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spinal cord unit Flashcards

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1
Q
A
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2
Q

What is the anatomical extent of the spinal cord?

A

The spinal cord extends from the medulla to vertebral level L1-L2

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3
Q

Does the spinal cord extend the entire length of the vertebral column?

A

No, it does not extend the entire length of the vertebral column

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4
Q

What is the cauda equina?

A

A bundle of nerve roots that continues from the spinal cord

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5
Q

What is the filum terminale?

A

An extension of the pia mater that anchors the spinal cord to the coccyx

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6
Q

How many regions is the spinal cord divided into?

A

Four regions

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7
Q

What type of matter does the spinal cord include?

A

Both gray matter and white matter

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8
Q

What are the differences in spinal cord levels?

A

Cervical and lumbar levels have more gray matter for limbs; thoracic levels have a lateral horn

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9
Q

What is the function of the dorsal horn?

A

Related to afferent sensory information

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10
Q

What is the function of the ventral horn?

A

Related to efferent motor information

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11
Q

Where are motor neurons located?

A

In the ventral horn

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12
Q

What is the intermediate zone?

A

An overlapping region between the dorsal and ventral horns made of gray matter

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13
Q

What is the laminar organization of spinal gray matter?

A

Gray matter has a laminar organization (I-X), with laminae I-VI generally being sensory

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14
Q

What is Lissauer’s tract?

A

Part of lamina I, carrying nociceptive information through thinly myelinated and unmyelinated C fibers

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15
Q

What is the role of the marginal zone in gray matter?

A

Contributes to the lateral spinothalamic tract

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16
Q

What does the substantia gelatinosa contribute to?

A

Anterior and lateral spinothalamic tract

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17
Q

What is the function of the nucleus proprius?

A

Projects to the thalamus via the spinothalamic tract and to the cerebellum via the ventral spinocerebellar tract

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18
Q

What is the dorsal nucleus of Clarke?

A

Only found in segments C8-L3, forming the dorsal spinocerebellar tract

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19
Q

What is the function of the intermediolateral nucleus?

A

Receives viscerosensory information and contains preganglionic sympathetic neurons

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20
Q

How are motor neurons organized in the anterior horn?

A

Medially for proximal limb and axial muscles, laterally for distal muscles

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21
Q

What is somatotopy?

A

Representation of body regions in the organization of white matter

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22
Q

What are the main ascending pathways?

A
  • Dorsal column-medial lemniscal pathway
  • Spinothalamic pathway
  • Spinocerebellar pathways
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23
Q

What is the function of the dorsal column-medial lemniscal pathway?

A

Transmits fine touch, vibration, two-point discrimination, proprioception, and kinesthesia

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24
Q

What occurs if there is a lesion in the right cuneate nucleus?

A

Ipsilateral UE sensation loss (arm, trunk region)

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25
What is the spinothalamic pathway responsible for?
Transmits sharp (noxious) pain, temperature, and crude touch
26
What happens if there is a lesion in the left thalamus?
Contralateral absence of feeling to noxious stimuli (pain, temp, pressure)
27
What are the spinocerebellar pathways responsible for?
Transmit afferent proprioceptive information for coordination and postural control
28
How does the lateral corticospinal tract function?
Controls fine motor control and voluntary, highly skilled movement
29
What occurs if there is a lesion in the left lateral corticospinal tract?
Ipsilateral deficits of fine motor control
30
What is the anterior corticospinal tract responsible for?
Voluntary control of bilateral axial and girdle muscles
31
What does the rubrospinal tract do?
Augments activity of flexor muscles and inhibits extensor muscles
32
What is the function of the lateral vestibulospinal tract?
Controls balance and proximal muscles
33
What is the function of the medial vestibulospinal tract?
Coordinates head movements with eye movements
34
What is the tectospinal tract responsible for?
Reflexive head turning in response to sudden visual or auditory stimuli
35
What does the reticulospinal tract control?
Automatic posture and walking, muscle tone
36
What supplies the ventral surface of the spinal cord?
Anterior spinal artery
37
What supplies the dorsal surface of the spinal cord?
Posterior spinal arteries
38
What is the greater radicular artery of Adamkiewicz?
A radicular artery providing major blood supply to lumbar and sacral cord
39
What are common traumatic causes of spinal cord injury?
* Vehicular * Falls * Violence * Medical/Surgical * Sports * Other
40
What are common non-traumatic causes of spinal cord injury?
* Tumors * Myelomeningocele * Viral and bacterial infections * Prolapsed disc * Vascular problems * Spinal stenosis
41
What are the phases of spinal shock?
* Phase 1: Areflexia * Phase 2: Denervation hypersensitivity * Phase 3: Early hyper-reflexia * Phase 4: UMN presentation
42
What is lost in transverse cord lesions?
All sensory and motor pathways are interrupted
43
What is Brown-Sequard syndrome?
A hemi cord lesion affecting DCML and anterolateral spinothalamic tracts
44
What functions are lost in Brown-Sequard syndrome?
* Ipsilesional loss of light touch * Contralesional loss of pain & temp
45
What type of weakness is associated with lesions at and below the level of the lesion?
Bilateral weakness (UMN signs) ## Footnote This weakness occurs in the context of the lateral corticospinal tracts.
46
What are common causes of motor weakness due to spinal lesions?
* Trauma * Tumors * Multiple Sclerosis (MS) * Transverse myelitis
47
What structures are damaged in Brown-Sequard syndrome?
* DCML * Anterolateral spinothalamic tracts * Lateral corticospinal tract
48
What sensory functions are lost in Brown-Sequard syndrome?
* Ipsilesional loss of light touch at & below the level of the lesion * Contralesional loss of pain & temperature 1-2 segments below the lesion * Ipsilesional strip of pain/temperature loss at 1-2 segments at the level of the lesion
49
What motor functions are lost in Brown-Sequard syndrome?
Ipsilesional motor weakness (UMN signs) at & below the level of injury ## Footnote This includes damage to Lissauer's tracts and anterior white commissure.
50
What are common causes of Brown-Sequard syndrome?
* Penetrating injury (e.g., stab wound) * Closed injury with bony fracture
51
What is the presentation of Central Cord Syndrome?
Bilateral sensory and motor symptoms ## Footnote This syndrome often presents with weakness more pronounced in the upper extremities.
52
What structures are damaged in Central Cord Syndrome?
* Spinothalamic fibers crossing ventral/anterior commissure * Ventral horn cells * Large lesions may affect posterior column/anterolateral columns/lateral CST
53
What sensory functions are lost in Central Cord Syndrome?
* Bilateral loss of pain & temperature at 1-2 levels below the lesion * Maybe bilateral reduction of light touch, vibration, proprioception at and below the lesion
54
What motor functions are lost in Central Cord Syndrome?
* Bilateral loss of volitional movements (LMN signs) at the level of the lesion * Maybe bilateral weakness (UMN signs) at and below the level of the lesion
55
What are common causes of Central Cord Syndrome?
* Degenerative narrowing of spinal canal * Severe neck hyperextension injury
56
What is damaged in Anterior Spinal Cord Syndrome?
* Spinothalamic tract * Ventral horn * Maybe lateral corticospinal tract
57
What sensory functions are lost in Anterior Spinal Cord Syndrome?
Bilateral loss of pain & temperature at and below the level of the lesion
58
What motor functions are lost in Anterior Spinal Cord Syndrome?
* Bilateral loss of volitional movements (LMN signs) at the level of the lesion * Maybe weakness (UMN signs) at and below the level of the lesion
59
What are common causes of Anterior Spinal Cord Syndrome?
* Anterior spinal artery infarct * Traumatic flexion injury * Multiple Sclerosis (MS)
60
What is damaged in Posterior Spinal Cord Syndrome?
DCML bilaterally ## Footnote Large lesions may encroach on the lateral corticospinal tract.
61
What sensory functions are lost in Posterior Spinal Cord Syndrome?
Bilateral loss of light touch, vibration, proprioception at and below the level of the lesion
62
What motor functions are lost in Posterior Spinal Cord Syndrome?
Maybe bilateral weakness (UMN signs) at and below the level of the lesion
63
What are common causes of Posterior Spinal Cord Syndrome?
Vascular disruption of posterior spinal arteries from trauma or disease
64
What is the Conus Medullaris?
Injury at L1 vertebral level where the spinal cord ends ## Footnote Affects nerves that originate from this part of the cord and those traveling through this space.
65
What are the symptoms of Conus Medullaris injury?
* Deep aching pain in the low back * Numbness in the groin, thigh, leg, or foot * Urinary retention and bowel dysfunction * Bilateral lower limb weakness
66
What is Cauda Equina syndrome?
Simultaneous compression of multiple lumbosacral nerve roots below the level of the Conus Medullaris ## Footnote Occurs below L2 vertebral level.
67
What are the symptoms of Cauda Equina syndrome?
* Severe, stabbing (radicular) pain along dermatomal patterns * 'Saddle anesthesia' sensory disturbance * Weakness in the distribution of nerve roots (lower extremities)
68
What is Spinal Subdural/Epidural Hematoma?
Accumulation of blood in subdural or epidural space that can mechanically compress the spinal cord
69
What is Multiple Sclerosis (MS)?
Chronic autoimmune disease involving damage to the myelin sheaths of nerve cells in the brain and spinal cord
70
What are symptoms of Degenerative Disk Disease?
* Back or neck pain * Sometimes weakness * Numbness and hot, shooting pains into the arms or legs (radicular pain)
71
What is Transverse Myelitis?
Inflammation of the spinal cord with myelin damage ## Footnote Etiology includes infections and immune system disorders.
72
What are symptoms of Transverse Myelitis?
* Band-like sensation across the trunk * Pain * Sensory problems * Weakness in bladder and bowel * Sudden onset or gradual over days/weeks
73
What is Amyotrophic Lateral Sclerosis (ALS)?
Progressive neurodegenerative disease causing damage to motor neurons and subsequent loss of motor control
74
What are early symptoms of Amyotrophic Lateral Sclerosis (ALS)?
* Muscle twitches/cramps * Weakness or stiffness * Difficulty speaking, swallowing, and breathing
75
What is Spina Bifida?
Birth defect occurring when the spine and spinal cord don’t form properly ## Footnote A type of neural tube defect.
76
What are symptoms of Spina Bifida?
* Bladder and bowel dysfunction * Walking and mobility problems * Orthopedic complications * Hydrocephalus
77
What is Spinal Muscular Atrophy?
Group of hereditary diseases damaging and killing motor neurons in the brain and spinal cord
78
What are symptoms of Spinal Muscular Atrophy?
* Reduced movement * Contractures * Reduced muscle tone * Lack of tendon reflexes

Neuro & imaging (11 decks)

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