Spinal cord disorders Flashcards
What are the major differences between upper and lower motor neuron lesions?
UMN lesions have more diffuse weakness than LMN. Fasciculations are only seen in LMN. UMN have increased muscle tone and increased reflexes whereas LMN are decreased for both. UMN may have clonus, LMN never do.
Do CST lesions cause ipsilateral or contralateral deficits?
Depends on where in the CST. Brain/brainstem lesions of the CST will cause contralateral deficits. Spinal lesions of the CST will cause ipsilateral deficits.
What is radicular pain?
Stabbing/shooting pain in the dermatomal distribution of a dorsal root caused by inflammation or extramedullary compression.
What is the relationship between spinal cord roots and the vertebral column levels?
Because the vertebral column ends up longer than the spinal cord, the spinal levels do not line up with the vertebral levels.
Spinal nerves exit several levels below their root, and are named according to the level that they exit.
Ex: A tumor at L1 would compress spinal cord L5/S1 level
What is posterior column syndrome?
Lesion of the posterior column causes loss of proprioception and vibration below the lesion
What is anterior spinal artery syndrome?
Occlusion of the anterior spinal artery causes a lesion of the anterior 2/3 of the spine causing sudden hyperreflexic, spastic paraparesis, loss of pain/temp below lesion with preserved vibration sense.
What is central cord syndrome?
Lesion expanding from the central canal outward affects all 3 main tracts. Upper limbs are more affected than lower limbs due to somatotopic organization.
What is syringomyelia?
A cavity (syrinx) within the central gray matter which can expand and cause vest like spinothalamic sensory loss with sacral sparing. Caused by abnormal CSF flow or pressure in canal (Chiari malformation, tumor, trauma)
What is subacute combined degeneration of the spinal cord?
Lesions of the posterior and lateral columns typically in the thoracic spine. Loss of vibration and position sense in lower limbs (DCP lesion) with preserved pain and temperature (STT spared). UMN signs in lower limbs due to CST involvement.
Caused by B12 deficiency, copper deficiency or HIV.
What is amyotrophic lateral sclerosis?
Progressive degeneration of UMN and LMN. LMN signs often with diffuse fasciculations, normal sensation.
Motor signs due to weakness include loss of fine motor control, dragging foot gait, head-drop, difficulty chewing/swallowing, speech impairment
Eventually fatal.
What is tabes dorsalis?
Dorsal column degeneration causes loss of proprioception, vibration. Reflexes are lost due to damaged dorsal roots.
Caused by neurosyphilis.
What are Charcot joints?
severe traumatic injury and deformation of ankle joints due to loss of sensation from tabes dorsalis
What is Brown-sequard syndrome?
Contralateral loss of pain/temp (STT) with ipsilateral weakness (CST) due to hemisection of the spinal cord by tumor, trauma or herniated disc
