Spinal Cord Compression Flashcards
How many neurones are there to a Corticospinal tract?
two
What 4 signs are present with an upper motor neurone lesion?
Increased tone, Muscle wasting NOT marked, No fasciculation, Hyper - reflexia
What 4 signs are present with an lower motor neurone lesion?
Decreased tone, muscle wasting, fasciculation, diminished reflexes
Which motor neurone is responsible for directly sending a signal to the muscle to tell it to start contracting?
Lower motor neurone
What tells the lower motor neurones to stop telling the muscles to contract?
upper motor neurones
In which, upper or lower lesions, would you see muscle weakness?
BOTH
What is a key feature of upper motor neurone lesions which is not seen in lower?
spasticity
What is the name for the empty spaces between between myelin schwann cells?
nodes of ranver
What is the Spinothalamic tract responsible for in terms of sensory signalling?
Pain, temperature and crude touch
What is the dorsal column responsible for in terms of sensory signalling?
fine touch, proprioception, vibration
At what level does the dorsal colum intersect (decussate)?
medullary level
At what level does the spinothalamic tract intersect?
spinal level
Give 4 causes of acute spinal cord compression.
Trauma
Tumours – haemorrhage or collapse
Infection
Spontaneous haemorrhage
Give 3 causes of chronic spinal cord compression.
Degenerative disease – spondylosis
Tumours
Rheumatoid Arthritis
What type of lesion is a Cord Transection?
complete - both upper and lower affected
What are signs of a cord transection?
Initially a flaccid arreflexic paralysis “Spinal Shock”
Upper motor neurone signs appear later
At what levels does a Brown-Sequard Syndrome (Cord Hemisection) occur?
Ipsilateral motor level
Ipsilateral Dorsal Column sensory level
Contralateral spinothalamic sensory level
What is Central cord syndrome?
Hyperflexion or extension injury to already stenotic neck
Main signs of central cord syndrome?
Predominantly distal upper limb weakness
“Cape-like” spinothalamic sensory loss
Lower limb power preserved
Dorsal Columns preserved
Which signs predominate in chronic cord compression?
upper motor neurone signs
What tumours are extradural?
normally metastasis
What tumours are intradural?
Extramedullary: meningioma, Schwannoma
Intramedullary: Astrocytoma, Ependymoma
What do these signs suggest has caused compression: osteophyte formation bulging of intervertebral discs facet joint hypertrophy subluxation ?
Spinal cord stenosis
Investigation for trauma causing spinal cord injury?
X-Ray/CT , then MRI
Treatment for trauma causing spinal cord injury?
Methylprednisolone - Bolus 24hr infusion
Decompress + stabilise - Surgery (Traction,External fixation)
