Spinal cord Dysfunction Flashcards
Name some descending motor tracts of the spinal cord
- Lateral Corticospinal Tract
- Pontine Reticulospinal tract
- Vestibulospinal Tract
- Tectospinal tract
- Anterior corticospinal tract
What would you see in LMN injury?
Reduced Tone Reduced reflexes Muscle atrophy Flaccid Fasciculations May have sensory disturbrances
what would you see in UMN injury?
Spasticity Increased tone Increased muscle stretch reflexes minimal atrophy NO. fasciculations
What would happen if you damaged the lateral corticospinal tract?
Are they upper or lower MNs?
Ipsilateral: Paralysis Paresis hyperreflexia Clonus Babinkskis sign
What would happen if you damaged Spinal Motor Neurons? Are they UMN or LMN
paralysis paresia Hypotonia Hyporeflexia fibrillations muscle atrophy
explain the process of urinary storage from the PONS
pons storage centre ->pelvic nerve
OR -> external bladder, inhibition of detrusor
&
- > pudendal nerve -> external urethral sphincter
What are the main causes of spinal cord syndromes
- Extra axial : extra dural or intradural
b. Extradural: Structures related to the vertebral column
c. Intradrual: meningeal based - Axial: arising within the spinal cord
Name some common spinal cord syndromes
- Complete sensorimotor myelopathy
- Combined painful radiculopathy and transverse myelopathy
- hemi-cord (brown sequard) syndrome
- …
…
What is Brown Sequard Syndrome
lateral hemisection (cutting) of the spinal cord- causing SENSATION and MOTOR function loss (paralysis and anesthesia)
What ipsilateral signs would you see?
Interruption of the LATERAL CORTICOSPINAL TRACTS:
Ipsilateral spastic paralysis below the level of the lesion
Babinski sign ipsilateral to lesion
Abnormal reflexes and Babinski sign may not be present in acute injury.
Interruption of DORSAL COLUMN/MEDIAL LEMN PATHWAY:
Ipsilateral loss of tactile discrimination, vibratory, and position sensation below the level of the lesion
What contralateral signs would you see?
Spinothalamic tract: loss of pain and temp and crude touch
Whats the difference in symptoms between an EARLY central cord lesion and a LATE central cord lesion? think location
EARLY lesion- would be very central- only get spinothalamic fibres which are crossing over:ie. crude touch, pain and temp from within 1 spinal segment, so only some loss
LATE: crossing spinothalamic fibres and motor tract neurons would be involved
Vitamin B12 related myopathy
Combined system degeneration- ESPECIALLY:
Posterior column/medial lemniscal pathway AND
UMN signs
What is the CAUDA EQUINA?
What is cauda equina syndrome?
L2-L5, Coxygeal and sacral nerves - >originate from the CONUS meularis of the spinal cord
CES is acute loss of function of CE causing acute loss of function of the lumbar plexus, (nerve roots) of the spinal canal below the termination (conus medullaris) of the spinal cord. CES is a lower motor neuron lesion.
What do you see in CES?
Sciatic and nerve root pain
Bilateral and asymmetric, atrophic paralysis
Radocicular sensory loss and sphincteric disorder
->Severe back pain, saddle anesthesia, incontinence and sexual dysfunction are considered “red flags”
