Spinal Cord Issues Flashcards
What is transverse mylopathy
Inflammation of myelin sheath
Symptoms:
Weakness, paralysis
Pain (sharp, shooting in lb, radiate)
Sensory changes
Increased reflex( this shows it is transverse mylopathy and not just a lower motor lesion)
B and b disorders
Mobility issues
Causes:
Autoimmune disorders
Infections
MS, myelin disorders
In a lower motor neuron issue, what will occur to the reflex
It will be diminished
What occurs to the reflex when we have an upper neuron issue
There wil be a lack of suppression/inhibition from the CNS
Hyperreflexisity
What is inside the spinal cord causes for disorders
Infections (syphilis, HIV, polio)
Autoimmune diseases (MS)
Degenerative diseases (MS, B12 deficiency)
Name outside causes for spinal issue
Compression (stenosis like osteophytes, herniated disc, tumours)
Trauma
What is anterior spinal artery syndrome
Spinal cord infarction caused by interruption of blood flow in the anterior spinal artery
It supplies:
Anterior horns (motor neurons)
Spinothalamic tracts and Corticospinal tracts (voluntary motor control)
Atherosclerosis, aortic surgery, trauma, disc herniation ,, compression
Bilateral, motor weakness, loss of pain and temp,
Preserve propriception, vibration and fijne touch
What is central cord syndrome
Incomplete spinal cord injury where the central part of the spinal cord- specifically cervical is damaged.
(Corticospinal tract and spinothalamic tract loss of function)
Motor impairment of the upper limbs
Caused by: hyper extension of the neck
Trauma and compression, haemorrhage or isch emma. Cervical disc herniation and tumours rarely
What is brown sequard syndrome
Neurological condition caused by damage to one half of the spinal cord. A hemisection.
Typically due to trauma affecting one side. Penetrating trauma, tumours, ms, herniated disc, spinal infections and ischemia
Symptoms:
Ispilateral weakness/paralysis
Loss or propriception and vibration sense (dorsal columns same side) and loss of voluntary motor (Corticospinal same side)
Controlateral loss of pain and temperature sensation
Damage of Corticospinal and dorsal collumn and spinothalamic
Hyper reflex is below the lesion
What is Corticospinal tract
Major motor pathway
Primary motor cortex
Travel down Corticospinal tract
Internal capsule
Brain stem in medulla
Function: voluntary motor control for thr body’s muscles
Controls skilled precise movements like typing, writing, playing music
UMN: damage can result in weakness, paralysis, space city, loss of fine motor control
LMN: paralysis, loss muscle tone, muscle atrophy
What is motor neuron disease
Progressive Neurological disorder that Affect motor neurones
They are damaged or degenerate, muscle they control weaken and atrophy leading to a range of movement issues. Does not typically affect sensation or cognition. Can lead to spactisity
These muscles are essential for controlling functions such as speaking, swallowing, breathing and moveme
10%genetuc family history
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What is the dorsal column
Major sensory pathway
Fine tough, propriception, vibration
Reaches medulla oblongata
Signal cross to ascend the thalamus
What is spynomyelia
Abnormal formation in the spinal cord of a cyst. It forms in cervical or thoracic and can expand and elongate over time
Causes : tumours, infections, injury, congenital
Symptoms: dpedning on size or location
Px cape like in neck, back, shoulders
Loss of sensation pain and temp
Muscle weakness
Spinal deformities
Headaches
It affects the spinothalamic tract ( temp and sensation)
Corticospinal motor control WHEN IT EXPANDS
dorsal column
Less common
Fine touch, propriception, vibration
What is Motor neuron disease
Motor neurones which are essential for transmitting signals form brain ti muscles damage or degenerate, causing muscle atrophy
Amyotrophic Lateral Sclerosis
Is the mc form of MND
Affect both upper and lower motor neurons
Symptoms: progressive muscle weakness, atrophy, difficulty speaking, swallowing and breathing
Rapidly progressive disease, mc die within 3-5 yers due to respiratory failure
What is spinothalamic tracts
Pain, temperature,light touch
Lateral spinothalamic tracts (pain and temperature)
Dorsal root ganglion
Substantial gelatinosa cross over into anterior grey and white matter
Thalamus
Anterior spinothalamic tract (pressure)
Dorsal root ganglion
Substantia gelatinosia
Cross over into anterolateral white column
Ventroposterior lateral nucleus of thalamus
Describe MS
Multiple sclerosis is a chronic autoimmune diseases that affects th CNS
It involves demyelination of myelin sheat which helps nerves transmit electrical signals efficiently
Autoreactive T cells are produced and BBB becomes compromised allowing autoreactive T cells to cross into the brain and spinal cord which then causes inflammation and demyelination. This results in plaques or lesion which affected nerve fibres, disrupting the ability of the nerve to transmit Signals properly.
Over time affects oligodendryctes and axon damage.
Risk factors: 20-40
Women 2-3 x more likely
Caucaseuones or Northern European
Further from the equator due to vitamin D deficiency
Relapsing remitting ms
Mc 85%
Relapse or flare ups where symptoms worsen over days to weeks followed by remissions where symptoms fully or partially imropiove
During remissions, some neurological function may be recovered, but not always completely.
Secondary progressive MS
SPMS often develops after RRMS, to a stage where the disease progresses steadily, with or without relapses.
Over time, experience increasing disability, and remissions become less frequent or disappear.
Primary Progressive MS (PPMS):
In PPMS, symptoms gradually worsen from the onset without distinct relapses or remissions.
a more gradual and consistent progression, and the rate of progression can vary from person to person.
is less common and typically occurs later in life.
Progressive-Relapsing MS (PRMS):
This is a rare form of MS where there is a steady worsening of neurological function from the beginning, with occasional acute relapses.
There are no periods of remission, and the disease progresses over time.
Symptoms
Fatigue
Numbness or tingling
Muscle weakness
Vision problems
Balance and coordination issues
Cognitive change
Band B
Ox
Speech issues
Muscle spasms
Describe radiculopathy
Condition involving nerve root compression or irritation typically in spinal column
Leads to px, numbness tingling weakness
Damage or dysfunction at the nerve root
Central issue which refers peripherally
Describe plexopathy
Damage to plexus which is a network of nerves
Mc is brachial or lumbosacral
Transmit motor and sensory signals to limbs, can cause weakness, px, numbness, loss of function of affected areas
What is the enthesis
The place Where tendon or ligament attatches to bone
Describe lumbar radiculopathy
When a cerviacal nerve in neck gets compressed or irritated
This can put pressure on nerves affecting upper peripheral body function
L4-S1 MC. It occurs in inter vertabral foraemen (where nerves exit)
Common causes are herniate ddiscs, degenerative disc disease, bone spurs, spinal stenosis (spinal canal narrows), injury or trauma lobe whiplash or sudden trauma, tumours or infection , DDD, OA, Spondylolisthesis (ant vert slip)
Symptoms:
Px
Numbness tingling
Weakness
Neck px/ stiffness
L4 motor knee ext reduced = decreased patella reflex, sensory issues with medial lower leg
L5= Dorsiflexcion issue= no reflex change= sensory issues of lateral lower leg dorsal of foot
S1=plantar flex issue= decreased Achilles reflex= lateral foot sensory issues
MRI, CT, X-RAY, electropmyography
Clinical test like SLR 35-70
Slu,p test assess neural tension
Red flakes: foot drop, cauda equina
Treatment: lifestyle mod, rehab, soft tissue techniques, spinal manipulation
what is posterior column syndrome
affects posterior columns
proprioception, vibration fine touch, dorsal part including gracile fascilus and cuneatus
causes: trauma, infections like TB or syhilis, vit b12 deficiency, MS, tumour, ischia, degenerative disease
loss of fine touch, ataxia, gait abnodmrlait
it affects the antler spinothalanic tract
what is a crevical radiculopathy
compression of irritation of nerve ROOTS in Cx
herenated disc
DDD
spinal stenosis
bone spurs
trauna
infection
tumour
px. sharp, shooting, burning
numbness
weaknes
reflex change
neck px
C5-C6 mc
ne k brace
surgery
what is lumbar radiculogpthy
nerve ROOT iritation
compressed or irritated
herenated disc
DDD
spinal stenosis
bone spurs
trauna
infection
tumour
spondlythesis
px
numbness tingles
weakness
reflex change/ decreased or absent
worse with certain movements that increase pressure on nerve root s
what is a brachial plexopathy
damage to the brachial plexus which originates from c5-T1 nerve ROOTS
trauma
compression
inflammation
diabetic neuropathy
radiation injury
tumour
px
weaknes
numbness or tingling
atrophy
reflex change
what is a lumbosacral plexopathy
lumboscarl plexus L1-L5 and S1-S5
motor and sneery innervation
trauna
tomour
diabete
infection
vascular causes like aneurysm
inflammatory conditions
compression
px
weakness
numbness and tingling
loss of reflex
Band B
muscle atrophy
