Neurology- Spinal cord lesions- Pathoma Flashcards Preview

STEP1 2014 > Neurology- Spinal cord lesions- Pathoma > Flashcards

Flashcards in Neurology- Spinal cord lesions- Pathoma Deck (21):
1

spinal cord tracts (list 4)

-spinothalamic (pain and temperature sensation)
-dorsal column- medial lemniscus (pressure, touch, vibration, and proprioception)
-lateral corticospinal (voluntary movement)
-hypothalamospinal (sympathetic input of the face)

2

spinothalamic (pain and sensation)
first- order neuron

peripheral nerves to posterior horn; cell body in dorsal root ganglion

3

spinothalamic (pain and sensation)
second- order neuron

arises from posterior horn, immediately crosses over in anterior white commmissure, and ascends via the spinothalamic tract to the thalamus

4

spinothalamic (pain and sensation)
third- order neuron

thalamus to cortex

5

Dorsal column- medial lemniscus (pressure, touch, vibration, and proprioception)
first- order neuron

peripheral nerves to medulla via dorsal column; cell body is in dorsal root ganglion

6

Dorsal column- medial lemniscus (pressure, touch, vibration, and proprioception)
second- order neuron

arises from medulla, crosses over, asvends via the medial lemniscus to thalamus

7

Dorsal column- medial lemniscus (pressure, touch, vibration, and proprioception)
third- order neuron

thalamus to cortex

8

Lateral corticospinal (voluntary movement)
first- order neuron

pyramidal neurons in cortex descend, cross over in medullary pyramids, and synapse on the anterior motor horn of the neuron (upper motor neuron)

9

Lateral corticospinal (voluntary movement)
second- order neuron

arises from the anterior motor horn and synapses on muscle (lower motor neuron)

10

Lateral corticospinal (voluntary movement)
third order neuron

haha jk. there are only 2 neurons in this tract

11

Hypothalamospinal (sympathetic input of the face)
first- order neuron

arises from the hypothalamus and synapses on the lateral horn at T1

12

Hypothalamospinal (sympathetic input of the face)
second- order neuron

arises from the lateral horn at T1 and synapses on the superior cervical ganglion (sympathetic)

13

Hypothalamospinal (sympathetic input of the face)
third- order neuron

superior cervical ganglion to eyelids, pupil, skin of face

14

Syringomyelia- what is it?

cystic spinal cord degeneration secondary to trauma or Arnold- Chiari malformation

15

Syringomyelia- where does it happen?

Usually C8-T1
Presents as sensory loss of pain and temperature. Fine touch and position sense are spared in the upper extremities (cape- like distribution) due to involvement of the anterior white commissure of the apinothalamic tract. Dorsal column is spared

16

Syringomyelia- complications

Other spinal tracts, aside from the spinothalamic tract, become involved when the syrinx expands. When LMN of anterior horn is damaged, the patient may experience muscle atrophy, weakness, decreased muscle tone, impaired reflexes.
When the lateral horn of the hypothalamospinal tract is damaged, there is Horner Syndrome

17

Horner Syndrome

ptosis, miosis, anhidrosis due to disruption of the hypothalamospinal tract

18

Poliomyelitis- where does it occur?

anterior motor horn due to poliovirus infection (feco-oral transmission followed by hematogenous spread to the spine)

19

Poliomyelitis- how does it present?

lower motor neuron signs- flaccid paralysis with muscle atrophy, fasciculations, weakness with decreased muscle tone, impaired reflexes

20

Werdnig-Hoffman- what is the pattern of inheritance?

autosomal recessive degeneration of the anterior motor horn

21

Werdnig- Hoffman- how does it present?

"floppy baby" death by age 2