spinal cord

Question 1

radiculopathy

Answer 1

sensory and motor dysfunction due to an injury to a nerve root

Question 2

radiculopathy pain

Answer 2

1. variable, shooting, burning, tingling, numb

2. radiates into dermatome or myotome

Question 3

radiculopathy exam

Answer 3

1. possible LMN signs–reduced or absent reflexes +/- weakenss
2. localization: determine with root the abnormal muscles and dermatomes have in common

Question 4

common causes of reticulopathy

Answer 4

1. compression by degenerative joint disease (causing bony proliferation) or herniated disc near intervertebral foramen
2. herpes zoster
3. carcinoma
4. lymphoma
5. sarcoidosis

Question 5

Lhermitte’s symptoms

Answer 5

1. neck flexion results in “electric shock” sensation down the back or arms
2. attributed to posterior column disease (MS, disc, B12 deficiency, mass)

Question 6

LMN signs

Answer 6

1. atrophy
2. fasciculations
3. flaccidity–decreased tone
4. decreased or absent DTRs
5. downward plantar response

Question 7

UMN signs

Answer 7

1. spasticity–increased muscle tone
2. hyperreflexia
   up-going plantar response (babinski sign)

Question 8

tracts affected in complete cord transection

Answer 8

All ascending sensory and descending motor/autonomic tracts

Question 9

deficits in complete cord transection

Answer 9

1. Sensory + motor levels below the lesions

2. May also have root signs at the site

Question 10

tracts affected in central lesions

Answer 10

initially involve crossing spinothalamic tract

Question 11

deficits in Central lesions

Answer 11

1. Pain/temp loss at level of lesion, with sparing of position sense
2. Cape-like distribution if in C-spine

Question 12

tracts affected in posterior column syndrome

Answer 12

PCML

Question 13

deficits in the posterior column syndrome

Answer 13

bilateral loss of position and vibration sense

Question 14

tracts affected in Combined anterior horn cell-pyramidal tract syndrome

Answer 14

Corticospinal tract and LMN cells in the cord

Question 15

deficits in Combined anterior horn cell-pyramidal tract syndrome

Answer 15

loss of bilateral strength

Question 16

tracts affected in Brown sequard

Answer 16

1. Crossed spinothalamic tract
2. Uncrossed PCML
3. Crossed Corticospinal tract

Question 17

deficits in brown sequard

Answer 17

Below lesion: contralateral pain and temp + ipsilateral position and strength

Question 18

tracts in Posteriolateral Column Syndrome

Answer 18

PCML & Corticospinal tract

Question 19

deficits in Posteriolateral Column Syndrome

Answer 19

Bilateral loss of position, vibration, and strength

Question 20

tracts in anterior horn cell syndrome

Answer 20

no tract, just LMN

Question 21

deficits in anterior horn cell syndrome

Answer 21

bilateral loss of strength

Question 22

tracts affected in Anterior Spinal Artery Occlusion

Answer 22

1. STT

2. CST

Question 23

deficits in Anterior Spinal Artery Occlusion

Answer 23

1. Bilateral loss of strength, pain, and temp

2. Sparing of position sense

Question 24

deficits in Pyramidal Tract Syndrome

Answer 24

1. Bilateral UMN weakness with spastic gait
2. Increased DTRs
3. Complete sparing of all sensory tracts and bladder function

Question 25

tracts affected in Pyramidal Tract Syndrome

Answer 25

CST

Question 26

tracts involved in Myelopathy with Radiculopathy

Answer 26

Any of all 3 tracts, especially the corticospinal tract

Question 27

deficits in Myelopathy with Radiculopathy

Answer 27

1. Bilateral UMN syndrome with spastic gait 2. increased DTRs 3. Ipsilateral or contralateral root signs 4. Possible bladder dysfunction