Spinal Cord Compression

Question 1

the corticospinal tract is __lateral

Answer 1

ipsi

Question 2

the spinothalamic tract carry sensation from the ___ side of the body

Answer 2

opposite

Question 3

DCML pathway is __lateral

Answer 3

ipsi

Question 4

the body’s main sensory tracts carry information from the __ side of the body

Answer 4

same

Question 5

causes of acute spinal cord compression?

Answer 5

trauma esp to the neck
tumour
infection
spontaneous haemorrhage

Question 6

what brain tumours are most likely to cause acute spinal cord compression

Answer 6

bony metastases

Question 7

chronic spinal cord compression is caused by…

Answer 7

spondylosis
tumours
RA

Question 8

C4/5 myotome

Answer 8

shoulder abduction

Question 9

if a complete cord transection happens, nothing lower than the lesion will work T or F

Answer 9

T

Question 10

describe spinal shock

Answer 10

flaccid areflexic paralysis

get hypotension

Question 11

brown sequard syndrome is also known as…

Answer 11

cord hemisection (half of the spinal cord is injured)

Question 12

what tracts are affected in BS syndrome?

Answer 12

DCML
spinothalamic
corticospinal

Question 13

why will a patient with BS syndrome lose temperature and pain sensation on the right side but maintain fine touch on the right side and not the left?

Answer 13

patient must have a left sided lesion:
the spinothalamic tract is contralateral so will affect the opposite side to the lesion whereas DCML (for fine touch etc) will be preserved on the right as it only affects the side of the lesion

Question 14

patient with a bump on the head, can’t move their hands, pins and needles…

Answer 14

central cord syndrome

Question 15

patients with central cord syndrome present with mainly __ limb weakness

Answer 15

upper limb

Question 16

“cape like spinothalamic sensory loss”

Answer 16

central cord syndrome

Question 17

what tracts are preserved in central cord syndrome?

Answer 17

dorsal column

Question 18

which part of the spinal cord is most vulnerable to ischaemic injury

Answer 18

central cord

Question 19

___ limb fibres are most medial in the corticospinal tract

Answer 19

upper

Question 20

why are the legs preserved in central cord syndrome?

Answer 20

they are located on the lateral aspect of the corticospinal tract in the spinal cord so will avoid the ischaemic injury

Question 21

why do you get cape like spinothalamic sensory disturbance?

Answer 21

central cord is usually from a neck injury so only really affects the spinothalamic tract in the area of injury so only get sensory loss over a couple of cervical spinal levels

Question 22

chronic spinal cord compression will present with ___ mtoor neurone signs

Answer 22

upper

Question 23

what part of the brain do mets tend to go to?

Answer 23

extradural area

Question 24

main mets sources?

Answer 24

lung
breast
kidney
prostate

Question 25

what brain tumours arise intramedullary?

Answer 25

astrocytoma

Question 26

what brain tumours arise extramedullary?

Answer 26

meningioma

schwannoma

Question 27

what do you get hypertrophy of in spinal stenosis?

Answer 27

facet joints

Question 28

bacterial sources of an epidural abscess?

Answer 28

staph from bloodborne infection

can be TB

Question 29

immediate management of head trauma?

Answer 29

immobilise the head
investigate with CT/MRI (if interested in soft tissue)
decompress and stabilise
bolus of methylprednisolone if appropriate

Question 30

what steroid should be given for brain/bone mets?

Answer 30

high dose dexamethasone IV

Question 31

main Tx for spinal mets?

Answer 31

usually radiotherapy

may have chemo too