Spinal cord lecture Flashcards
Describe the DCML tract
- 1st order neurones enter the spinal cord via the dorsal horn transmitting sensory info regarding fine touch, proprioception + vibration
- They synapse with a 2nd ON in the medulla oblongata
- Upper limb ( lateral) - synapse with 2nd ON in nucleus cuneatus
- ## Lower limb ( medial) synapse with 2nd ON in nucleus gracilis
- Dessucates in the medulla
- Ascends PONS -> midbrain -> thalamus
- Synapses with 3rd ON in the thalamus
- 3rd ON projects to internal capsule-> sensory cortex
What do cervical spine lesions affect?
What do thoracic spine lesions affect?
Arms and legs
Legs
What type of lesion are those in the
cervical/thoracic spine?
lumbar spine?
Conus medullaris?
UMN
LMN
UMN/LMN
What is autonomic dysreflexia?
Occurs after severe traumatic injury normally when lesion> T6 so affects the sympathetic chain
- High changes in BP + other autonomic changes
What are the 3 types of presentations of spinal cord and what is their likely cause?
Acute = vascular
Sub acute = inflammatory
Chronic/longer = malignancy/neurodegenerative
What is transverse myelitis ?
What are typical signs?
Inflammation of one part of the spinal cord = subacute
Both legs involved but not arms -> thoracic lesion
Upper motor neurone signs
Bladder involvement
Treated with high dose steroids
What is cauda equina syndrome ?
What are typical signs?
LMN signs
Bladder + bowel involvement
Nerves in the lower back suddenly become severely compressed.
What is a Spinal stroke?
What is the blood supply to the spinal cord?
What are typical signs?
Typically in the anterior spinal artery
DCML is spared
Posterior spinal artery strokes are much less common
Anterior spinal artery - Anterior 2/3
Posterior spinal artery - Posterior 1/3
Spinal shock e.g flaccid weakness ( LMN) then UMN signs e.g spasticity
What is Brown Sequard syndrome ?
In which part of the spinal cord is the lesion?
Same side as lesion: DCML loss + loss of lateral corticospinal tract
- Loss of vibration, proprioception + crude touch on same side as lesion
Opposite side as lesion: Spino thalamic tract,
- Loss of temperature, pain and fine touch on opposite side of lesion
Cervical spine involvement ( UMN) so arms and legs affected
What is sub acute degeneration of the cord ?
What can also affect the posterior cord?
Postero lateral symptoms
Caused normally by vitamin B12 deficiency but associated with peripheral neuropathy
Tabes dorsalis ( secondary to syphilus)
What is synringomelia ?
What part of the spinal cord is affected?
What is it typically associated with?
Expansion of part of the spinal cord
Cervical spine
Loss of temp sensation - affects spinothalamic tract
Can expand to involve ventral horn cells, sympathetic chain, DCML + corticospinal tract
Congenital - chiari malformation
