Spinal Cord compression

Question 1

Where does the corticospinal tract decussate?

Answer 1

medulla

Question 2

Is the Corticospinal tract ipsilateral or contralateral?

Answer 2

ipsilateral

Question 3

Where does the corticospinal tract travel between?

Answer 3

motor cortex to anterior grey horn

Question 4

What are some upper motor neuron signs?

Answer 4

increased tone
hyperreflexia
reduced power

Question 5

What are some lower motor neurone signs?

Answer 5

decreased tone
muscle wasting
fasciculations
diminished reflexes

Question 6

What sensory modalities are supplied by the spinothalamic tracts?

Answer 6

pain
temperature
crude touch

Question 7

Is the spinothalamic tract ipsilateral?

Answer 7

no - contralateral

decussates at spinal level

Question 8

Where does the spinothalamic tracts decussate?

Answer 8

at the spinal level

Question 9

What sensory modalities are supplied by the dorsal columns?

Answer 9

fine touch
proprioception
vibration

Question 10

Where do the dorsal columns decussate?

Answer 10

at medullary level - ipsilateral

Question 11

What is the most common cause of acute spinal cord compression?

Answer 11

metastatic disease and pathological fracture

Question 12

which tumours common metastasise to bone?

Answer 12

lung
breast
prostate
renal

Question 13

What is spondylosis?

Answer 13

degeneration of intervertebral discs

Question 14

what happens in a cord transection?

Answer 14

all motor and sensory modalities knocked out below level of the lesion

Question 15

What is spinal shock?

Answer 15

flaccid arreflexic paralysis

Question 16

What is Brown-Squard Syndrome?

Answer 16

cord hemisection

Question 17

What are the clinical features of Brown-Sequard Syndrome?

Answer 17

ipsilateral motor level
ipsilateral dorsal column sensory level
contralateral spinothalamic sensory level

Question 18

What can cause central cord syndrome?

Answer 18

hyperflexion or extension injury to an already stenotic neck

Question 19

what are the clinical features of central cord syndrome?

Answer 19

cape-like spinothalamic sensory loss
lower limb power preserved
upper limb weakness
dorsal columns preserved.

Question 20

What parts of the spinothalamic tracts are damaged in central cord syndrome?

Answer 20

the crossing point - the tracts themselves are fine

Question 21

How do tumours cause acute compression?

Answer 21

collapse

haemorrhage

Question 22

How does degenerative disease cause compression?

Answer 22

canal stenosis 
osteophytes 
bulging discs 
facet joint hypertrophy 
subluxation

Question 23

What is the treatment for infection causing cord compression?

Answer 23

antibiotics
surgical drainage
stabilisation if required

Question 24

What is the treatment for haemorrhage causing spinal cord compression?

Answer 24

reverse anticoagulation

surgical decompression

Question 25

How are degenerative processes causing spinal cord compression treated ?

Answer 25

surgical decompression + stabilisation

Question 26

Acute compression is a benign condition that is managed in primary care or the community - T/F?

Answer 26

False - its an EMERGENCY

Question 27

What is the overall purpose of treatment in cord compression?

Answer 27

prevent further deterioration