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Clinical Neuroscience > Spinal Cord Dysfunction > Flashcards

Spinal Cord Dysfunction Flashcards

1
Q

What type of lesion is this?

  • affects function of a single cord segment
  • interfere with neural function only at the level of the lesion
A

Segmental function

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2
Q

What type of lesion is this?

  • tracts conveying ascending & descending information
  • result in loss of function below the level of the lesion
A

Vertical tract function

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3
Q

Focal lesion involving dorsal or ventral root or a spinal nerve also results in segmental signs due to what?

A

Interruption of sensory and motor signals to and from a spinal segment

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4
Q

This lesion interferes with sensory function in a spinal segment causing abnormal sensation or loss of sensation in a dermatomal distribution

A

Dorsal root, spinal nerve or dorsal horn in segmental dysfunction

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5
Q

This lesion interferes with LMN functions
signs of LMN dsyfunction: flaccid weakness, atrophy, fibrilation, & fasciculation

A

Ventral root, ventral horn or spinal nerve in segmental dysfunction

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6
Q

If LMN signs occur in a mytomal pattern where is the lesion?

A

Spinal region

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7
Q

What sign helps differentiate spinal region from peripheral nerve lesions?

A

Paraspinal involvment

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8
Q

What is absent if sensory or motor fibers contributing to reflex circuit is damaged?

A

Reflex is absent

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9
Q

What are the segmental signs of segmental dysfunction?

A
  • abnormal or lost sensation in dermatome distribution &/or LMN signs in myotome distribution
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10
Q

Lesions here result in loss of communication to &/or from spinal levels below the lesion

A

Vertical Tract Dysfunction

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11
Q

What are the ascending tract signs of vertical tract dysfunction?

A
  • ipsilateral if dorsal column is interrupted
  • contralateral if spinothalamic tracts are involved
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12
Q

What are autonomic tract signs that take place during a vertical tract dysfunction?

A

problems with regulation of BP, sweating, & bladder and bowel control

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13
Q

Lesions that affect UMN in vertical tract dysfunction cause what signs?

A
  • paralysis
  • spasticity
  • muscle hypertonia
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14
Q

What are ascending tract signs of vertical dysfunction?

A

decrease or loss of somatosensation

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15
Q

Is the following peripheral region or spinal region lesion?

Deficits in distribution of peripheral nerve distrbution

A

Peripheral region

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16
Q

What lesion causing the following?

  • decrease or loss of muscle power in peripheral nerve distribution
  • no vertical tract signs
  • decreased or lost phasic stretch reflex
A

Peripheral nerve lesion

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17
Q

Is the following spinal region segmental or vertical tract signs?

spinal segment, nerve root &/or spinal nerve is compressed
- alterted or loss sensation in dermatome
- lost muscle power in myotome
- decreased or lost phasic stretch reflex

A

Spinal region segmental signs

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18
Q

Is the following spinal region segmental or vertical tract signs?

  • altered or lost sensation below level of lesion
  • altered or lost descending control of BP, pelvic visera & thermoregulation
  • UMN signs: decrease or loss of muscle power, spasticity & muscle hypertonia
  • Lat corticospinal: positive Babinski’s sign & clonus
A

Spinal region vertical tract signs

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19
Q

What is the following a defintion of?

Collection of signs and symptoms that consistently occur together & do not indicate a specific cause

A

Syndrome

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20
Q

Anterior cord syndrome is caused by what?

A

Blood flow disruption in anterior spinal artery

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21
Q

In anterior cord syndrome ischemai damages anterior 2/3 of the spinal cord affecting what?

A
  • ascending spinothalamic tracts
  • descending UMN’s
  • cell bodies of LMN’s
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22
Q

Anterior cord syndrome interfers with what?

A

nociceptive & temp. sensation and motor control

23
Q

In the anterior cord syndrome there is what type of loss?

A
  • incomplete to complete loss of motor function (anterior horns & lat. corticospinal tract)
  • incomplete to complete loss of pain, temperature, & crude touch (anterolateral system)
24
Q

Why are the DCML tracts not affecting in the anterior cord syndrome?

A

B/c they are located in the posterior spinal cord

25
Q

Where does the central cord syndrome occur?

A

cervical level resulting from trauma

26
Q

In the central cord syndrome there is greater weakness in UE than LE due to what?

A

Somatotopic organization of nerve fibers within tract & proximity to central portion of the cord

27
Q

Is the following small or large lesion in central cord syndrome?

Loss of nociceptive & temperature information at the level of the lesion b/c spinothalmic fibers crossing midline are interrupted

A

Small lesion

28
Q

Is the following small or large lesion in central cord syndrome?

impaired upper limb motor function due to medial location of upper limb fibers in the lat. corticospinal tract & loss of nociceptive & temp information at the level of the lesion

A

Large lesion

28
Q

What is the Brown-sequard syndrome caused by?

A

Hemisection of the spinal cord

29
Q

In the brown-sequard syndrome segmental losses are what? and include what type of loss?

A
  • ipsilateral
  • loss of LMN’s & all sensations & ipsilatral flaccid paralysis (ant. horn) & ipsilateral loss of all sensation (dorsal root and post. horn)
30
Q

In brown-sequard syndrome below the level of lesion there is ipsilateral loss of what?

A
  • voluntary motor control (lat. corticospinal tract), conscious proprioception & light touch (dorsal column)
31
Q

In brown-sequard syndrome below the level of lesion there is contralateral loss of what?

A

loss of nocicpetive, temperature, & crude touch sensation (anteroloateral system: spinothalamic tract)

32
Q

What causes cauda equina syndrome?

A

compression &/or irritation of spinal nerve roots below L2 vertebral level

33
Q

What are common causes of cauda equina syndrome?

A
  • herniated disks
  • vertebral fracture
  • tumor
34
Q

In cauda equina syndrome the ‘saddle area’ is usually affected. What is this innervated by?

A

S2-5

35
Q

What are the signs of cauda equina syndrome? (3 signs)

A
  • urine &/or stool retention or incontincence
  • paresis or paralysis
  • impariment of nerver roots cause decrase or loss of reflexes
36
Q

What is the tethered cord syndrome caused by?

A

spinal cord becomes attached to surrounding structures during early development

37
Q

What are some causes that lead to tethered cord syndrome?

A
  • scar tissue
  • lipoma
  • abnormal development
  • stretch injury damages &/or cauda equina
38
Q

When do signs and symptoms of tethered cord syndrome appear?

A

Growth spurt of children

39
Q

What are the symptoms of tethered cord syndrome? (6)

A
  • LB and lower limb pain
  • difficulty walking
  • excessive lordosis
  • scoliosis
  • problems with bowel/bladder control
  • foot deformities
40
Q

In tethered cord syndrome LMN (weakness, flaccidity) signs occur if what is stretched?

A

Ant. cauda equina is stretched

41
Q

In tethered cord syndrome UMN signs (abnormal reflexes, paresis, skeletal muscle changes) occur if what is stretched?

A

Spinal cord is stretched

42
Q

Signs that tethered cord is associated with spina bifida, spina bifida myelomeningocele occur at what levels?

A

L4, L5, & S1

43
Q

What damages the reflexive bladder emptying circuit?

A

complete lesions involving S2-4 levels or assoicated roots in cauda equina damage

44
Q

Reflexive bladder control results in what?

A

Flaccid paralyzed bladder

45
Q

What results in hypertonic, hyperreflexia bladder with reduced capacity?

A

complete lesions above sacral spinal cord interrupts descending axons

46
Q

What type of neurogenic bladder symptoms are the following?

intermittent bladder contractions result in urine leakage
sphincter spasm during voiding can prevent complete emptying of bladder

A

Hypertonic or reflexive bladder

47
Q

What type of neurogenic bladder symptoms are the following?

overflow incontinence results in involuntary release due to overly full bladder

A

Flaccid bladder

48
Q

Person with lesion above sacral cord is unaware of what?

A
  • rectal stretch
  • no voluntary control of sphincters
49
Q

What can rectal stretch elicit?

A

reflexive emptying of lower bowel b/c reflexive lower bowel emptying circuit is intact

50
Q

Where is this lesion for male sexual function?

  • loss of psychogenic erection; genital sensation absent
  • reflexive erection possible
  • if lumbosacral cord intact –> reflexive ejaculation possible
A

Above T12 with intact sacral reflex circuits

51
Q

Where is this lesion for male sexual function?

  • most likely has normal sexual function
  • genital sensation is absent
A

Between L1 and S2 with intact sacral reflex circuits

52
Q

Where is this lesion for male sexual function?

  • impotence
  • genital sensation absent
A

lesion of S2-4 reflex circuit

Clinical Neuroscience (22 decks)

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