Spinal Cord Compression Flashcards
How many neuron tracts are present in the Corticospinal tract?
2 - upper and lower neuron tract
Is the tract ipsilateral or contralateral?
Ipsilateral
Describe the upper motor neuron path?
From the motor cortex to anterior grey horn.
Decussates at medullary level
What are signs of an Upper Motor Neuron Lesion?
Increased tone
Muscle wasting NOT marked
No Fasciculation
Hyper-flexia
What are signs of a Lower Motor Neurone Lesion?
Decreased tone
Muscle wasting
Fasciculations
Diminished reflexes
Describe the Spinothalamic tracts
Sense pain, temperature and crude touch
Contralateral
Decussates at spinal level
Describe the dorsal columns
Sense fine touch, proprioception and vibration
Ipsilateral
Decussates at medullary level
What can cause acute spinal cord cmpression?
Trauma
Tumours - haemorrhage or collapse
Infection
Spontaneous haemorrhage
What degenerative disease can cause chronic spinal cord compression?
Spondylosis
What else can cause chronic spinal cord compression?
Tumours
Rheumatoid Arthritis
Describe a Cord Transection
Complete lesion - all motor and sensory modalities affected.
How does a cord transection present?
Initially a flaccid arreflexic paralysis “spinal shock”
Upper motor neuron signs appear later
What is Brown-Sequard Syndrome?
Cord Hemisection
What happens in a cord hemisection?
Ipsilateral motor level
Ipsilateral dorsal column sensory level
Contralateral spinothalamic sensory level
What can cause Central Cord Syndrome?
Hyperflexion or extension injury to already stenotic neck
What does central cord syndrome predominantly affect?
Distal upper limb weakness
What is preserved in a central cord syndrome?
Lower limb power
Dorsal columns
How is the spnothalamic sensory loss described in central cord syndrome?
Cape-like
Whats the difference between acute and chronic spinal cord compression?
Upper motor neuron signs predominate in chronic
Describe extradural tumours
Usually metastasis
lung, breast, kidney, prostate
Describe intradural tumours
Extramedullary -meniingioma, schwannoma
Intramedullary - Astrocytoma
Ependymoma
How do tumours cause acute compression?
Collapse or haemorrhage
What happens in Spinal canal stenosis?
Osteophyte formation
Bulging of intervertebral discs
Facet joint hypertrophy
Subluxation
What can be causes of an epidural abscess?
Bloodbourne
Staph
TB
