Spinal Cord Problems Flashcards
what tract is responsible for fine, precise movement
corticospinal
what tract is responsible for fine touch + proprioception
dorsal column
what tract is responsible for pain + temperature sensations
spinothalamic
what is affected in a complete cord transection
all modalities
- loss of motor + sensory divisions
what initially happens after complete cord transection
“spinal shock” – flaccid areflexic paralysis
- loss of tone, loss of reflexes
later symptoms of complete cord transection
UMN signs
- increased tone
- spasticity
- hyperreflexia
what is Brown Sequard syndrome
cord hemisection
symptoms of Brown Sequard syndrome
ipsilateral paralysis
ipsilateral loss of proprioception + fine touch
contralateral loss of pain + temperature sensation
what causes central cord syndrome
hyperextension / flexion injury to an already stenotic spine
presentation of central cord syndrome
bilateral arm weakness
cape like spinothalamic sensory loss
presentation of anterior cord syndrome
bilateral weakness + loss of pain + temperature sensation
- spares Dorsal column
presentation of posterior cord syndrome
only affects dorsal column – loss of fine touch + proprioception
what is spinal stenosis
narrowing of the spinal canal due to spinal degeneration
causes of spinal stenosis
osteophyte formation
bulging of intervertebral disks
facet joint hypertrophy
subluxation
symptoms of spinal stenosis
neurogenic claudication
- leg pain on exertion
- improved with walking uphill
gradual bilateral leg weakness
what is syringomyelia
cyst formation in the spinal cord
what causes syringomyelia?
what age does it present?
blocked CSF circulation
- Arnold-Chiari malformation predisposes
mean age of 30
symptoms of syringomyelia
slowly progressive spinothalamic sensory loss (pain + temp)
wasting / weakness of arms
what is spondylosis
loss of water from nucleus pulposis of disc
what is sciatica
compression of sciatic nerve roots (L4-S3)
symptoms of sciatica
unilateral buttock + leg pain that radiates to foot
- sharp / shooting pain
- worse with straight leg raise ‘sciatic stretch test’
numbness + parasthesia
presentation of degenerative cervical myelopathy
pain in neck/ upper/lower limbs
loss of motor function – dexterity problems, arm/leg weakness, gait abnormality, balance problems
loss of sensory function – numbness
loss of autonomic function
investigation for degenerative cervical myelopathy
MRI
treatment of degenerative cervical myelopathy
surgical decompression
- urgent referral to spinal/neuro surgery
