Spinal Cord Compression Flashcards

1
Q

Corticospinal tract is a ___ neurone tract. Upper motor neuron is from ____ _____ to _______ ____ ____. It decussates at ________ level.

The tract is ___lateral.

The lower motor neurone is an _______ _____ ____.

A

Corticospinal tract is a two neurone tract. Upper motor neuron is from motor cortex to anterior grey horn. It decussates at medullary level.

The tract is ipsilateral.

The lower motor neurone is an anterior horn cell.

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2
Q

UMN lesion causes ______ tone, muscle _____ NOT ______. No _____. ____-reflexia.

A

UMN lesion causes increased tone, muscle wasting NOT marked. No fasciculations. Hyper-reflexia.

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3
Q

LMN lesions cause _____ tone, muscle _____, _______ and ______ reflexes.

A

LMN lesions cause decreased tone, muscle wasting, fasciculations and diminished reflexes

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4
Q

Spinothalamic tracts are responsible for;

A

Pain, temperature and crude touch

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5
Q

Spinothalamic tracts are _____lateral and deccusate at _____ level.

A

Spinothalamic tracts are contralateral and deccusate at spinal level.

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6
Q

Dorsal columns are responsible for;

_____, ______, ____ _____

They are ____lateral and decussate at ______ level

A

Dorsal columns are responsible for;

proprioception, vibration, fine touch

They are ipsilateral and decussate at medullary level

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7
Q

Spinal cord compression can be (duration) _____ or ____.

Severity- _____ or _____.

A

Spinal cord compression can be (duration) acute or chronic.

Severity- complete or incomplete.

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8
Q

What causes acute spinal cord compression?

A

Trauma

Tumours- haemorrhage/collapse

Infection

Spontaeneous haemorrhage

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9
Q

What causes chronic spinal cord compression?

A

Degenerative disease- spondylosis

Tumours

Rheumatoid arthritis

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10
Q

How does cord transection present?

A

Initially a flaccid arreflexic paralysis ‘ spinal shock’

UMN signs appear later.

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11
Q

Cord transection is a _____ lesion- all _____ and ______ modalities are affected below the _____ and _____ level.

A

Cord transection is a complete lesion- all motor and sensory modalities are affected below the sensory and motor level.

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12
Q

What is affected in brown-sequard syndrome?

A

Ipsilateral motor level

Ipsilateral dorsal column sensory level

Contralateral spinothalamic sensory level

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13
Q

What is central cord syndrome?

A

Occurs after hyperflexion or extension of neck to injure an already stenotic neck

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14
Q

How does central cord syndrome present?

A

Predominantly distal upper limb weakness

“cape-like’’ spinothalamic sensory loss

Lower limb power preserved

Dorsal columns preserved

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15
Q

What is the presentation of chronic spinal cord compression?

A

Same as acute but UMN signs predominate

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16
Q

What traumatic injuries cause spinal cord compression?

A

High energy injury

to mobile sements of spine: cervical

17
Q

What types of extradural tumours cause spinal cord compression?

A

Metastasis; lung, breast, kidney, prostate

18
Q

What kind of intradural tumours cause spinal cord compression?

A

Extramedullary: meningioma, schwanoma

Intramedullary: astrocytoma, ependymoma

19
Q

Tumours can slowly compress and can cause acute compression by ______ or _______.

A

Tumours can slowly compress and can cause acute compression by collapse or haemorrhage.

20
Q

What happens in spinal canal stenosis?

A
  • osteophyte formation
  • bulging of intervertebral discs
  • facet joint hypertrophy
  • subluxation
21
Q

What infecions can cause spinal cord compression?

A

Epidural abscess- bloodborne, staph aureus, tuberculosis

Surgery or trauma

22
Q

What is the management for head trauma?

A
  • immobilise
  • investigate
  • decompress + stabilise
  • Methylprednisosolone
23
Q

Which investigations are carried out in head trauma?

A

X-ray/CT/MRI

24
Q

How is decompression + stabilisation achieved after trauma?

A

Surgery

Traction

External fixation

25
Q

Methylprisnisolone is probably of…

A

No useful benefit

26
Q

What is the treatment for metastatic tumours causing spinal cord compression?

A

Depends on patient and on tumour;

  • Dexamethasone
  • Radiotherapy
  • Chemotherapy
  • Surgical decompression and stabilisation
27
Q

What is the treatment for infection causing spinal cord comrpession?

A

Antimicrobial therapy

Surgical drainage

Stabilisation where required

28
Q

What is the management of haemorrhage?

A

Reverse anticoagulation

Surgical decompression

29
Q

What is the management for degenerative disease?

A

Surgical decompression +/- stabilisation