Lec 05: Disorders of the Spinal Cord

Question 1

What is the anatomical extent of the spinal cord?

Answer 1

craniocervical junction (basi-occiput) to nerve roots in the cauda equina

Question 2

What are the two most mobile segments of the spine?

Answer 2

cervical and lumbar

Question 3

Most degenerative spinal diseases are found in which segments of the spine?

Answer 3

cervical and lumbar

Question 4

What are the transitional regions of the spine?

Answer 4

cervicothoracic, thoracolumbar, lumbosacral

Question 5

Which type of vertebra has the smallest vertebral body?

Answer 5

cervical

Question 6

What is the trend in vertebral body size in relation to position?

Answer 6

As we go down, there is increasing size of the bodies because of increasing weight.

Question 7

Which cervical vertebra does not have a body?

Answer 7

C1

Question 8

Which cervical vertebra is the strongest?

Answer 8

C2

Question 9

The odontoid process articulates with?

Answer 9

ring of the atlas (C1)

Question 10

What is the purpose of the transverse atlantal ligament?

Answer 10

connects the dens to the ring of the atlas, preventing transverse displacement of the atlas

Question 11

Which vertebral segment is the least mobile?

Answer 11

thoracic

Question 12

Cervical facets have what angle?

Answer 12

45 degrees

Question 13

Thoracic facets have what angle?

Answer 13

60 degrees

Question 14

Lumbar facets have what angle?

Answer 14

90 degrees

Question 15

What movements are allowed by the lumbar vertebra?

Answer 15

flexion and extension only

Question 16

Which vertebral segment does not have any muscles anteriorly?

Answer 16

thoracic

Question 17

What is the strongest vertebral ligament?

Answer 17

ALL - only ligament that limits extension

Question 18

Which vertebral ligament has pain nerve endings?

Answer 18

PLL

Question 19

The adult spinal cord ends at what level?

Answer 19

L1

Question 20

What are the three levels of the spinal MRI?

Answer 20

cervical, thoracic, and lumbosacral

Question 21

What are the characteristics of Central Cord syndrome?

Answer 21

more extensive motor weakness in the UE than in the LE, typically in patients with hyperextension injuries (UE fibers are located more centrally)

Question 22

What are the characteristics of Anterior Cord syndrome?

Answer 22

motor function deficits, loss of detailed sensation

Question 23

What are the characteristics of Posterior Cord syndrome?

Answer 23

position sense deficit

Question 24

What are the characteristics of Brown-Sequard syndrome? (injury to the lateral half of the spinal cord)

Answer 24

motor paralysis and loss of proprioception are greater ipsilaterally, pain and temperature sensory loss are greater contralaterally

Question 25

What are the characteristics of Conus Medullary syndrome?

Answer 25

combined lower and upper motor neuron deficits, flaccid paralysis (LMN), hyperreflexia (UMN)

Question 26

What is spinal shock?

Answer 26

transient loss of all neurologic function below the level of the spinal cord injury

Question 27

What is the difference between spinal shock and complete cord syndrome?

Answer 27

cord syndromes do not manifest until after 72 hours

Question 28

What are possible spine pathology mimickers?

Answer 28

nerve entrapment syndromes, soft tissue injuries

Question 29

What is the difference between vascular and neurogenic claudication?

Answer 29

vascular claudication - immediate relief upon resting (for surgery) neurogenic claudication - relief in certain positions

Question 30

What is the most common extramedullary tumor?

Answer 30

Schwanomma

Question 31

(T/F) A meningioma commonly presents anteriorly.

Answer 31

T

Question 32

What is the usual location of an ependymoma?

Answer 32

conus medullaris

Question 33

What is a syrinx?

Answer 33

CSF pocket within the spinal cord

Question 34

(T/F) A low-grade astrocytoma is easier to surgically remove than a high-grade astrocytoma.

Answer 34

F

Question 35

When is the posterior approach in surgery used?

Answer 35

lumbar and thoracic tumors

Question 36

What is the difference between a meningocoele and a myelomeningocoele?

Answer 36

meningocoele - csf and meninges in herniation but no neural elements myelomeningocoele - w/ spine

Question 37

What are the 4 stages of disc herniation?

Answer 37

incomplete: degeneration, prolapse complete: extrusion, sequestration