spinal cord

Question 1

function of spinothalamic tract

Answer 1

pain, temp, coarse touch, pressure

Question 2

where do spinothalamic tracts desuccate + which side do they affect

Answer 2

spinal level - contralateral side

Question 3

function dorsal columns

Answer 3

fine touch, vibration, proprioception

Question 4

where do dorsal column tracts desuccate + which side do they affect

Answer 4

brainstem (medulla) - ipsilateral

Question 5

where do UMN legions occur

Answer 5

above anterior horn - spinal cord and brain

Question 6

symptoms UMN

Answer 6

hyperrefelxia, increased tone, no fasculations

Question 7

where do LMN legions occur

Answer 7

ant horn, nerves + muscles

Question 8

LMN symptoms

Answer 8

decreased tone, wasting, fasculations, hyporeflex

Question 9

what tracts are affected in anterior spinal artery infarction

Answer 9

lateral spinothalamic + corticospinal

Question 10

symptoms anterior spinal artery infarction

Answer 10

bilateral spastic paralysis // bilateral loss of pain + temp (vibration + proprioception intact)

Question 11

symptoms complete cord transection

Answer 11

all motor and sensory levels affected below level, UMN signs appear later

Question 12

what is neurogenic shock

Answer 12

cord transection–> interrupted autonomic tract –> increases parasymp / decreased symp –> vasodilation + reduced CO

Question 13

what level does neurogenic shock usually occur

Answer 13

above T5

Question 14

what is spinal shock

Answer 14

acute spinal cord injury –> sudden physiological response –> flaccid paralysis, loss of reflexes, bulbocavernous reflex absent

Question 15

where does autonomic dysreflexia occur + what is it

Answer 15

above T6 // increased thoracic-sacral sympathetic outflow + inhibited parasympathetic

Question 16

what can trigger autonomic dysreflexia

Answer 16

faecal impaction or urinary retention

Question 17

symptoms autonomic dysreflexia

Answer 17

extreme hypertension, sweating, flushing, headache, agitation

Question 18

complication autonomic dysreflexia

Answer 18

haemorrhagic shock

Question 19

mx autonomic dysreflexia

Answer 19

remove stimuli + manage hypertension

Question 20

what is brown sequared syndrome

Answer 20

hemi-section of spine (usually knife)

Question 21

symptoms brown sequared

Answer 21

contralateral spinothalamic loss (pain, temp) // ipsilateral dorsal column (vibration + proprioception) + motor loss

Question 22

symptoms of central cor lesions

Answer 22

bilateral upper limb weakness + cape like spinothalamic sensory loss (power and dorsal columns OK)

Question 23

where do disc herniations usually occur

Answer 23

L4/5 or L5/S1

Question 24

sciatica symptoms

Answer 24

shooting pain buttocks –> knee // straight leg test +ive // absent ankle reflex!!

Question 25

L3/4 herniation symptoms

Answer 25

sensory loss anterior thigh (L3) or ant knee (L4) // wasting quads // reduced knee // positive femoral stretch

Question 26

L5 herniation symptoms

Answer 26

sensory loss posterior thigh + dorsum of foot --> weak foot and toe dorsiflexion // reflexes ok

Question 27

S1 herniation symptoms

Answer 27

posteriorlateral leg + lateral foot // weak plantar flexion // reduced ankle reflex

Question 28

nerve assoc with foot drop

Answer 28

common peroneal

Question 29

invx + mx disc herniation

Answer 29

MRI if no improvement 4-6 weeks // physio + analgesia

Question 30

what is CES

Answer 30

compression cauda equina S2-4

Question 31

causes CES

Answer 31

slippied disc (L4/5 or L5/S1) // tumour, trauma, infection

Question 32

symptoms CES

Answer 32

bilateral sciatica // urinary + rectal incontinence // back pain // saddle anaesthesia // decreased anal tone

Question 33

CES invx

Answer 33

PR + urgent MRI

Question 34

what is degenerative cervical myelopathy

Answer 34

degenerative narrowing of spinal canal --> cord compression

Question 35

causes degenerative cervical myelopathy

Answer 35

smoking, OA, occupation

Question 36

symptoms degenerative cervical myelopathy

Answer 36

neck pain // loss of fine motor function eg buttoning shirt // sensory numbness // autonomic incontinence // hoffmans sign: flick a finger the others twitch

Question 37

invx degenerative cervical myelopathy

Answer 37

MRI

Question 38

mx degenerative cervical myelopathy

Answer 38

urgent ortho referall --> decompressive surgery

Question 39

causes of cervical spondlylosis

Answer 39

wear + tear --> OA --> osteophytes

Question 40

symptoms cervical spondylosis

Answer 40

neck pain // radiculopathy: LMN signs eg hyporeflexia, muscle weakness // myelopathy: UMN signs

Question 41

invx cervical spondlysosis

Answer 41

neck Xray

Question 42

what causes subacute degeneration of the spinal cord

Answer 42

B12 deficiency

Question 43

symptoms subacute degeneration spinal cord

Answer 43

UMN signs in legs. eg brisk knee reflexes, absent ankle // lost joint position + vibration in fingers

Question 44

tracts affected subacute degeneration spinal cord

Answer 44

lateral dorsal column + corticospinal

Question 45

symptoms neoplastic spinal cord compression

Answer 45

1 = back pain // lower limb weakness, sensory changes // neurological signs

Question 46

what level of neoplastic spinal cord compression causes UMN vs LMN

Answer 46

above L1 = UMN // below L1 = LMN

Question 47

invx neoplastic spinal cord compression

Answer 47

MRI within 24 hours

Question 48

mx neoplastic spinal cord compression

Answer 48

high dose dexamethasone

Question 49

what is syringomyelia

Answer 49

collection of CSF in spinal cord

Question 50

tracts syringiomyeloma

Answer 50

spinothalamic + ventral horns (motor)

Question 51

causes syringomyelia

Answer 51

chiari malformation, trauma, tumoujr

Question 52

symptoms syringomyelia

Answer 52

cape like loss of temp (spinothal) eg burn hand and do not realise // weakness lower limbs // neuropathic pain // upgoing plantar // horners syndrome // scoliolosis

Question 53

invx syringiomyelia

Answer 53

spine + brain MRI

Question 54

symptoms of neurosyphillis + tract affected

Answer 54

dorsal columns --> loss of proprioception + vibration

Question 55

what inheritence is friedrechs ataxia

Answer 55

autosomoal recessive (GAA on chromosome 9)

Question 56

spinal tracts friedrechs ataxia

Answer 56

same as subacute degeneration (cortiical, spinocerebellar, dorsal columns)