, after anesthetic drugs ware off
33
Most common effect of intervertebral disk disease
Low back pain
34
Cervical Disk disease usually occurs are which intravertebral spaces?
C5-C6 or C6-C7
35
Treatment for cervical disk disease
Surgical decompression
36
Most common sites of lumbar disk disease
L4-L5, L5-S1
37
Treatment for lumbar disk disease
analgesia, muscle relaxants, epidural steroids, surgical laminectomy and microdisectomy
38
Cervical Plexus
C1-C4
39
Brachial Plexus
C5-T1, phrenic nerve C3-C5
40
Phrenic nerve
C3-C5
41
Lumbosacral Plexus
L1-S5
42
Bells Palsy causes
Ipislateral motor weakness all muscles innervated by VII (7)
43
Which CN is affected in BeLLs Palsy
CN VII, causes inflammation and edema of CN VII
44
What is affected in Bells Palsy? Cranial or Motor nerves?
Motor are affected, sensations are not
45
Virus implicated in Bells Palsy (5)
Herpes simplex 1, mumps, Epstein Barr, cytomegalovirus, rubella
46
More common in what pts Bells Palsy?
DM, (4x) Immunocompression (Aids), and 3rd trimerster of pregnancy
47
Tx of Bells Palsy
Prednisone, cover eye if not blinking. Sever cases: Surgical decompression
48
Trigeminal Neuralgia is
sudden unilateral facial, stabbing pain
49
Which nerve is affected in trigeminal neuralgia
CN V, trigeminal
50
Tx of trigeminal neuroalgia
Antiepileptic meds; carbamazepine,
51
Exam question; what may happen when surgical treatment of CN V in trigeminal neuralgia
Bradycardia due to trigeminocardiac reflex
52
Tx for Trigeminal Neuralgia of placement of retractor to access CN V may cause
Hearing loss; stretches CN VIII
53
Glossopharyngeal Neuralgia causes
Episodes of intense pain in throat, neck, tongue and ear triggered by talking, chewing, swallowing and coughing
54
Glossopharyngeal Neuralgia causes
Bradycardia and syncope, Hypotension , seizures and cardiac arrest
55
Tx of glossopharyngeal Neurolgia
acute cardio symptoms; atropine, isoproterenosl, cardiac pacemaker or combo of above. anticonvulsant drugs, carbamazepine, phenytoin. Intracranial surgical transection of CN IX and CN V
56
In glossopharyngeal neuralgia, pt with bradycardia, what should be placed if episodes of bradycadia and syncope
transcutaneous cardiac pacing, placement of tranvenous cardiac pacemaker before induction of anesthesia
57
What is likely during manipulation of CN X
Bradycardia and hypertension, premature V
58
What to use post op to control HTN after Glossopharyngeal neuralgia
Hydralazine
59
What neuromuscular blocker should be avoided with Charcot Marie Tooth disease
Succycholine; also avoid in chronic SCI
60
What may happen post op in Charcto Marie Tooth Disease
Resp failure, resulting from weakness of resp muscles focus on response fo neuromuscular blocking drugs
61
Guillain Barre syndrome causes what in the face, head
Difficulty swallowing and impaired ventilation
62
Reasons of mortality in Guillain Barrre syndrome
sepsis, acute resp failure, pulmonary embolism or caridac arrest

Spinal Cord (1 decks)

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