Spinal Cord Disease Flashcards Preview

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Flashcards in Spinal Cord Disease Deck (18):
1

spinal cord compression px

-spinal cord TENDERNESS
-hyperreflexive DTRs (no inhibition from UMN)
-sensory loss below that level
-incontinence

2

spinal cord compression causes

-cancer
-epidural abscess (fever)
-hematoma (trauma)

3

spinal cord compression tx

-steroids = best initial (dexamethasone, dec inflammation)

-radiotherapy (tumors)
-surgical decmpression (herniation, abscess, hematoma)

4

spinal cord compression dx

-CXR = best initial
-MRI
-biopsy = most accurate
-CT myelogram (when MRI unavailable)

5

syringomyelia is..

-fluid filled cavity at center of spinal cord
-cervical spine often

6

syringomyelia causes

-congenital: Arnold-Chiari malformation

-acquired: trauma (whiplash), tumors

7

syringomyelia dx

MRI = most accurate

8

syringomyelia px

-loss of nocioception (pain & temp) BILATERALLY
(cape-like distribution)
-dec strength
-absent reflexes

-proprioception
-no spinal tenderness

9

syringomyelia tx

surgical decompression

10

subacute combined degeneration cause & tx?

-B12 deficiency

-B12 replacement

11

vitamin B12 deficiency px

-peripheral neuropathy
-weakness
-ovalocytes (oval shaped RBCs)
-megaloblastic anemia
-inc LDH
-inc bilirubin
(normal retic count)
-inc methylmalonic acid

12

macrocytic vs megaloblastic

macrocytic = high MCV

megaloblastic = hyper segmented neutrophils (B12 and folate deficiencies)

13

subacute combined degeneration px

-POSTERIOR COLUMN --> loss of positional & vibratory sensation
-CORTICOSPINAL TRACT --> weakness, spastic paresis

-peripheral neuropathy
-high bilirubin, high LDH

14

posterior column deficit causes?

-syphilis
-subacute combined degeneration

15

causes of B12 deficiency

-lack of intrinsic factor (secreted from parietal cells)
-malabsorption in ileum
-dietary deficiency

16

anterior spinal artery occlusion px

-anterior spinal cord infarct --> weakness, pain & temp loss, autonomic loss
-flaccid --> spastic paresis

-proprioception INTACT

17

anterior spinal artery occlusion tx

none
(supportive)

18

Brown-Sequard syndrome =

hemisection of spinal cord -->

-contralateral loss of nocioception (pain & temp)
-ipsilateral proprioception (vibration) loss

-no tx