Spinal cord Path

Question 1

Treponema pallidum

Answer 1

causes syphilis

Question 2

untreated syphilis

Answer 2

Tabes Dorsalis

Question 3

primary syphilis presents as

Answer 3

painless ulcer known as chancre; common among men with other men sex partners

Question 4

secondary syphilis

Answer 4

lesions on skin and mucous membranes (pic of hand and tongue lesions

Question 5

Latent/tertiary syphilis

Answer 5

Neurosyphilis

Question 6

Neurosyphilis includes

Answer 6

meningovascular syphilis; Tabes Dorsalis; syphilitic paresis

Question 7

Meningovasular syphilis

Answer 7

onset is 5-10 yrs after primary infection; Chronic meningeal involvement causes arteritis; May cause aseptic meningitis

Question 8

Symphilitic Paresis

Answer 8

Depression is primary symptom; Progressive loss of memory and higher cognitive functions; frontal lobe often involved–> changes in personality; Grandiose delusions; Diffuse UMN type weakness

Question 9

Tabes Dorsalis

Answer 9

Often seen with symphilitic paresis; occurs more frequently in males with peak onset in 40s-50s; demyelination often occurs in lumbosacral region; pts have sensory ataxia; high stepping gait; incontinence; charcot joints; Argyll Robertsons pupils

Question 10

Charcot joints Stage I

Answer 10

AKA Neuropathic Arthropathy; Stage I: Destruction of joint and surrounding bone; bone becomes unstable and reabsorbed. Severe deformity of foot/ankle; bony prominences develop on plantar surface of foot.

Question 11

Charcot jts Stage II

Answer 11

Decreased destructive process and healing process begins

Question 12

Charcot jts Stage III

Answer 12

reconstruction of bones but foot often deformed.

Question 13

Argyll Robertson’s Pupils

Answer 13

“Prostitutes pupils”; Bilateral small pupils; pupils constrict poorly/not at all to light; Do constrict for accommodation reflex

Question 14

Tabes Dorsalis: CS+S

Answer 14

weakness; Diminished reflexes; unsteady gait; progressive degeneration of jts; loss of coordination; episodes of intense P! /disturbed sensation; personality changes/dementia; deafness; visual impairment and impaired response to light; loss of tactile discriminations and position sense (kinesthesia); Positive Romberg’s sign

Question 15

Posterior cord syndrome

Answer 15

injury to posterior column/occlusion to PSA; Isolated loss of proprioception and vibratory sense

Question 16

Brown Sequard syndrome

Answer 16

ipsilateral: loss of proprioceptive function at and below lesion (DCML), UMNL signs below lesion, LMNL at lesion; ipsilateral loss of sweating; ipsilateral hemidiaphramatic paralysis

Question 17

what commonly precedes Guillain-Barre syndrome

Answer 17

correlates with respiratory/viral infection

Question 18

GBS

Answer 18

demyelination of axons in the PNS; very rapid progression; begins in LE and ascends bilaterally. knee jerk reflex is lost; decreased nerve conduction velocity

Question 19

MS

Answer 19

demyelination/ breakdown of myelin in CNS; young adults; periventricular/juxtacortical lesions; CS&S: vision probs, muscle spasms/weak/stiff; balance probs; incontinence; vertigo; FATIGUE; mood; difficulty w/ goal oriented activities

Question 20

Syringomyelia

Answer 20

Development of fluid filled cysts or syrinx w/in SC, symptoms develop slowly over time. Causes loss of AWC–> damage to decussating STT fibers

Question 21

syringomyelia believed cause

Answer 21

obstructed flow–> CSF pressure causes it to push out syrinx and into SC–> cyst growth and damage to SC tissue

Question 22

syringomyelia usual lesion location

Answer 22

lower cervical levels/first few thoracic

Question 23

Syringomyelia CS+S

Answer 23

bilateral loss of sensititvty to pain and temp in the neck shoulder arms and hands due to the cysts pressing on the AWC resulting in damage to the decussating STT fibers. Later- cysts will press on neurons in the ventral horn resulting in the bilateral LMN signs, including bilateral muscle weakness and m atrophy generally confined to the UE

Question 24

central cord syndrome

Answer 24

shawl like loss of pain & temp in UE; paralysis or loss of fine motor to arms/hands; loss of bladder control; usually result of trauma injury to vertebra/herniation of disc/individuals over 50 w/ weak disc

Question 25

Anterior Spinal Artery Syndrome

Answer 25

Can affect any segment of SC, lower thoracic /conus medullaris most commonly involved; abrupt onset; most often associated w/ radicular p!

Question 26

ASA syndromE CS+S

Answer 26

bilateral loss of motor function; impaired bladder/bowel control; bi lat loss of p! and temp below level of lesion; rapidly progressive LMNLsigns; (PRESERVATION OF DCML BILAT); bi lat anhidrosis caudal to lesion +hemidiaphramatic paralysis

Question 27

transverse cord lesion

Answer 27

complete severing of SC; loss of all motor and sensory at and below level of lesion; flaccid paralysis, areflexia, and anesthesia @ and below lesion; return of reflexes at 4-6 weeks post; injury at T6 or higher , AD often occurs w/ return of reflexes (^ BP, sweating,headache, flushed face, dec HR,

Question 28

Cauda equina syndrome

Answer 28

unilateral, gradual progression of symptoms caused by herniated disc compressing cauda equina below level of conus medullaris. PN injury common in levels L2-sacrum. CS+S commonly P! in thigh/perineum area; unilateral saddle anesthesia; asymmetric paraplegia; atrophy of muscles (LMN sign)

Question 29

Conus Medullaris syndrome

Answer 29

presents w symptoms similar to CES, but suddenly and bilaterally. loss of sensory to perianal area; paresis w fasciculations to LE; bilateral saddle anesthesia; loss of anal reflex; common in L1-L2

Question 30

ALS

Answer 30

impairs m movements and eventually results in total paralysis of patient; progressive degeneration of both UMN and LMN; age of onset 50-60; proteins normally w/in nucleus are found outside in cell body, form clumps

Question 31

ALS CS+S

Answer 31

focal weakness/clumsiness that spreads to adjacent m groups; m cramps; fasciculations; dysarthria/dysphagia; hyperreflexia/spasticity; head droop; pseudobulbar effect;