PDF - Spinal Cord

Question 1

Another name for LMNs?

Answer 1

Anterior horn cells

Question 2

Weakness in LMN lesions?

Answer 2

Can present immediately but atrophy can takes weeks - months to develop

Question 3

What do c5 and C6 innervate?

Answer 3

Deltoids and biceps

Question 4

What do C7/8 Innervated?

Answer 4

Triceps

Question 5

What innervates Tricep?

Answer 5

C7/8

Question 6

What innervates biceps?

Answer 6

C5/6

Question 7

What innervates deltoid?

Answer 7

C5/6

Question 8

What do C8/T1 innervate?

Answer 8

Flexor digitorum

Interoseii

Question 9

What innervates the Flexor digitorum?

Answer 9

C8/T1

Question 10

What innervates the Interossei?

Answer 10

C8/T1

Question 11

What do L2-4 innervate?

Answer 11

Quadriceps

Iliopsoas (hip flexor)

Question 12

What innervates the Quadriceps?

Answer 12

L2-4

Question 13

What innervates the Iliopsoas (hip flexor)?

Answer 13

L2-4

Question 14

What does L4/5 innervate?

Answer 14

Tibialis anterior (foot dorsiflexor)

Question 15

What innervates the tibialis anterior (foot dorsiflexor)?

Answer 15

L4/5

Question 16

What innervates the Gastrocnemius (foot plantar flexor)?

Answer 16

S1/2

Question 17

What does S1/2 innervate?

Answer 17

Gastrocnemius (foot plantar flexor)

Question 18

LMN signs?

Answer 18

1. Severe atrophy w/ milder weakness
2. Fasciculations
3. Decreased Tone
4. Decreased stretch reflexes
5. No babinski
6. No clonus

Question 19

UMN signs?

Answer 19

1. Severe weakness w/ mild atrophy
2. Never fasciculations
3. increased tone / spasticity
4. Increased reflexes
5. Positive Babinski
6. Possible Clonus

Question 20

What is radicular pain?

Answer 20

Lightning, stabbing, shooting or electrical pain in dermatomal distribution of a dorsal root

Question 21

Causes radicular pain?

Answer 21

1. Inflammation: Herpes zoster

2. Extramedullary compression

Question 22

Difference in intra/extramedullary compression of cord?

Answer 22

Extra: Radicular pain
Intra: No pain or diffuse pain

Question 23

Rx Radicular pain?

Answer 23

1. Analgesics
2. Nerve blocks
3. Antidepressants: duloxetine / amitriptyline
4. Anticonvulsants: gabapentin / carbamazepine

Question 24

Presentation spinothalamic lesion?

Answer 24

Pain and temperature deficit in contralateral body

Question 25

What does a A suspended pattern of pain / temp deficit with sacral sparing indicate?

Answer 25

- Intramedullary spinothalamic lesion within spinal cord - Disrupts decussating spinothalamic fibers - Since sacral fibers of spinothalamic are most lateral, they may be spared

Question 26

What does sensory deficit for pain and temperature up to a level with sacral involvement indicate?

Answer 26

Extramedullary lesion arising from outside spinal cord, and typically compressing it: IE, tumor

Question 27

What is a transection?

Answer 27

"Transverse myelopathy" | - Complete or nearly complete lesion encompassing cross-sectional extent of spinal cord

Question 28

Presentation spinal shock?

Answer 28

Weakness may be accompanied by decreased muscle tone and muscle stretch reflexes, with expected UMN signs gradually emerging weeks to months later

Question 29

What can extensive involvement of anterior horn cells at C3, C4 and C5 may cause?

Answer 29

impaired phrenic nerve function causing respiratory failure

Question 30

What is a brown sequard lesion?

Answer 30

- Lesion impacting half of spinal cord - Contralateral deficit to pain and temperature - Involvement of the dorsal or posterior columns produces ipsilateral deficit of vibration / position sense

Question 31

What is syringomyelia?

Answer 31

Spinal cord lesion from a syrinx, or cavity, within center of spinal cord - Dermatomal deficit of pain / temp sparing sacrum "a suspended sensory level with sacral sparing" - Vibration / proprioception spared

Question 32

Presentation anterior spinal artery occlusion?

Answer 32

1. Paraplegia with UMN signs in lower limbs 2. Thoracic level sensory loss, w/o sacral sparing, to pain and temp 3. Vibration / position remain normal 4. Back / radicular pain = common initial symptoms

Question 33

Risks spinal artery occlusion?

Answer 33

1. AAA repair 2. Aortic dissection 3. Atherosclerosis

Question 34

What is this: 1. Paraplegia with UMN signs in lower limbs 2. Thoracic level sensory loss, w/o sacral sparing, to pain and temp 3. Vibration / position remain normal 4. Back / radicular pain = common initial symptoms

Answer 34

Anterior spinal artery occlusion

Question 35

Cause Posterolateral syndrome?

Answer 35

"Subacute combined degeneration" 1. B12 deficiency (most common) 2. Copper deficiency 3. HIV

Question 36

Presentation Subacute combined degeneration?

Answer 36

1. Vibration / position are reduced in lower limbs - Unsteadiness when patient stands or walks in dark 2. Spastic paraparesis from involvement of corticospinal tract 3. Pain / temp not affected

Question 37

What is this: 1. Vibration / position are reduced in lower limbs - Unsteadiness when patient stands or walks in dark 2. Spastic paraparesis from involvement of corticospinal tract 3. Pain / temp not affected

Answer 37

"Subacute combined degeneration"

Question 38

What is ALS?

Answer 38

Degenerative disease where upper / LMNs are selectively and progressively destroyed, for unknown reasons - Lesions occur diffusely, in cortex / stem, as well as cord

Question 39

What is not present in ALS?

Answer 39

1. Sensory impairment 2. Bowel / bladder incontinence 3. Radicular pain

Question 40

Cause Tabes dorsalis?

Answer 40

Syphilis

Question 41

Presentation Tabes Dorsalis

Answer 41

1. Radicular pains in lower limbs 2. Impairment of vibration / position sense in lower limbs 3. Eventual loss of all sensation in lower limbs, where reflexes are lost 4. Strength remains intact

Question 42

What is the following: 1. Radicular pains in lower limbs 2. Impairment of vibration / position sense in lower limbs 3. Eventual loss of all sensation in lower limbs, where reflexes are lost 4. Strength remains intact

Answer 42

Tabes Dorsalis