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neuro 22 Flashcards

1
Q

anterior gray matter

A

alpha motor neurons and motor fibers innervation skeletal muscles

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2
Q

in the lateral portion of the SC white matter

A

descending corticospinal tract

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3
Q

where does the CST cross

A

in he medulla

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4
Q

where does the CST synapse?

A

on alpha motor neurons in the anterior horn

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5
Q

dorsal columns do what

A

ascending tracts that mediate joint position sense

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6
Q

where do dorsal columns cross

A

the brainstem

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7
Q

where does the spinothalamic tract run?

A

anterolateral

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8
Q

what info does the spinothalamic tract carry?

A

pain and temp

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9
Q

where does the Spinothalamic tract synapse?

A

come into the SC and then synapse within two levels and then cross the cord an dascend contralateral to the limbs from which they originated

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10
Q

motor nerve roots

A

anterior in the SC

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11
Q

sensory nerve roots

A

posterior in the SC

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12
Q

where do the CERVICAL nerve roots exit the canal?

A

just above the corresponding vertebrae

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13
Q

why is there no C8 vertebra?

A

C8 nerve exits just above the T1

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14
Q

does C1 have sensory fibers?

A

nope

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15
Q

below the cervical region, where do the nerves exit the canal?

A

below their corresponding vertebal bodies

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16
Q

the corresponding level of the cord itself is typically where in relation to the root?

A

the level of the cord is typically a few bony levels above the root; for example, the T10 cord may lie adjacent to the T8 vert

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17
Q

where does the spinal cord ent?

A

L1 vertebral level

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18
Q

where do the dorsal columns cross?

A

brainstem

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19
Q

where does the spinothalamic tract cross?

A

in the cord, near the level of entry

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20
Q

transection at what spinal cord level gives you respiratory insuff

A

above C3-C5; and Horner’s may also develop due to transit of symp fibers up here

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21
Q

abdominal reflexes are lost with lesions above what?

A

T6

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22
Q

bowel and bladder dysfunction may follow lesions above what?

A

sacral spinal cord level

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23
Q

intramedullary

A

within the SC

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24
Q

common causes of cord compression

A

bony lesions from metastatic cancer, esp breast and prostate

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25
Q

Brown-Sequard syndome

A

hemicord

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26
Q

loss of proprioception and light touch ipsilateral, motor ipsi, and pain and temp contra

A

hemicord lesion

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27
Q

what does a central SC lesion affect?

A

spinothalamic tract fibers crossing at the level of the lesion; deficits in pain and temp are bilateral and over several segments

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28
Q

what is a “dissociated” sensory loss

A

pain and temp sesation are affected but proprioception ang light touch are not; seen in central cord lesions

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29
Q

syringomyelia

A

expanison of the potential fluid space in the center of the SC, usually over several levels

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30
Q

cape-like loss of pain and temp sensation

A

syringomyelia

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31
Q

syringomyelia often assoc with what?

A

posterior skull and brain malformations such as Chiari malformations

32
Q

syringobulbia

A

when the syrinx extends into the brainstem causing brainstem neuro signs

33
Q

treatment of syringomyelia

A

drain with a shunt; controversial

34
Q

hematomyelia

A

bleeding into the center of the cord

35
Q

central cord syndrome symptoms

A

moor and sensory dysfunction below the lesion and often cape=like loss of pain and temp at levels near the lesion

36
Q

radiation myelopathy

A

develops 6 months to years after radiotherapy

37
Q

syphilis affects what part of the spinal cord

A

posterior columns (tabes dorsalis)

38
Q

Vit b12 def

A

affects posterior columns

39
Q

cauda equina lesions

A

affect the spinal nerve roots with the spinal canal in the lumbar and sacral regions without affecting the spinal cord itself;

40
Q

how do cauda equina lesions present

A

wasting, weakness, and fasciculations in muscles innervated by these roots, often with lots of pain

41
Q

what causes cauda equina syndromes?

A

narrowing or obstruction of the SC in the lumbosacral region, by infections and by central disks below the level of the SC

42
Q

conus medullaris

A

the tip of the SC; this includes the centers controlling bowel, bladder, and sex function

43
Q

how do conus lesions present?

A

may affect bowel, bladder, and sex function; and if they remain below the lubar cord, may leave leg strength and reflexes intact

44
Q

blood supply for anterior two-thirds of the SC

A

anterior spinal artery

45
Q

what does the anterior spinal artery arise from?

A

branches of the two vertebral arteries, that join at the top the cord

46
Q

caudally, what is the largest single artery supplyng the ASA?

A

artery of Adamkiewicz, fed by perforating arteries from the aorta entering the SC at about the L2 level

47
Q

what supplies the anterior horns and corticospinal tracts

A

SA

48
Q

what supplies the dorsal columns posteriorly

A

plexus of many arteries, in turn fed by segmental arteries that arise from aorta and course along the ribs, giving off radicular arteries next to the nerve roots near the cord

49
Q

anterior spinal artery syndrome

A

stroke of the ASA; weakness below the lesion and there may be intense radicular pain or back pain and sphincter dysfunction; no loss of position sense

50
Q

which part of the SC is the least well perfused

A

thoracic cord, so it is most susceptible to stroke

51
Q

where is the border between the bascular supply from the vertebral arteries above and the ASA inferiorly

A

T4; systemic hypotension can lead to a watershed infarct here

52
Q

common causes of ASA syndrome

A

aortic surgery and atherosclerosis

53
Q

spinal shock

A

flaccid weakness and complete absence of DTRs immediately after trauma; spasticity typically develops over the next few days or weeks

54
Q

what treatment fo traumatic cord compression

A

high doses of methylprednisolone

55
Q

treatment for compression of SC due to tumors

A

high dose dexamtehasone

56
Q

surgical decompression of the SC

A

of uncertain benefit

57
Q

ALS

A

aka Lou Gherig’s disease; extensive neuro loss, mostly within the SC but also some dementia

58
Q

cause of ALS

A

unkonwn, about 10% genetic

59
Q

what neurons are involved in ALS?

A

alpha motor neurons (LMNs) and also cortical motor nerons and lateral corticospinal tracts

60
Q

what does amyotrophic mean

A

loss of muscle mass from denervation and lateral to the CST dysfunction

61
Q

does ALS cause sensory dysfunction

A

no

62
Q

eye movements in ALS

A

remain normal

63
Q

prognosis of ALS

A

typically fatal within 3-5 years

64
Q

Riluzole

A

retards the speed of deteriortation in ALS somewhat does not reverse it

65
Q

primary lateral sclerosis

A

primaruly lateral CST dysfunction, producing spastiicty and loss of motor control without prominent alpha motor neuron loss

66
Q

SMA

A

spinal muscular atrophies (SMAs) affect primarily the alpha motor neurons; anterior horn cell degeneration

67
Q

Wednig-Hoffman disease

A

an SMA presenting in infancy

68
Q

chiari formation

A

downward protrusion of the medulla with or witout the cerebellum through the foramen magnum

69
Q

dysraphisms

A

failure of proper closure fo the neural tibe can result in tis midline structural deficit

70
Q

Hypertrophy of the filum terminale

A

produces a “tethered cord syndrome” with pain and dysfunction of the SC, esp at lower levels

71
Q

herniated disks most common in what region?

A

cervical

72
Q

treatment of herniated disk

A

surgical removal of the disc, but some extruded disks are reversible on their own with time

73
Q

spondylolisthesis

A

one vertebra displaced onto another

74
Q

lytic lesions of the vertebra

A

from mets; can lead to SC compression

75
Q

a “sensory level to T6” means

A

he can’t feel below T6; means the lesion is at or above this level

Neuro (43 decks)

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