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Neurology > Spinal Cord and Root Dysfunction > Flashcards

Spinal Cord and Root Dysfunction Flashcards

1
Q

What are the main tracts of the spinal cord?

A

Corticospinal tract, spinothalamic tract and the dorsal columns

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2
Q

What are some features of the corticospinal tract?

A

2 neuron tract

Tract is ipsilateral

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3
Q

What are the symptoms of an UMN lesion?

A

Increased tone, muscle wasting not marked, no fasciculation, hyperreflexia

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4
Q

What are the symptoms of a LMN lesion?

A

Decreased tone, muscle wasting, fasciculation, diminished reflexes

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5
Q

What are some features of the spinothalamic tract?

A

Responsible for pain, temperature and crude touch

Contralateral and decussates at spinal level

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6
Q

What are the dorsal columns responsible for?

A

Fine touch, proprioception and fine touch

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7
Q

What are the types of spinal cord compression?

A

Acute or chronic

Complete or incomplete

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8
Q

What are the causes of acute cord compression?

A

Trauma, tumour, infection, haemorrhage

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9
Q

What are the causes of chronic cord compression?

A

Spondylosis, tumours, rheumatoid arthritis

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10
Q

What is cord transection?

A

Complete lesion = all motor and sensory modalities affected

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11
Q

What are the symptoms of cord transection?

A

Present with sensory or motor level = flaccid arreflexic paralysis initially (spinal shock), UMN signs appear later

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12
Q

What is Brown-Sequard syndrome?

A

Cord hemisection = ipsilateral motor level and dorsal column sensory level, spinothalamic sensory level affected contralaterally

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13
Q

What causes central cord syndrome?

A

Hyperflexion or extension injury to already stenotic neck = best recovery rates of all syndromes

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14
Q

What does central cord syndrome present with?

A

Predominantly distal upper limb weakness
Cape-like spinothalamic sensory loss
Lower limb power and dorsal column preserved

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15
Q

What are the causes of spinal cord compression?

A

Trauma, tumour, degenerative disease, infection or haemorrhage

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16
Q

What kind of trauma causes spinal cord compression?

A

High energy or fall from height = mobile segments especially affected

17
Q

What kind of tumours cause spinal cord compression?

A

Extradural, intradural and intramedullary

Haemorrhage may cause acute compression

18
Q

What are some features of extradural tumours?

A

Usually metastasis = especially haematological malignancy, lung, breast, prostate and kidney

19
Q

What are some examples of intradural tumours?

A

Extramedullary, meningioma and schwannoma

20
Q

What are some examples of intramedullary tumours?

A

Astrocytoma and ependymoma

21
Q

What are some causes of spinal canal stenosis?

A

Osteophytes, bulging of IV discs, facet joint hypertrophy, subluxation

22
Q

What are some features of infections that can cause compression?

A

Epidural abscess = bloodborne, staph, TB, strep in IV drug users and children
Spread from surgery or trauma

23
Q

What are some features of haemorrhages that can cause compression?

A

Epidural, subdural or intramedullary haemorrhages
May be due to trauma, bleeding diathesis or AV malformations
Less common cause of compression

24
Q

How is trauma causing compression treated?

A

Immobilise and investigate, decompress and stabilise to aid rehabilitation

25
Q

How are metastatic tumours treated?

A

Dexamethasone, radio/chemotherapy, decompression and stabilisation = need life expectancy of at least 6 months to qualify for surgery

26
Q

How are primary tumours treated?

A

Surgical excision = not done very often as it’s difficult to qualify

27
Q

How is infection treated?

A

Antibiotics, surgical drainage, stabilisation when needed = surgery only done if there is neurological deficit

28
Q

How are haemorrhages treated?

A

Reverse anticoagulation and perform surgical decompression

29
Q

How is degenerative disease treated?

A

Surgical decompression and stabilisation

Neurology (48 decks)

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