Spinal Cord Injuries

Question 0

Site that spinal nerves are most vulnerable

Answer 0

When emerging from intervertebral foramina

Question 1

Most serious site of vertebral fracture and reason for this

Answer 1

C3-C5

Due to phrenic nerve roots which are needed for respiration

Question 2

Definition of sciatica

Answer 2

Lumbar disc herniation causing referred pain down L5 and S1 dermatomes

Question 3

Diseases that involve posterior nerve roots

Answer 3

Herpes zoster

Tabes dorsalis

Question 4

Risk to spinal nerves in spinal canal

Answer 4

• Compression from tumours of column

* Irritation from abnormal CSF constituents eg. Blood

Question 5

Risk to spinal nerves in intervertebral foramina

Answer 5

• Herniated intervertebral disc
• Vertebral tumour
• Fracture dislocation

Question 6

Result of posterior root lesion

Answer 6

Pain in skin and muscles

Question 7

Result of anterior root lesion

Answer 7

Full paralysis in supplied muscle causing atrophy and fasciculation

Question 8

Result of injury to spinothalamic tract

Answer 8

Contralateral pain, temperature, crude touch and pressure loss

Question 9

Result of injury to d.c.m.l pathway

Answer 9

Ipsilateral conscious proprioception, tactile discrimination, vibration loss

Question 10

Result of injury to monosynaptic reflex arc

Answer 10

Loss of muscle tone

Question 11

Result of lesion to corticospinal tract

Answer 11

• Babinski sign
• Absent superficial abdominal reflexes
• Loss of fine-skilled voluntary motor movements

Question 12

Result of lesion to extrapyramidal tracts

Answer 12

• Severe paralysis with little atrophy
• Spasticity and hypertonicity
• Exaggerated deep reflexes and clonus
• Clasp knife reaction

Question 13

Result of lower motor neuron lesions

Answer 13

• Flaccid paralysis
• Atrophy
• Reflex loss
• Fasciculation
• Muscular contraction
• Degeneration reaction

Question 14

Definition of hemiplegia

Answer 14

Paralysis of one side of the body

Question 15

Definition of monoplegia

Answer 15

Paralysis of one limb

Question 16

Definition of diplegia

Answer 16

Paralysis of corresponding limbs

Question 17

Definition of paraplegia

Answer 17

Paralysis of lower two limbs

Question 18

Definition of quadriplegia

Answer 18

Paralysis of all four limbs

Question 19

Definition of hypotonia

Answer 19

Decreased or absent muscle tone

Question 20

Cause of hypotonia

Answer 20

• Interruption to monosynaptic reflex

* Cerebellar conditions

Question 21

Definition of hypertonia

Answer 21

Increased muscle tone seen in spasticity or rigidity

Question 22

Cause of hypertonia

Answer 22

Lesions involving supraspinal centres/tracts not involving corticospinal tract

Question 23

Definition of tremor

Answer 23

Rhythmic involuntary movements due to contraction of opposing muscle groups

Question 24

Types of tremor and their causes

Answer 24

* Resting tremor: basal ganglia disorder | * Intention tremor: Cerebellar disorder

Question 25

Definition of chorea and its cause

Answer 25

* Continuous rapid, involuntary, jerky, purposeless movement | * Caused by corpus striatum lesions

Question 26

Definition of myoclonus and its cause

Answer 26

* Sudden contraction of isolated muscle/muscle part | * Reticular formation and/or Cerebellar dysfunction

Question 27

Causes of chronic cord compression

Answer 27

* Disc herniation * TB infection of vertebrae * Primary/secondary tumours * Abscesses

Question 28

Clinical signs of chronic cord compression

Answer 28

* Pain * Interference to motor function * Sensory loss

Question 29

What is spinal cord syndrome?

Answer 29

* acute Response to severe spinal cord damage * All cord functions below lesion are lost or decreased * depressed segmental spinal reflexes

Question 30

Signs of complete cord transaction syndrome

Answer 30

1. Bilateral lower motor neuron paralysis and muscle atrophy in lesion segment 2. Bilateral spastic paralysis below lesion 3. Bilateral sensory loss below lesion 4. Loss of voluntary bladder and bowel control

Question 31

Causes of anteroom cord syndrome

Answer 31

* Contusion of cord during vertebral fracture * Ischaemia * Herniated vertebral disc

Question 32

Symptoms of anterior cord syndrome

Answer 32

1. Bilateral lower motor neuron paralysis and muscular atrophy in lesion region 2. Bilateral spastic paralysis below lesion level (extrapyramidal/ant. c.spinal) 3. Bilateral loss of crude touch, pain, temp below lesion (spinothalamic)

Question 33

Main cause of central cord syndrome

Answer 33

Hyperextension of cervical spine

Question 34

Symptoms of central cord syndrome

Answer 34

1. Bilateral lower motor neuron paralysis and muscular atrophy in lesion region 2. Bilateral spastic paralysis below lesion with sacral sparing 3. Bilateral loss of crude touch, pain, temp, pressure with sacral sparing

Question 35

Cause of Brown-Sequade syndrome/cord hemisection

Answer 35

* Vertebral column fracture dislocation * Trauma * Tumour

Question 36

Symptoms of Brown-Sequade syndrome/cord hemisection

Answer 36

1. Ipsilateral lower motor neuron paralysis and muscular atrophy in lesion region 2. Ipsilateral spastic paralysis below lesion level 3. Ipsilateral band of cutaneous anaesthesia in lesion segment 4. Ipsilateral loss of tactile discrimination vibration and conscious proprioception below lesion level 5. Contralateral loss of pain, temp, crude touch, pressure

Question 37

Cause of syringomyelia

Answer 37

CSF cyst in central canal causing gliosis

Question 38

Symptoms of syringomyelia

Answer 38

1. Loss of pain, temp, crude touch, pressure in dermatomes both sides of lesion 2. Lower motor neuron weakness present in small muscles of hand

Question 39

Cause of Poliomyelitis and consequences

Answer 39

* Viral infection of anterior grey column neurons | * Causes motor nerve cell death resulting in paralysis and muscle wasting

Question 40

Definition of multiple sclerosis

Answer 40

Demyelination of ascending and descending tracts

Question 41

Clinical signs of multiple sclerosis

Answer 41

* Limb weakness * Ataxia due to Cerebellar involvement * Spastic paralysis

Question 42

Areas affected by amylotrophic lateral sclerosis

Answer 42

* Corticospinal tracts | * Motor neurons of anterior grey horn

Question 43

Clinical signs of amylotrophic lateral sclerosis

Answer 43

* Lower motor neuron: progressive muscular atrophy, paresis, fasciculations * Upper motor neuron: paresis, spasticity, Babinski response