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Flashcards in Cord compression Deck (26):
1

Name of the main spinal motor tract

Corticospinal tracts (anterior and lateral)

2

Where does the corticospinal tract decussate?

At the medulla- tract is ipsilateral

3

Signs of upper motor neurone lesion (4)

Increased tone
Muscle wasting not marked
No fasciculation
Hyper-reflexia

4

Signs of lower motor neurone lesion (4)

Decreased tone
Muscle wasting
Fasciculation
Absent or reduced reflexes

5

Name of the sensory pathway carrying information relating to pain, temperature and crude touch

Spinothalamic tracts

6

Where does the spinothalamic tract decussate?

At the spinal level

7

Name of the sensory pathway carrying information relating to proprioception, pressure and light touch

Dorsal column/medial lemniscus

8

Where does the dorsal column decussate?

Medulla

9

Four causes of acute spinal cord compression (4)

Trauma
Tumours (collapse or haemorrhage)
Infection
Haemorrhage

10

Three causes of chronic spinal cord compression (3)

Spondylosis
Tumours
Rheumatoid arthritis

11

Initial signs in acute cord transection

Spinal shock- flaccid arreflexic paralysis

12

Describe the symptoms of Brown-Sequard syndrome (3)

Ipsilateral motor level (UMN weakness)
Ipsilateral dorsal column level (proprioception, pressure, light touch)
Contralateral spinothalamic level (pain, temperature, crude touch)

13

How is sensory loss classically experienced in central cord syndrome?

"Cape-like" spinothalamic sensory loss, with preservation of the dorsal columns

14

What usually causes central cord syndrome?

Hyperflexion or extension injury to an already stenotic neck

15

How does central cord syndrome usually present?

Distal upper limb weakness

16

How is traumatic spinal cord damage treated? (4)

Immobilise
Investigate (imaging)
Methylprednisolone
Decompress and stabilise

17

Commonest cause of cord compression

Secondary malignancy

18

Management of spinal cord compression due to malignancy

Dexamethasone whilst considering further treatment e.g. radio, chemo, surgical decompression

19

What is syringomyelia?

Expansion of the central cord canal due to CSF blockage, causing slowly progressive sensory and motor symptoms

20

Symptoms of syringomyelia

Cape-like distribution of pain/temperature sensation loss
LMN signs in upper limbs
Spastic paraparesis of low limbs

21

What is a malformation commonly underlying syringomyelia?

Chiari malformation- extension of the lower part of the brain into the spinal cord

22

Signs suggestive of a root compression (radiculopathy)

Dermatomal distribution of sensory disturbance (pain/tingling/numbness)
LMN pattern of weakness for muscles innervated by the root

23

Below the level of a compressed root, what signs might there be? (2) What do these suggest?

UMN signs (spastic weakness, hyperreflexia, upgoing plantars)
Sensory level
These suggest cord compression starting below the radiculopathy

24

Lhermitte's symptom

Neck flexion producing tingling down the spine- suggestive of cervical spondylosis

25

Worrying symptoms in suspected cord compression (3)

Nocturnal pain
Weight loss
Fever

26

What is radiculopathy?

Compression of the nerve root as it leaves the spinal cord