Spinal Cord Syndromes & Tracts

Question 1

What does the Dorsal Column Medial Lemniscus Tract supply?

Answer 1

Vibration, proprioception, stereognosis, 2 POINT DISCRIMINATION, barognosis, FINE TOUCH, graphesthesia

Question 2

What does the Anterior Spino Thalamic Tract supply?

Answer 2

Crude touch

Question 3

What does the Lateral Spino thalamic Tract supply?

Answer 3

Pain and temperature

Question 4

What does the Corticospinal tract supply?

Answer 4

Movement

Question 5

What are the ascending tracts?

Answer 5

Named for their pathway
DCML and ASTT and LSTT, spinocerebellar, spinoreticular

Question 6

Descending Tract?

Answer 6

Corticospinal tract, vestibulospinal, rubro spinal, retículo spinal, tectospinal

Question 7

If an individual has Posterior Cord syndrome what is effected?

Answer 7

DCML
-Bilateral loss of proprioception, vibration, pressure, and epicritic sensations (stereognosis, two point discrimination)
-Preservation of motor function, pain and light touch

Question 8

If an individual has anterior Cord syndrome what is effected?

Answer 8

STT and Corticospinal tracts are affected
-HYPERFLEXION INJURY
-Bilateral loss of pain and temperature
-Bilateral loss of motor function, spastic paralysis below level of lesion
-Proprioception, light touch and vibratory sense are generally preserved

Question 9

If an individual has a Brown Sequard Syndrome what is affected?

Answer 9

BROWN POTS
Ipsilateral: DCML sensory (tactile discrimination, pressure, vibration and proprioception), and motor function loss below injury
Contralateral: loss of p! And temp below level of injury

Question 10

What is Cauda Equina Syndrome?

Answer 10

Location: Unilateral and asymmetrical in perineum, thighs, leg, and back- loss of nerve roots at or below L1
Flaccid paralysis of bladder and bowel, no spinal reflexes
Sensory: saddle distribution UNILATERAL AND ASYMMETRIC
LMN

Question 11

What is Conus Medullaris?

Answer 11

Location: bilateral and symmetrical in perineum and thighs
Sensory: saddle distribution, bilateral and symmetric
LMN & UMN

Question 12

What is central cord syndrome?

Answer 12

HYPEREXT INJURY
-Bilateral UE affected because the cervical tracts are located more centrally located
-Loss of bilateral pain and temperature

Question 13

What is autonomic dysreflexia?

Answer 13

-At or above T6
-Noxious (painful) stimuli below level of lesion
-Rise in systolic BP of 20-30 mmHg

Question 14

What is the PT response for Autonomic dysreflexia?

Answer 14

SIT UP AND LOWER LEGS
-remove painful stimuli

Question 15

What is the treatment for spastic bladder?

Answer 15

UMN/Reflexive bladder
-Seen in patients with injury above S2 sacral segments
Trx
-Require intermittent catheterization every 3-6 hours
-Suprapubic tapping

Question 16

What is the treatment for Flaccid bladder?

Answer 16

LMN/Areflexic bladder
-Seen in patients with injury at or below S2 sacral segments
Trx:
-Require intermittent catheterization every 3-6 hours
-Valsalva or Crede’s maneuver

Question 17

What does a patient do with pushers syndrome?

Answer 17

PUSH TO THE WEAK SIDE

Question 18

Spinocerebellar tracts

Answer 18

Convey proprioception info from muscle spindles, Golgi tendon organs, and touch and pressure receptors to cerebellum for control of voluntary movements; dorsal spinocerebellar tract ascends to ipsilateral inferior cerebellar peduncle, and ventrospinocerebellar tract ascends to contralateral and ipsilateral superior cerebellar peduncle

Question 19

Spinoreticular tracts?

Answer 19

Convey deep and chronic pain to the reticular formation of brain stem via diffuse, polysynaptic pathways

Question 20

Corticospinal tracts?

Answer 20

Arise from primary motor cortex, descend in brain stem, cross in medulla (pyramidal decussation), via lateral corticospinal tract to ventral gray matter (anterior horn cells); 10% of fibers do not cross and travel in anterior corticospinal tract to cervical and upper thoracic segments; important for VOLUNTARY MOTOR CONTROL

Question 21

Vestibulospinal tracts?

Answer 21

Arise from vestibular nucleus and descend to spinal cord in lateral (uncrossed) and medial vestibulospinal tracts; important for control of muscle tone, antigravity muscles and postural reflexes

Question 22

Rubrospinal tract?

Answer 22

Arise in contralateral red nucleus and descend in lateral columns to spinal gray matter; assist in motor function

Question 23

Reticulospinal system?

Answer 23

Arises in the reticular formation of the brain stem and descends in ventral and lateral columns, terminates both on dorsal gray and ventral grey. *Modifies transmission of sensation, especially pain, influences gamma motor neurons and spinal reflexes

Question 24

Tectospinal tract?

Answer 24

Arises from superior colliculus and descends to ventral gray; assists in head turning responses to visual stimuli