Spinal Cord Disorders

Question 1

thoracic spinal cord lesions detected by which signs

Answer 1

UMN signs

Question 2

region for LMN

Answer 2

anterior horn cells

Question 3

region for UMN

Answer 3

CST

Question 4

atrophy and weakness for UMN lesions

Answer 4

severe weakness with mild atrophy

Question 5

atrophy and weakness for LMN lesions

Answer 5

severe atrophy with mild weakness

Question 6

spasticity seen with

Answer 6

UMN lesion

Question 7

clonus seen with

Answer 7

UMN lesion

Question 8

deltoid/biceps root

Answer 8

C5/6

Question 9

triceps root

Answer 9

C7/8

Question 10

interossei/flexor digitorum (finger flexors)

Answer 10

C8/T1

Question 11

Iliopsoas (hip flexor), quadriceps

Answer 11

L2-4

Question 12

tibialis anterior (foot dorsiflexor)

Answer 12

L4,5

Question 13

Gastrocnemius (foot plantar flexor)

Answer 13

S1,2

Question 14

lightning, stabbing, shooting, or electrical pain in dorsal root dermatomal distribution

Answer 14

radicular/root pain

Question 15

cause of radicular pain

Answer 15

shingles (herpes zoster) or extramedullary lesion (herniated disc, tumor) giving compression

Question 16

pain from intramedullary lesion

Answer 16

dull or absent

Question 17

STT lesion gives

Answer 17

contra pain/temp deficit

Question 18

suspended pattern of STT deficit w/ sacral sparing

Answer 18

intramedullary lesion w/in spinal cord (sacral fibers spared b/c they are most lateral)

Question 19

STT deficit up to a level w/ sacral invovlement

Answer 19

extramedullary lesion

Question 20

dorsal column lesion gives

Answer 20

ipsi position/vibration deficit

Question 21

where does dorsal column decussate

Answer 21

rostrally in medulla

Question 22

transverse myelopathy (transection) level indicated by

Answer 22

dermatomal level of sensory loss and LMN signs

Question 23

spinal/neurogenic shock initially present if

Answer 23

transection is due to severe acute trauma

Question 24

spinal/neurogenic shock sxs

Answer 24

weakness + dec muscle tone/reflexes (UMN signs seen wks-months later)

Question 25

transverse myelopathy due to

Answer 25

tumor, spinal stenosis, hemorrhage, abscess, ischemia, trauma

Question 26

transverse myelitis (inflammatory) due to

Answer 26

viral infection, vaccine reaction, autoimmune demyelination (MS)

Question 27

brown sequard sxs

Answer 27

hemisection - contra STT, ipsi dorsal column, ipsi weakness, UMN and LMN signs

Question 28

syringomyelia is intra- or extra- medullary

Answer 28

intramedullary - primarily affects gray matter

Question 29

syringomyelia sxs

Answer 29

STT - suspended sensory level (just the select dermatomes invovled) w/ sacral sparing
dorsal unaffected

Question 30

ASA supplies

Answer 30

anterior/ventral 2/3 of spinal cord

Question 31

ASA occlusion (spinal cord stroke) via

Answer 31

atherosclerosis, complication of aortic aneurysm surgery, aortic dissection via HTN

Question 32

ASA occlusion (spinal cord stroke) sxs

Answer 32

CST - paraplegia
UMN signs in lower limbs
thoracic level of STT loss (no sacral sparing)
nl dorsal columns

Question 33

ASA occlusion (spinal cord stroke) initial presentation

Answer 33

back or radicular pain - sudden onset and progresses over hrs

Question 34

subacute combined degen due to

Answer 34

Vit B12 deficiency
aka posterolateral sclerosis

Copper deficiency or HIV can also cause this

Question 35

subacute combined degen sxs

Answer 35

dec vibration/position in lower limbs
spastic paraparesis
STT spared
demyelination/degenration of white matter at thoracic levels

Question 36

spared with ALS

Answer 36

sensory pathways
bowel/bladder fxn
no radicullar pain

Question 37

tabes dorsalis

Answer 37

neurosyphilis affecting the spinal cord

Question 38

tabes dorsalis sxs

Answer 38

radicular pain in lower limbs
impaired vibration/position in lower limbs
loss of all sensation and reflexes in lower limbs
strength intact