spinal cord compression

Question 1

Motor tract

Answer 1

corticospinal tract- 2 neurone tract

Question 2

where is upper motor neurone and LMN in corticospinal tract

Answer 2

UMN- from motor cortex to anterior grey horn (decussates at medullary level)
Tract- ipsilateral
Lower motor neurone- from anterior horn cell

Question 3

UMN lesion

Answer 3

increased tone, no fasciculation, hyper-reflexia

Question 4

LMN lesion

Answer 4

decreased tone, muscle wasting, fasciculation, diminished reflexes

Question 5

sensory pathways

Answer 5

spinothalamic tracts

dorsal column

Question 6

spinothalamic tract

Answer 6

pain, temp, crude touch
decussates at spinal level
contralateral

Question 7

dorsal column

Answer 7

fine touch, proprioception
decussates at medullary level
ipsilateral

Question 8

acute spinal cord compression

Answer 8

trauma, tumours, haemorrhage, infection

Question 9

chronic cord compression

Answer 9

degenerative disease- spondolysis
tumours
RA

Question 10

cord transection complete lesion

Answer 10

all motor and sensory modalities affected- sensory level, motor level
initially a flaccid arreflexic paralysis- “spinal shock”
UMN signs appear later

Question 11

Brown Sequard syndrome (cord hemisection)

Answer 11

tracts affected- lateral corticospinal, dorsal column, lateral spinothalamic
Ipsilateral spastic pareses below level, ipsilateral loss of proprioception and vibration, contralateral pain and temp loss

Question 12

subacute combined degeneration of cord

Answer 12

caused by bit B12/E deficiency
tracts affected- lateral corticospinal tracts, dorsal column, spinocerebellar
bilateral spastic paresis, bilateral loss of proprioception, bilateral limb ataxia

Question 13

Friedrichs ataxia

Answer 13

same tracts affected as in subacute combined degeneration, same clinical symptoms plus cerebellar ataxia

Question 14

Anterior spinal artery occlusion

Answer 14

lateral corticospinal tract, lateral spinothalamic tradt

bilateral spastic paresis, bilateral loss of pain temp

Question 15

syringomelia

Answer 15

ventral horns, lateral spinothalamic tract
flacid paralysis (particularly intrinsic hand muscles)
loss of pain and temp

Question 16

Central cord syndrome

Answer 16

hyperflexion/extension injury to already stenotic neck
predominantly distal upper limb weakness, cape like spinothalamic sensory loss, lower limb preserved, dorsal columns preserved

Question 17

spinal cord stenosis

Answer 17

osteophyte formation, bulging of intravertebral discs, facet joint hypertrophy, subluxation