Spinal Cord compression Flashcards
Where does the corticospinal tract decussate?
medulla
Is the Corticospinal tract ipsilateral or contralateral?
ipsilateral
Where does the corticospinal tract travel between?
motor cortex to anterior grey horn
What are some upper motor neuron signs?
increased tone
hyperreflexia
reduced power
What are some lower motor neurone signs?
decreased tone
muscle wasting
fasciculations
diminished reflexes
What sensory modalities are supplied by the spinothalamic tracts?
pain
temperature
crude touch
Is the spinothalamic tract ipsilateral?
no - contralateral
decussates at spinal level
Where does the spinothalamic tracts decussate?
at the spinal level
What sensory modalities are supplied by the dorsal columns?
fine touch
proprioception
vibration
Where do the dorsal columns decussate?
at medullary level - ipsilateral
What is the most common cause of acute spinal cord compression?
metastatic disease and pathological fracture
which tumours common metastasise to bone?
lung
breast
prostate
renal
What is spondylosis?
degeneration of intervertebral discs
what happens in a cord transection?
all motor and sensory modalities knocked out below level of the lesion
What is spinal shock?
flaccid arreflexic paralysis
What is Brown-Squard Syndrome?
cord hemisection
What are the clinical features of Brown-Sequard Syndrome?
ipsilateral motor level
ipsilateral dorsal column sensory level
contralateral spinothalamic sensory level
What can cause central cord syndrome?
hyperflexion or extension injury to an already stenotic neck
what are the clinical features of central cord syndrome?
cape-like spinothalamic sensory loss
lower limb power preserved
upper limb weakness
dorsal columns preserved.
What parts of the spinothalamic tracts are damaged in central cord syndrome?
the crossing point - the tracts themselves are fine
How do tumours cause acute compression?
collapse
haemorrhage
How does degenerative disease cause compression?
canal stenosis osteophytes bulging discs facet joint hypertrophy subluxation
What is the treatment for infection causing cord compression?
antibiotics
surgical drainage
stabilisation if required
What is the treatment for haemorrhage causing spinal cord compression?
reverse anticoagulation
surgical decompression
How are degenerative processes causing spinal cord compression treated ?
surgical decompression + stabilisation
Acute compression is a benign condition that is managed in primary care or the community - T/F?
False - its an EMERGENCY
What is the overall purpose of treatment in cord compression?
prevent further deterioration
