spinal cord lesions & pathways - lecture 7

Question 1

radiculopathy

Answer 1

damage to nerve toor

Question 2

cause of radiculopathy

Answer 2

intervertebral disc disease

facet joints become misaligned

Question 3

symptoms of radiculopathy

Answer 3

sharp, burning pain in dermatomal portion of damaged nerve

Question 4

symptoms of cervical disc disease

Answer 4

pain in base of neck, over shoulder or down UE

Question 5

lumbar disc disease

Answer 5

pain radiating down LE

sciatica –> L4-S3

Question 6

mononeuropathy

Answer 6

damage to 1 peripheral nerve

motor sensory or both

Question 7

causes of mononeuropathy

Answer 7

trauma & compression

Question 8

symptoms mononeuropathy

Answer 8

• tingling or numb feeling in hand
• shooting pains in wrist or forearm
• difficulty clenching fist

Question 9

polyneuropathy

Answer 9

damage to peripheral nerve

Question 10

where does damage begin in axons during polyneuropathy

Answer 10

distal axonopathy start in LE –> UE

Question 11

which myelinated fibers are effected first during polyneuropathy

Answer 11

small diameter unmyelinated —> large diameter fibers

Question 12

causes of polyneuropathy

Answer 12

diabetes

glove and stocking sensory loss in extremities

Question 13

motor neuropathy

Answer 13

• loss of anterior horn cells
• muscle fasciculations
• muscle atrophy

Question 14

example of motor neuropathy

Answer 14

Amyotrophic lateral sclerosis (Lou Gehrig Disease)

Question 15

dorsal funiculus carries what type of information

Answer 15

concious proprioception
fine touch & vibration

to IPSILATERAL BODY

Question 16

injury to dorsal funiculus

Answer 16

ipsilateral loss of proprioception, fine touch, and vibratory sense from level below the legion

Question 17

dorsal funiculus - fasciculus gracilis

Answer 17

from sacral, lumbar, and lower thoracic (below T6)

to medulla (gracile nu)

Question 18

dorsal funiculus - fasciculus cuneatus

Answer 18

ascending fibers from T6 and above regions

to medula (cuneate nu)

Question 19

Classifications of Lateral Funiculi

Answer 19

• Anterolateral System (ALS)
• Spinocerebellar tract
• Lateral Corticospinal Tract (CST)

Question 20

Anterolateral System (ALS)

Answer 20

ascending tract carrying pain, temp, and crude touch

travels to contralateral side

Question 21

Spinocerebellar tract

Answer 21

ascending (unconscious) proprioception to cerebellum

Question 22

Lateral Corticospinal Tract (CST)

Answer 22

Descending motor carrying motor control from cortex to distal limb

Question 23

ALS pathway

Answer 23

1. start in spinal cord –> synapse on nuclei of dorsal horn (laminae I-VII)
2. axons cross in anterior white commissure
3. Ascend to brain stem and thalamus in lateral funiculus

Question 24

subdivisions of ALS

Answer 24

o Spinothalamic
o Sino-mesencephalic
o Spino- reticular
o Spino-hypothalmic

Question 25

injury to ALS

Answer 25

loss of pain input from contralateral body part in lumbar/ thoracic/cervical

Question 26

Posterior Column

Answer 26

ascending pathway that responds to vibration, fine touch -- highly myelinated

Question 27

Posterior Column Ascending pathway

Answer 27

1. comes through spinal cord 2. travels through fasciculus gracilis or cuneatus 3. travels up same side (ipsi) 4. synapses on fasciculus gracilis or cuneatus in brain stem 5. CROSSES 6. Travels in medial meniscus pathway 7. Project to thalamus 8. follows somatotopic

Question 28

lesion in cortex

Answer 28

you will loose contralateral control

Question 29

lesion in the spinal cord

Answer 29

you will loose ipsilateral control

Question 30

Spinocerebellar tract pathway through anterior and posterior horn

Answer 30

to cerebellum through anterior horn (laminae V-VII = L3/L5) through posterior horn (Lamina VII = T1 - L2)

Question 31

injury to lateral corticospinal tract (LCST)

Answer 31

``` abnormal reflexes (hyper) deficits in volitional strength ```

Question 32

lateral corticospinal tract (LCST) pathway

Answer 32

1. cerebral cortex - precentral gyri 2. descend voluntary motor input to anterior horn cells innervating distal limb 3. lamina IV-IX

Question 33

brown-sequard syndrome

Answer 33

an incomplete lesion of the spinal cord

Question 34

cause of brown-sequard syndrome

Answer 34

traumatic injury (stab or gunshot) or tumor encroaching spinal cord

Question 35

ventral funiculus

Answer 35

- anterior corticospinal tract (ACST) - medial reticulospinal - medial longitudinal fasiiculus (MLF)

Question 36

-anterior corticospinal tract (ACST)

Answer 36

descending motor from cortex voluntary movement of axial motor control

Question 37

medial reticulospinal

Answer 37

descending motor from reticular nuclei in brainstm for balance / axial & proximal joint motor control

Question 38

medial longitudinal fasciculus (MLF)

Answer 38

descending motor from brain stem for balance and axial motor control