Spinal Cord Morphology and Lesions - 4/21 Stephens

Question 1

What structure may be compromised secondary to Thoracolumbar fracture or surgical repair of AAA?

Major supply to what?

Answer 1

Anterior artery of Adamkiewicz

Inferior 2/3 of the spinal cord

Question 2

Which areas of the spinal cord are most vulnerable to ischemic necrosis of the spinal cord?

Answer 2

C2-3, T1-4, L1

Question 3

Disruption of blood flow to what results in central cord syndrome?

Answer 3

Anterior spinal artery

Question 4

What arteries supply the peripheral margins of the cord?

Answer 4

Posterior spinal arteries (2)

Radicular arteries

Question 5

Gamma motor neurons are directly influenced by what tracts?

Output from the gamma motor neuron innervates what?

Answer 5

RF (reticulospinal)
Rubrospinal
Corticospinal

Intrafusal muscle fibers

Question 6

Alpha and gamma neurons are what?

Answer 6

LMN

Question 7

Location of SG?

Fx?

Sends fibers to?

Answer 7

Posterolateral tip of dorsal horn at all spinal levels

Pain/temp

LSTT

Question 8

Location of NP?

Fx?

Sends fibers to?

Answer 8

Mid-portion of dorsal horn

Pain/temp

FP

Question 9

Location of Nucleus Dorsalis?

Fx?

Sends fibers to?

Answer 9

Dorsal horn C8-L2

Unconscious proprio pathway

DSCT

Question 10

Location of VAN?

Fx?

Sends fibers to?

Answer 10

T1-L2 and S2,3,4

Visceral sensory integration and reflex center

Intermediolateral gray, ventral horn, hypothalamus via RF

Question 11

Location of IG?

Fx?

Sends fibers to?

Answer 11

Between dorsal and ventral horns at all spinal levels

Sensorimotor integration center

Ventral horn

Question 12

The Medial Motor Cell Column is located where?

Innervates what?

Answer 12

Medial parts of ventral horn, all levels

Axial musculature

Question 13

The Lateral Motor Cell Column is located where?

Innervates what?

Answer 13

Lateral part of ventral horn in the regions of the cervical and lumbosacral enlargements

Muscles of the extremities

Question 14

Phrenic Nucleus is located where?

Innervates what?

Answer 14

C3-5, subdivision of the MMCC

Respiratory diaphragm

Question 15

Spinal Accessory Nucleus is located where?

Innervates what?

Answer 15

C1-6, continuous with the nucleus Ambiguus in the medulla

SCM, traps

Question 16

Intermediolateral Nucleus is located where?

Innervates what?

Answer 16

Lateral horn T1-L2

PRE-gang Symp fibers to visceral structures

Question 17

SAN Nucleus is located where?

Innervates what?

Answer 17

Lateral horn S2-4

PRE-gang PS fibers to bowel and bladder

Question 18

Sensory Dermatome spinal cord segment:

little finger, elbow?

Nipple?

Inguinal region?

Answer 18

T1

T4

L1

Question 19

Sensory Dermatome spinal cord segment:

Thumb

Big Toe

Little toe

Perianal region

Answer 19

C5

L5

S1

S5

Question 20

Motor Dermatome Reflexes spinal cord segment:

Brachialis

Triceps

Muscle of the hand

Gastroc m.

Answer 20

C6-7

C6-8

C8-T1

L5-S2

Question 21

Motor Dermatome Reflexes spinal cord segment:

Quadriceps Femoris

Scapular

Abdominal

Answer 21

L2-4

C5-T1

T8-12

Question 22

Motor Dermatome Reflexes spinal cord segment:

Epigastric

Cremasteric

Superficial Anal

Answer 22

T7-9

L1-2

S4-Co1

Question 23

What important structure is located at the level of L1?

Answer 23

Conus medullaris

Question 24

Spinal Cord Injury C1-4 results in what?

Answer 24

Disruption of phrenic nucleus and respiratory depression or arrest

Question 25

Spinal cord injury above T1 results in what?

Answer 25

Horner's syndrome if lesions to the reticulospinal fibers descending to the intermediolateral cell column at T1

Question 26

Spinal cord injury above T2 results in what?

Answer 26

Sweating and vasomotor disturbances of the body

Question 27

Rocking horse type of respiration is due to what injury?

Answer 27

C5-T6

Question 28

Incontinence is due to a lesion where? Results in what?

Answer 28

S3-5 Flaccid anal sphincter tone w/bowel incontinence

Question 29

Lesions above where result in reflex bladder?

Answer 29

S2

Question 30

Brown-Sequard Syndrome results from what?

Answer 30

Unilateral transverse lesion or hemisection of the spinal cord due to a knife or bullet wound, or to a meningioma

Question 31

What characterizes Brown-Sequard Syndrome?

Answer 31

Ipsilateral loss of proprioception and vibratory sensations from the body below level of lesion - bc of post column Ipsilateral spastic paralysis below lesion bc destruction of descending motor tracts Contralateral loss of pain/temp from the body 2 segments below lesion due to destruction of LSTT

Question 32

Macrocytic anemia causes what? How can Macrocytic anemia result?

Answer 32

Degeneration of the posterior columns and pyramidal tracts and polyneuropathy Atrophy of mucosal lining w/out intrinsic factor, therefore no absorption of vitamin B12

Question 33

Signs of Subacute combined degeneration?

Answer 33

Numbness and tingling in fingers and toes (glove and stocking) Bilateral loss of prop/vibratory sensation UMN signs - Babinski, hyperreflexia, spastic paralysis