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Flashcards in Spinal Cord Deck (24):
1

Refers to the collection of posterior and anterior roots that occupy the lumbar cistern

Cauda equina

2

SPINAL CORD
- held in position by the denticulate ligaments on each side and filum terminale inferiorly
- segmented and paired posterior/sensory and anterior/motor roots corresponding to each segment of the cord leave the vertebral canal through the intervertebral foramina
- shorter than the vertebral column and terminates in the adult at the level of the lower border of the first lumbar vertebra
- basically, gray and white matter and a central canal

SPINAL CORD
- held in position by the denticulate ligaments on each side and filum terminale inferiorly
- segmented and paired posterior/sensory and anterior/motor roots corresponding to each segment of the cord leave the vertebral canal through the intervertebral foramina
- shorter than the vertebral column and terminates in the adult at the level of the lower border of the first lumbar vertebra
- basically, gray and white matter and a central canal

3

POSITIONAL CHANGES OF THE SPINAL CORD
In the embryo - entire length of vertebral canal
Vertebral column and dura mater grow more rapidly.
Six months AOG - ___
Birth - ___
Adult - L1

POSITIONAL CHANGES OF THE SPINAL CORD
In the embryo - entire length of vertebral canal
Vertebral column and dura mater grow more rapidly.
Six months AOG - S1
Birth - L3
Adult - L1

4

Fasciculus gracilis is present in all segments of the spinal cord.
Fasciculus cuneatus is present only in __________ and __________ segments of the spinal cord.
The lateral horn is absent in _________ and ________ segments of the spinal cord.

Fasciculus gracilis is present in all segments of the spinal cord.
Fasciculus cuneatus is present only in cervical and thoracic segments of the spinal cord.
The lateral horn is absent in cervical and sacral segments of the spinal cord.

5

COLUMNS IN WHITE MATTER
1. Ascending tract
-- Anterolateral System
----- Spinothalamic tract
--------- ________ STT - touch, pressure
--------- ________ STT - pain, temperature
-- Dorsal/posterior column
2. Descending tract
3. Intersegmental tracts

COLUMNS IN WHITE MATTER
1. Ascending tract
-- Spinothalamic tract
----- Anterior STT - touch, pressure
----- Lateral STT - pain, temperature
-- Dorsal/posterior column
2. Descending tract
3. Intersegmental tracts

6

______________ Syndrome
- spinal cord hemisection
- features:
--- contralateral loss of pain and temperature
--- _____________ loss of proprioception
--- _____________ manifestations of upper and lower motor neuron lesions

Brown-Sequard Syndrome
- spinal cord hemisection
- features:
--- contralateral loss of pain and temperature
--- ipsilateral loss of proprioception
--- ipsilateral manifestations of upper and lower motor neuron lesions

7

______________ / _____________
- progressive cavitation around the central canal
- loss of ___________ and ___________ sensations in hands and forearm (common in cervical)

Syringomyelia / Central Cord Syndrome
- progressive cavitation around the central canal
- loss of pain and temperature sensations in hands and forearm (common in cervical)

8

________________
- attacks the anterior horn cells leading to lower motor neuron lesion

Poliomyelitis

9

______________
- caused by neurosyphilis
- dorsal root involvement with secondary degeneration of dorsal columns (loss of vibration and position senses)

Tabes Dorsalis

10

_________________
- pure motor disease involving the degeneration of anterior horn cells (lower motor neuron lesion) and corticospinal tract (upper motor neuron lesion); no sensory loss

Amyotrophic lateral sclerosis

11

__________________
- caused by vitamin B12 deficiency
- degeneration of posterior and lateral columns (loss of position sense and vibration in legs associated with UMNL)

Subacute combined degeneration
- caused by vitamin B12 deficiency
- degeneration of posterior and lateral columns (loss of position sense and vibration in legs associated with UMNL)

12

The spinal lemniscal pathway carries to the cerebral cortex proprioception information from receptors for position sense, kinesthesia, and tactile discrimination.

Clinical Signs of Injury to the Lemniscal Pathway
- inability to recognize limb position
- astereognosis
- loss of two-point discrimination
- loss of vibratory sense
(+) ___________ sign
---- A patient can stand with feet together with eyes open but sways and falls when the eyes are closed
---- indicates absence of __________ sense in the lower limbs

The spinal lemniscal pathway carries to the cerebral cortex proprioception information from receptors for position sense, kinesthesia, and tactile discrimination.

Clinical Signs of Injury to the Lemniscal Pathway
- inability to recognize limb position
- astereognosis
- loss of two-point discrimination
- loss of vibratory sense
(+) Romberg sign
---- A patient can stand with feet together with eyes open but sways and falls when the eyes are closed
---- indicates absence of position sense in the lower limbs

13

______________ / ______________ / _______________
- a disorder in which the patient has a constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain, resulting in tissue ischemia and necrosis
- characterized by sensory deficits affecting the trunk (torso) and extremities on the opposite side of the infarction and sensory deficits affecting the face and cranial nerves on the same side with the infarct. Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face. This CROSSED FINDING is diagnostic for the syndrome.

Lateral medullary syndrome
Wallenberg syndrome
Posterior inferior cerebellar artery syndrome

14

______________
- tract of nerves in the spinal cord that primarily transmits information from the arms
- part of the posterior column-medial lemniscus pathway.

______________
- bundle of axon fibers in the posterior column-medial lemniscus pathway of the spinal cord and carries information from the middle thoracic and lower limbs of the body
- one of many ascending tracts, which carry received sensory information to the brain via the spinal cord.

cuneate fasciculus / fasciculus cuneatus / tract of Burdach
gracile fasciculus / fasciculus gracilis / tract of Goll

15

A 23 y/o is brought to the ER from a site of an automobile collision. Neurologic examination reveals weakness of the right lower extremity and loss of pain and thermal sensations on the left side beginning at the level of the umbilicus.
I) Damage to which of the following tracts would correlate with weakness of the lower extremity of this man?
A. Left lateral corticospinal tract
B. Left fasciculus gracilis
C. Right lateral corticospinal tract
D. Right fasciculus gracilis
II) Which of the following represents the most likely damage to the spinal cord resulting from fracture to the vertebral column of this man?
A. T8 on the left
B. T8 on the right
C. T10 on the left
D. T10 on the right

C. Right lateral corticospinal tract
B. T8 on the right

16

Anterolateral System
- There is loss of pain and thermal sensations on the contralateral side about _____ segments below the level of the lesion.

Anterolateral System
- There is loss of pain and thermal sensations on the contralateral side about 1-2 segments below the level of the lesion.

17

QUADRIPLEGIA: Bilateral cervical spinal cord damage at _______ may result in paralysis of all four extremities.

MONOPLEGIA: Unilateral spinal cord lesions in thoracic levels may result in paralysis of the ipsilateral lower extremity.

PARAPLEGIA: If the thoracic spinal cord damage is bilateral, both lower extremities may be paralyzed.

QUADRIPLEGIA: Bilateral cervical spinal cord damage at C4-C6 may result in paralysis of all four extremities.

MONOPLEGIA: Unilateral spinal cord lesions in thoracic levels may result in paralysis of the ipsilateral lower extremity.

PARAPLEGIA: If the thoracic spinal cord damage is bilateral, both lower extremities may be paralyzed.

18

LUMBAR PUNCTURE / SPINAL TAP
- patient on the side with vertebral column well flexed
- above or below ____ lumbar spine
- lies within imaginary line between highest points on iliac crest

Accurate sequence of layers from skin to the subarachnoid space: _________

4th

Skin, superficial fascia, supraspinous ligament, interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid, subarachnoid space containing CSF

19

A herniation of a cervical intervertebral disc is most likely to occur between _______.

C5-C6

20

A right posterolateral herniation of the disc between vertebrae C5 and C6 will impinge on the right C__ spinal nerve.
A herniation of the disc between the L5 and S1 vertebrae will impinge on the ___ spinal nerve, which exits between the S1 and S2 vertebrae.

6
S1

21

REFLEX / sensation -- SPINAL ROOT
Patellar tendon reflex / medial aspect of leg -
Achilles' tendon reflex / lateral aspect of foot -

L4
S1

22

A patient was examined and neurologic examination revealed a strong muscle function of the flexors of the thigh but with weakness of the hamstrings, a lesion occurred at which spinal cord level?

L5 or S1

Hamstring muscles are primarily innervated by the L5 and S1 roots.

23

A herniating intervertebral disc takes the path of least resistance, which is ____________.
The posterior part of the annulus fibrosus is weaker than its anterior margin.
The posterior longitudinal ligament is narrower and weaker than the anterior.

posterolateral

24

SPINA BIFIDA
- non-fusion of the embryonic halves of the vertebral arches

Spina Bifida Occulta
- frequently in ___ or ___; no clinical manifestation, just a presence of small dimple with a tuft of hair

Spina Bifida Cystica
- severe type
Spina bifida with _____________ - contains meninges with CSF
Spina bifida with _____________ - spinal cord and/or nerve roots included
Spina bifida with _____________ - most severe type; spinal cord in the affected area is open because the neural folds failed to fuse

SPINA BIFIDA
- non-fusion of the embryonic halves of the vertebral arches

Spina Bifida Occulta
- frequently in L5 or S1; no clinical manifestation, just a presence of small dimple with a tuft of hair

Spina Bifida Cystica
- severe type
Spina bifida with meningocele - contains meninges with CSF
Spina bifida with meningomyelocele - spinal cord and/or nerve roots included
Spina bifida with myeloschisis - most severe type; spinal cord in the affected area is open because the neural folds failed to fuse