Spinal Cord I and II

Question 1

The disk that surrounds the nucleus pulposus is called the _____________.

Answer 1

annulus fibrosis

Question 2

What bony process connects the vertebral arch to the vertebral body?

Answer 2

The pedicles

Question 3

Differentiate myelopathy and radiculopathy.

Answer 3

Myelopathy = impingement of the central part of the spinal cord

Radiculopathy = impingement of the nerve roots emerging from the spine

Question 4

What is a polyradiculopathy?

Answer 4

A condition in which the cauda equina is impinged (either by narrowing or other)

Question 5

Age-related use can result in hypertrophy of the ___________.

Answer 5

ligamentum flavum

Question 6

Describe Lhemitte’s sign.

Answer 6

A “lightning bolt” sensation when the chin is elevated

Question 7

Spurling’s sign results from ______________.

Answer 7

narrowing of the cervical foramina; twisting the neck leads to pinching of the roots of the brachial plexus

Question 8

The spinal cord ends at about vertebra _______.

Answer 8

L2

Question 9

Where do the spinal arteries arise?

Answer 9

The vertebral arteries

Question 10

The radicular arteries stem from the __________.

Answer 10

aorta

Question 11

Damage to the __________ can lead to increased urinary urgency.

Answer 11

frontal lobes

Question 12

Damage to the spinal cord above S2-S4 can lead to ___________.

Answer 12

spastic bladder

Question 13

What three thoracic/abdominal dermatomes do we need to know?

Answer 13

Nipple: T4
Xyphoid: T6
Umbilicus: T10

Question 14

What is the normal response to stroking the bottom of the foot?

Answer 14

The toes are supposed to curl down; if they curl up – in an extensor response –then that is evidence of hyperreflexia (called Babinski’s sign)

Question 15

Other than meningiomas, what masses can present on the edges spine?

Answer 15

Schwannomas on the cauda equina

Question 16

Differentiate cardiogenic shock and neurogenic shock.

Answer 16

Both result in insufficient oxygen delivery to tissues, but neurogenic shock results from failure of sympathetic tone leading to hypotension while cardiogenic shock results from insufficient cardiac output.

Question 17

Describe the difference in intramedullary spinal cord dysfunction presentation and extramedullary spinal cord dysfunction.

Answer 17

Intramedullary: early bladder problems; late pain problems
Extramedullary: early pain and UMN issues; late bladder problems

Question 18

What dermatomes cover the sensation of the feet?

Answer 18

L4: big toe, medial side of foot
L5: 3rd and 4th digits, middle of foot
S1: 5th digit, lateral side of foot

(Like your favorite dys-toe-pian sci-fi novel: Footenheit 451.)

Question 19

Describe the grading of muscle strength.

Answer 19

0/5: no movement
1/5: flicker but no movement
2/5: movement possible, but not against gravity
3/5: movement against gravity but not resistance
4/5: movement possible against some resistance
5/5: normal movement

Question 20

Describe the rating system for reflexes.

Answer 20

0: no reflex
1: trace of reflex
2: normal
3: brisk
4: nonsustained clonus
5: sustained clonus

Question 21

What spinal tracts are affected by B12 deficiency?

Answer 21

Posterior columns and lateral corticospinal tract (posterolateral disorder… PLease eat more animal products)

Question 22

What are two disorders that are purely anterior horn UMN?

Answer 22

Spinal muscular atrophy and polio

Question 23

What sensations will be preserved in those with occlusion of the anterior spinal artery?

Answer 23

Vibration/fine touch sensation

Question 24

Cervical stenosis results most often in ____________.

Answer 24

UMN symptoms with loss of bladder control

Question 25

The first reflexes to reappear after an SCI are the ___________.

Answer 25

polysynaptic ones (like the bulbocavernosus reflex)

Question 26

Describe the sensory innervation of the arm.

Answer 26

Lateral bicep: C5
Lateral forearm and hand: C6
Middle finger: C7
Medial hand: C8
Medial forearm: T1
Medial bicep: T2
Armpit: T3

Question 27

What root provides motor innervation to the deltoid and infraspinatus?

Answer 27

C5

Question 28

The biceps receives its innervation from the _______ roots.

Answer 28

C5-C6

Question 29

The triceps receives innervation from the ______ root.

Answer 29

C7

Question 30

If you lost sensation on your heel, what root might that be?

Answer 30

S1

Question 31

Hip flexion is mediated by __________.

Answer 31

L4

Question 32

Big toe extension, foot eversion and inversion, and dorsiflexion are what nerve root?

Answer 32

L5

Question 33

Plantarflexion is what nerve root?

Answer 33

S1