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Neuro > Spinal Cord Lesions > Flashcards

Spinal Cord Lesions Flashcards

1
Q

What are motor descending pyramidal tract
- Pass through pyramid of medulla

What is pattern of weakness

A

Anterior and Lateral corticospinal = 90%
Also corticobulbar

Extensor weaker in arms and flexor in legs

UMN originate at either motor cortex or brain stem nuclei
Travel to anterior horn cell in spinal cord at target level

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2
Q

What are extra pyramidal motor tracks

- Don’t pass through pyramid

A

Rubrospinal
Reticulospinal
Vestibulospinal

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3
Q

What are sensory descending tracts in dorsal column

A

Gracile fasiculus

Cuneate fasicullus

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4
Q

Sensory spinocerebelllar

A

Anterior

Posterior

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5
Q

Sensory spinothalamic

A

Anterolteral tract
Lateral
Anterior

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6
Q

What causes pure motor signs

A

MND

Poliomyelitis

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7
Q

How does motor neurone present

A

Corticospinal tracts

UMN and LMN signs

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8
Q

What does poliomyelitis affect

A

Anterior horn cell

LMN signs

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9
Q

How can sensory present

A

Dorsal column

Spinothalamic

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10
Q

If spinothalamic affected what are the signs

A

Loss of pain, temp and sensation

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11
Q

If dorsal column affected what are the signs

A

Loss of proprioception and vibration

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12
Q

What affects dorsal

A

Tabes dorsalis - late consequence of syphillis
SACD
Spinal cord infarction

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13
Q

What happens if spinothalamic lesion

A

Loss of pain, temp and sensation

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14
Q

What causes combined UMN and LMN signs

Fred
Tabby
Cat 
Seeks 
Mice
A 
Fredreich ataxia
Tabes dorsalis (syphillis) 
Cervical + lumbar spondylosis
SACD- B12
Motor neurone disease

Alnord chiari malformato / syndomyelia

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15
Q

What is Brown Squared

A

Spinal cord hemisection

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16
Q

What tracts are affected

A

Lateral corticospinal
Dorsal
Lateral Spinothalamic

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17
Q

What does it lead too

A

Ipsilateral spastic paralysis below lesion (corticospinal) + UMN signs
Ipsilateral loss of proprioception and vibration (dorsal)
Ipsilateral sensory loss
Contralateral loss of pain and temp (spinothalamic)

18
Q

What does cord compression lead too

A

UMN signs

19
Q

What can cause

A

Malignancy
Haematoma
Fracture

20
Q

What causes subacute combined degeneration of spinal cord (SCAD)

A

B12 / thiamine deficiency

  • Pernicious - Ab against intrinsic factor
  • Chron’s
  • Gastrectomy
21
Q

What tracts are affected

A

Lateral corticospinal
Dorsal
Spinocerebellar

22
Q

What does it cause

A

Bilateral spastic paralysis
Bilateral loss of proprioception and vibration - usually first
Distal paraesthesia after
Bilateral limb ataxia
UMN and LMN signs in leg - extensor plantar / absent knee / absent ankle reflex (hyporeflexia)
Painess urine retention
Pain and temp often remain intact

23
Q

What does Fredreich’s ataxia cause

A

Same as above

Also cerebellar ataxia signs

24
Q

What is syringomyelia

A

Collection of cerebrospinal fluid in spinal cord

Symptoms may be static for years but worsen fast e.g. on coughing or sneezing

25
Q

What can cause

A

Tumour
Trauma
Arnold Chiari malformation

26
Q

What tracts are affected

A

Antero-Lateral spinothalamic as fluid in middle of cor where this tract passes

27
Q

What does it cause

A 
Progressive slow neuro signs
Flaccid paralysis (typically hand) 
Loss of pain and temp but preserved touch / vibration 
Wasting and weakness of hands 
Cape like distribution 
Paraesthesia
Hyporeflexia 
Neuropathic pain
Upgoing plantar
Bladder. / bowel 
Horner due to compression of sympathetic but rare
28
Q

What is classic presentation

A

Burning hand without realising

29
Q

What happens if not Rx

A

Scoliosis

30
Q

How do you Dx

A

Spine MRI for tumour

Brain MRI for CHairi

31
Q

How do you Rx

A

Treat cause

Shunt

32
Q

How does MS present

A

Asymmetrical combination of motor, sensory and ataxia signs

33
Q

What tracts affecting in anterior spinal artery occlusion

A

Lateral corticospinal

Lateral spinothalamic

34
Q

What does it cause

A

Bilateral spastic paresis

Bilateral loss of pain and temp

35
Q

What is Alnord Chiari malformation

A

Downward displacement of cerebral tonsil through foramen magnum
Congenital
Trauam

36
Q

What does it cause

A

Synrigmyelia
Non-communicating hydrocephalus
Headache

37
Q

What is Fredreich’s ataxia

A

AR trinucleotide disorder that causes spinocerebellar degeneration
Anticipation

38
Q

How does it present

A

Present teens
UMN and LMN signs e.g. absent ankle jerk + extensor plantar
+ Ataxia

Other 
Kyphoscolisosis 
Optic atrophy
HOCM
DM
Associated with WPW
39
Q

What is Telangiectasia ataxia

A

AR defect in gene for DNA repair + immunodeficiency

40
Q

What does it cause

A 
Early childhood
Abnormal movement
Ataxia
Telangiectasia
IgA deficient so recurrent infection
41
Q

What is Leg term risk

A

Leukaemia

Neuro (19 decks)

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