Spinal Cord pathologies (myelopathy + cauda equina syndrome) Flashcards
Levels of the spinal cord?
If lesion here its called?
C1 - L1/2
myelopathy
What is after L2?
What is it called?
If lesion here its called?
L3
Conus medullans (lumbar and sacral spinal roots)
Cauda equina syndrome
What is hemiplegia and paraplegia?
one side of body (brain lesion)
Both legs (cord lesion)
What are the spinal nerve roots for reflexes:
Knee jerk
Big toe jerk
Ankle Jerk
L3/4
L5
S1
What are the 3 main tracts?
DCML
Spinothalamic
Cortiocospinal
DCML
what kind of tract, which way?
Motor or sensory?
Function?
Ascending, dorsal root to medulla then decussated
Sensory
Fine touch, proprioception, 2pt discrimination
Spinothalamic
what kind of tract, which way?
Motor or sensory?
Function?
Ascending
Decussated 1-2 spinal levels above dorsal root entry
Sensory
pain and temp
Corticospinal
what kind of tract, which way?
Motor or sensory?
Function?
Descending UMN, decussates at medulla - ventral root
Motor
Spinal cord lesion would lead to what kind of sensory and motor signs?
Ipsilateral sensory signs
Contralateral motor signs
Brown Sequard syndrome
What is it?
Symptoms of it (motor/sensory)?
Hemisection of spinal cord
Ispilateral motor weakness (UMN)
Ipsilateral DCML dysfunction - proprio, 2 pt discrimination
Contralateral spinothalamic dysfunction - pain and temp sensation
What is myelopathy?
Spinal cord compression C1-L1/2
2 Causes?
Vertebral Body neoplasms (MC) - Mets from lungs, breast, renal cc, melanoma
Spinal pathology (eg. disc prolapse/herniation)
Sx of myelopathy?
Progressive leg weakness with UMN signs (contralateral hyperreflexia, babinski +ve, spasticity)
sensory loss below lesion (as ascending tracts send info up)
Sphincter involvement uncommon (late - v bad sign)
Dx of myelopathy?
MRI cord ASAP - risk of permanent damage if not asap
Chest x ray if malignancy suspected
Tx for myelopathy?
Neurosurgery (laminectomy/microdiscectomy)
