Spinal cord function and dysfunction Flashcards
04.10.2019
How many segments of the spinal cord are there?
How many vertebrae are there?
SC: 31 (8C,12T,5L,5S,1C)
V: 30 (7C,12T,5L,5S,1C) -> discrepancy
Be careful when speaking about spinal and vertebral levels.
What are the spinal nerves subdivided into?
8 Cervical 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal
How do the spinal nerves exit the vertebral column?
Through intervertebral foramina
Where in the spinal cord are enlargements for the innervation of limb found?
Cervical (C3-T1)
Lumbar (L1-S3)
Which layer does the spinal block go into?
Subarachnoid space
Which layer does an epidural nerve block go in?
Epidural space
Where is CSF taken from in an LP?
From the subarachnoid space. (L3/L4 or L4/5)
What is the grey and white matter in the spinal cord?
Grey: cell bodies (inside)
White: tracts (outside)
Corticospinal tract
Main voluntary movement pathway
What are the main sensory pathways?
Dorsal column pathways and spinothalamic tract
Dorsal column pathways
->Discriminative touch, vibration, proprioception
fasciculus gracilis for ipsilateral lower limb
fasciculus cuneatus for ipsilateral upper limb
Spinothalamic tract
Pain and temperature (from contralateral side of the body)
Which factors affect the severity of a spinal cord lesion?
- Loss of neural tissue
- Vertical level
- Transverse plane
Loss of neural Tissue in spinal cord injury
- Usually small if due to trauma
- Can be more extensive e.g. metastases, degenerative disease
What is the relationship between the severity of the disability and the vertical level?
The higher the lesion, the greater the disability.
Transverse plain (spinal lesions)
most lesions are not complete
How many people are paralysed due to spinal cord injury every day in the UK?
6
What are the most common causes of spinal cause injury?
a broken neck or back as a result of road traffic accidents, accidents during sports or recreation or falls (in older people)
In principle, how many neurones are there between the skin and the brain?
3
What are the major 3 pathways affected by spinal cord injury?
lateral corticospinal - hence paralysis
dorsal column - hence loss of sensation of touch
spinothalamic - loss of feeling pain and temperature
What are the 2 stages of injury to the lateral corticospinal tract?
Stage 1. Spinal shock: loss of reflex activity below the lesion, lasting for days or weeks = flaccid paralysis
Stage 2. Return of reflexes: hyperreflexia and/or spasticity = rigid paralysis
Brown-Sequard Syndrome
With unilateral lesions the relationship of the deficit to the lesion depends on where the tract decussates
