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Neuroscience > Spinal Cord Pathology > Flashcards

Spinal Cord Pathology Flashcards

1
Q

What are some effects of a ventral horn ipsilateral segmental motor syndrome?

A
  • Paralysis (decreased voluntary motor unit recruitment)
  • Hypotonia
  • Areflexia
  • Muscle atrophy
  • Fasciculation, Fibrilltation

[Of the affected segments]

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2
Q

What type of symptoms is Polio characterized?

A
  • LMNL symptoms
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3
Q

How is nerve conduction affected by Polio?

A
  • Normal
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4
Q

What 3 phases does polio follow?

A
  • Fever

- Myalgia (cramping, pain), and malaise

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5
Q

What type of representation does Polio have in terms of weakness?

A

Either:

  • Unilateral
  • Focal
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6
Q

How are the sensory systems affected by Polio?

A

Unaffected

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7
Q

What symptoms would be present in a dorsal column lesion?

A
  • Discriminitive touch
  • Proprioception
  • Kinesthetic sense

All profoundly affected on the same side
- From the affected segment downwards

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8
Q

Will a patient with a dorsal column lesion have difficulty balancing with their eyes open?

A

Not necessarily

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9
Q

What are the motor symptoms and signs of Tabes Dorsalis?

A

There are none –> Psych!

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10
Q

What are the sensory symptoms and signs of Tabes Dorsalis?

A
  • Posterior roots lesioned

- Especially in lumbosacral region

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11
Q

What results from the lesioned dorsal roots of Tabes Dorsalis?

A

Degeneration of the dorsal columns

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12
Q

What are 4 common complaints of patients with Tabes Dorsalis?

A
  • unsteadiness
  • Sudden lacerating somatic pain
  • Urinary incontinence
  • Excruciating abdominal pain
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13
Q

What 7 Neuro Exam markers will be present in a patient with Tabes Dorsalis?

A
  • Marked impairment of vibration & joint position
  • Severe deficits in touch and pressure
  • Ataxic gait
  • Postitive Rhomberg
  • Abadie’s Sign (pressure on achilles tendon does not elicit pain)
  • Pain fibers can also be affected
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14
Q

What representation do the symptoms of Tabes Dorsalis have? At what spinal levels?

A
  • Ipsilateral

- At and below the level of the lesion

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15
Q

What is another name for a hemi-section of the spinal cord?

A

Brown Sequard Syndrome

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16
Q

What are the 4 ipsilateral signs of Brown Sequard Syndrome?

A
  • Upper motor neuron signs below level of lesion
  • Loss of kinesthesia and discriminitive touch at level of lesion and below
  • Segmental lower motor neuron signs at level of lesion
  • Autonomic signs
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17
Q

What is the controlateral signs of Brown Sequard Syndrome?

A
  • Loss of Pain and Temperature
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18
Q

What is the bilateral sign of Brown Sequard Syndrome?

A
  • Pain and temperature loss
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19
Q

What are the 5 aspects of Horner’s Syndrome?

A
  • Ptosis
  • Dry Face
  • Red
  • Warm
  • Miosis (constricted pupil)
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20
Q

In a C5 segmental hemi-section, will babinski be positive or negative? Will Hoffman be positive or negative?

A

+ Babinski

- Hoffman

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21
Q

Which cell column must be lesioned at what level for Horner’s Syndrome to occur?

A
  • Lateral cell column above T3
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22
Q

What symptoms will be present in a lesioning of the ventral funiculus?

A
  • Weakness due to loss of bilateral motor drive

- Gross touch system gone, but fine motor in tact

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23
Q

What symptoms/ signs will be present with a lesion of the anterior white commisure?

A
  • Bilateral loss of pain and temperature 1 or 2 levels lower than the level of the lesion
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24
Q

What fibers are affected by an early syringomyelia lesion? What does this cause?

A
  • Crossing spinothalamic fibers

- Contralateral loss of concious pain and temperature

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25
Q

What is affected by a late syringomyelia lesion? What does this cause?

A
  • Crossing spinothalamic fibers
  • Motor neurons
  • LMNS at level of lesion
  • Concious pain and temeprature loss
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26
Q

Where are syringomyelia more dangerous?

A
  • More dangerous are plexuses

- Not as dangerous in trunk

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27
Q

What areas are affected by amyotrophic lateral sclerosis?

A
  • Anterior and lateral corticospinal tracts

- Eventually the ventral horn and pyramidal tracts

28
Q

What type of disease is amyotrophic lateral scleorsis?

A
  • Autoimmune disease with a hardening of areas forming plaques
29
Q

What ipsilateral symptoms may present in amyotrophic latearl sclerosis?

A
  • Paralysis
  • Spasticity
  • Hyper-reflexia
  • Clonus
  • Babinski
  • Hypotonia
  • Hypo/ areflexia
  • Fibrillations
  • Muscle atrophy
30
Q

What representation does amyotrophic lateral scleorsis have?

A
  • Bilateral

- Symptoms are ipsilateral, but both sides are affected

31
Q

What is another name for amyotrophic lateral scleorsis?

A
  • Lou Gherig’s Disease
32
Q

Which spinal segments are more commonly affected by ALS?

A
  • Cervical and lumbar regions
33
Q

How does ALS typically progress?

A

From superior to inferior spinal segments

34
Q

What are 2 common complaints of patients with ALS?

A
  • Weakness in legs and arms

- Atrophy or fasciculations

35
Q

What 5 signs may be present in a patient with ALS?

A
  • Muscle atrophy of small muscles of hand and distal muscle groups
  • Fasciculations
  • Hyperactive reflexes
    • Babinski and + Hoffman
    • Bing’s reflex
36
Q

What is Bing’s reflex?

A
  • Extension of great toe following pricking of dorsum of toe or foot with a pin
37
Q

In what types of lesions is Bing’s reflex present?

A
  • Pyramidal tract
38
Q

What is primary lateral sclerosis?

A

ALS with only pyramidal tracts affected

39
Q

What is progressive muscular atrophy?

A

ALS with only the AHC affected

40
Q

What is progressive bulbar palsy?

A

ALS in the motor nuclei of the brain stem

41
Q

What are 2 symptoms of progressive bulbar palsy? What is a constant danger?

A
  • Slurred speech
  • Programs swallowing/ coughing
  • Aspiration constant danger
42
Q

What tracts are affected by a combined system disease?

A
  • Dorsal columns

- Lateral corticospinal tracts

43
Q

What is the hereditary form of combined system’s disease? What is also involved in the hereditary form?

A
  • Friedreich’s Ataxia

- Spinocerebellar tracts also involved

44
Q

What symptoms and signs are present in combined system disease?

A
  • Loss of discriminitive touch
  • Loss of proprioception
  • Some UMNS
45
Q

What specific force causes Combined Systems disease?

A

Compression force on spinal cord

46
Q

What is often seen following pernicious anemia (B12 deficiency)?

A
  • Subacute combined degeneration
47
Q

What structures are affected in subacute combined degeneration?

A
  • Dorsal and lateral funiculi

- Especially fibers of lumbosacral cord

48
Q

What are 4 common complaints of patients with subacute combined degeneration?

A
  • Distal paresthesias, dyesthesias, and weakness in the extremities (feet and hands first)
  • Spastic paraparesis with ataxia (from impaired postural sensation in legs)
  • Lhermitte’s sign (sudden electric-like shocks extending down the spine on flexing of the head
  • Difficulty in walking
49
Q

What will be the findings of a neuro exam of the subacute combined degeneration?

A
  • Dosral column symptoms present

- Pyramidal deficit in legs

50
Q

What 6 structures can be affected by multiple sclerosis?

A
  • Subcortical white matter
  • Corpus callosum and angles of lateral ventricles
  • Internal capsule
  • Pons
  • Cerebellum
  • Spinal cord
51
Q

How will the plaques of multiple sclerosis show up on MRI?

A

As white highlights

52
Q

Describe the progression of benign multiple sclerosis.

A

Mild early attacks, followed by a complete clearing of symptoms

53
Q

Describe the progression of relapsing remitting multiple sclerosis.

A
  • Frequent early attacks and incomplete clearing of symptoms, but long periods of stability
  • Some degree of disability
54
Q

Describe the progression of secondary chronic progressive multiple sclerosis.

A
  • Frequent attacks
  • Short and incomplete remissions
  • More severe than benign and relapsing remitting
  • Worsens for years, and then may level off
55
Q

Describe the progression of primary progressive multiple sclerosis.

A
  • Most severe form of MS
  • Onset is severe
  • Slowly progressive with no clearing of symptoms
56
Q

What % of each type of MS affects patients?

A

Benign multiple sclerosis: 20 %
Relapsing remitting multiple sclerosis: 25 %
Secondary chronic progressive: 40 %
Primary progressive: 15 %

57
Q

What is the early stage of spinal cord injury called?

A
  • Spinal shock
58
Q

What are the 4 aspects of spinal shock?

A
  • Flaccid/ bilateral paralysis of all muscles of spinal segment and below
  • Loss of all sensation at the level and below
  • Loss of all bladder and bowel functions
  • Loss of all sexual functions
59
Q

What is the course of later stage SCI?

A
  • UMNL symptoms
  • Sensation lost at level and below
  • Automatic reflex neurogenic bladder
  • Intermittent automatic reflex defecation
  • Reflex erection and ejaculation
  • Possible tempory cessation of menstruation and irregularities in menstrual cycle
60
Q

What is the most important aspect of treatment of a new patient with a SCI?

A
  • Control the sympathetic nervous system

- BP can skyrocket

61
Q

What level must a SCI occur above for autonomic dysfunction syndrome to occur?

A
  • SCIs above T5
62
Q

What 5 symptoms are caused by bladder or bowel distention in autonomic dysfunction syndrome?

A
  • Excessive sweating
  • Cutaneous flushing
  • Hypertension
  • Pounding headache
  • Reflex bradycardia
63
Q

What respiratory dysfunction may occur following SCI?

A
  • Decreased vital capacity due to a weakened diaphragm and other respiratory muscles
  • Decreased response to CO2 (due to loss of ascending spinoreticulo tract)
  • Disruption of ascending and descending pathways
64
Q

What type of lesion will cause Autonomic Respiratory Dysfunction Syndrome?

A
  • High cervical lesions
65
Q

What causes autonomic respiratory dysfunction?

A
  • Loss of ascending pathways
66
Q

What 5 symptoms may present in autonomic respiratory dysfunction syndrome?

A
  • Respiratory arrest/ sleep apnea
  • Hypotension
  • Hypontremia (low levels of Na++ in blood)
  • Inappropriate ADH secretion
  • Hyperhidrosis

Neuroscience (33 decks)

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