spinal cord lesions

Question 1

paresis vs. paralysis

Answer 1

reduction in muscle strength vs. inability to perform any movement

Question 2

paraplegia vs. quadriplegia

Answer 2

paralysis of the legs vs. paralysis of the legs and arms
-paraplegia below T1 or quadriplegia above T1

Question 3

upper motor neurons lesion signs

Answer 3

spasticity/weakness, increased Deep tendon Reflex, clonus, half the body!

Question 4

clonus

Answer 4

rapid contractions and relaxations

Question 5

lower motor neuron lesion signs

Answer 5

paralysis flaccid weakness
-following dermatome patterns

Question 6

most common causes of SCI

Answer 6

motor vehicle accident’s, falls, violence and sports injuries
-diving is a high risk sport

Question 7

neurologic level

Answer 7

assessing for the level of damage, sensory or motor function
-most caudal segment that tests as normal or intact for both sensory and motor function
-dermatomal level by pin and touch
-myotomal level by manual muscle testing

Question 8

manual muscle testing rating

Answer 8

5 is the best muscle function and 0 is no muscle contraction

Question 9

ASIA scale

Answer 9

A is complete lesions and E is excellent/normal motor or sensory function
-complete lesions results in no sensory or motor function

Question 10

sacral sparing

Answer 10

some sacral innervation remains intact
-bowel, bladder and rectal function is spared

Question 11

complete SCI

Answer 11

interruption of ascending and descending pathways
-paraplegia or quadriplegia
-loss of sensory modalities below the lesion

Question 12

acute stages

Answer 12

spinal shock, areflexia, flaccid paralysis
-duration is variable

Question 13

chronic stages

Answer 13

return of reflex activity below lesion spasticity
-clonus
-hyperactive cutaneous reflexes
-flexor and extensor spasms may alternate

Question 14

small central lesions

Answer 14

anterior white commissure

Question 15

large central lesions

Answer 15

affecting ventral gray horns
-motor

Question 16

dorsal column lesions

Answer 16

affecting dorsal white columns
-DCML

Question 17

central cord syndrome

Answer 17

involves a lesion of the central gray matter and medial white matter of the cervical SC
-upper limb weakness and sacral sensory sparing

Question 18

spinal cord hemisection

Answer 18

goes through the body and cut’s half the spinal cord and the other half is still intact
-ipsilateral loss of the corticospinal tract, dorsal column function, spinothalamic tract function and lower motor neurons

Question 19

motor system disease (called amyotrophic lateral sclerosis)

Answer 19

progressive deterioration of the corticospinal tract as well as lower motor neurons
-muscular atrophy and fasciculations
-hypereflexia and positive babinski sign

Question 20

combined systems disease

Answer 20

involves both motor and sensory, dorsal column and corticospinal tract
-subacute combined degeneration
-friedreich’s ataxia

Question 21

subacute combined degeneration

Answer 21

degeneration in doral & lateral columns
due to complication of pernicious anemia
-loss of proprioception
-numbness
-spastic paresis

Question 22

friedreich’s ataxia

Answer 22

a rare, inherited, degenerative disease,worsens over time
inherited disease with varying degrees of dorsal column, lateral corticospinal tract and spinocerebellar tract lesions
-ataxic gait and frequent loss of balance
-spastic weakness

Question 23

tabes dorsalis

Answer 23

complication of late stage syphilis infection.
dorsal column affected and the dorsal root affected
-complication of neurosyphilis
-abnormal sensations, intermittent attacks of sharp pain
-decreased sensitivity to pain, decreased or absent DTRs
-marked impairment of kinesthesis, loss of vibratory sense, and two point discrimination

Question 24

poliomyelitis

Answer 24

ventral gray horns which result in motor deficits
-LMN disease characterized by paresis or paralysis, atrophy, and/or complete flaccid paralysis