Spinal Lesions Neuro

Question 1

Floppy baby with tongue twitching

Answer 1

Spinal Muscular Atrophy (Werdnig-Hoffmann)

Question 2

Autosomal Recessive mutation in SMN1 resulting in defective snRNP assembly

Answer 2

Spinal Muscular Atrophy (Werdnig-Hoffmann)

Question 3

LMN only (No sensory defects)
Bilateral Symmetric Weakness

Answer 3

Spinal Muscular Atrophy (Werdnig-Hoffmann)

Question 4

Congential degeneration of anterior motor horns of the spinal cord affecting LMNs

Answer 4

Spinal Muscular Atrophy (Werdnig-Hoffmann)

Question 5

UMN (Face and extremities) & LMN degeneration.
No Sensory defects
No bowel or bladder deficits

Answer 5

Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

*Spinal Muscular Atrophy (Werdnig-Hoffmann) has ONLY LMN

Question 6

Defect in Superoxide dismutase 1

Answer 6

Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

Question 7

Bulbar palsy (Dysarthria, Dysphagia, Tongue atrophy)

Answer 7

LMN deficit

*Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

Question 8

Pseudobulbar palsy (Dysarthria, Dysphagia, emotional lability)

Answer 8

UMN deficit

Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

Question 9

Early sign is weakness of hands

Answer 9

Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

Question 10

CST (UMN) damage
&
Anterior Motor Horn (LMN) damage

Answer 10

Amyotrophic Lateral Sclerosis (Lou Gehrig’s)

Question 11

Damage spares only lissauer tract and Dorsal Columns

Answer 11

Complete Occlusion of Anterior Spinal Artery

Question 12

UMN deficits
LMN deficits (at the level of lesion)
Loss of pain and temperature (Bilateral)

Answer 12

Complete Occlusion of Anterior Spinal Artery

Question 13

Affects:
CST, STT, and anterior white commisure

Spares:
Dorsal Columns

Answer 13

Complete Occlusion of Anterior Spinal Artery

Question 14

Degeneration/ Demyelination of Dorsal Columns and roots

Answer 14

Tabes Dorsalis

Question 15

Progressive sensory ataxia (impaired propioception)
Absent DTRs
\+ Romberg
\+/- Argyll Robertson pupils
\+/- Shooting pain

Answer 15

Tabes Dorsalis

Question 16

Damages anterior white commissure of STT first

Answer 16

Syringomyelia

Question 17

Bilateral symmetric loss of pain and temperature sensation in a cape-like distribution (shoulders-arms)
No motor deficits

Answer 17

Syringomyelia

Question 18

Associated with Chiari I malformation (herniated cerebellar tonsils)

Answer 18

Syringomyelia

Question 19

Ataxic gait, paresthesias, impaired position/ vibration sensation, UMN symptoms.
Pain/Temp spared

Answer 19

Subacute Combined Degeneration

Vitamin B12 deficiency

Question 20

Demyelination of Spinocerebellar, Lateral Corticospinal tract, and Dorsal Columns

Answer 20

Subacute Combined Degeneration

Vitamin B12 deficiency

Question 21

Compression of spinal roots L2 and below often due to intervertebral disc herniation or tumor.

Answer 21

Cauda Equina

Question 22

Radicular Pain (lower back to legs)
Absent knee/ankle reflexes
loss of bladder and anal sphincter tone
saddle (butthole and crotch) anesthesia
Sudden onset

Answer 22

Cauda Equina

Question 23

Fecal-oral transmission
Replicates in the pharynx and small intestine
Spreads hematogenously to CNS
Destroys anterior horn of spinal cord (LMN dmg)

Answer 23

Poliomyelitis

Question 24

Asymetric weakness
Flaccid paralysis
Muscle atrophy
Hyporeflexia/ Fasciculations
\+/- Respiratory muscle involvement

Answer 24

Poliomyelitis

*(SMA is SYMMETRIC weakness)

Question 25

CSF shows lymphocytic pleocytosis, slightly elevated proteins, no change in glucose.

Answer 25

Poliomyelitis

Question 26

``` Degeenration of Spinocerebellar (ataxia) Lateral Corticospinal tract (spastic paralysis) Dorsal Columns (propioception/vibration) DRG (loss of DTRs) ```

Answer 26

Friedreich Ataxia

Question 27

``` Staggering gait Nystagmus Pes Cavus Hypertrophic Cardiomyopathy Diabetes Kyphoscoliosis ```

Answer 27

Friedreich Ataxia

Question 28

Contralateral loss of pain, temperature, touch Ipsilateral UMN signs Ipsilateral loss of propioception & touch *Horner's if lesion is above T1

Answer 28

Hemisection of spinal cord | Brown-Sequard

Question 29

UMN, LMN, or Both lesion? | Weakness

Answer 29

Both

Question 30

UMN, LMN, or Both lesion? | Atrophy

Answer 30

LMN

Question 31

UMN, LMN, or Both lesion? | Fasciculations

Answer 31

LMN

Question 32

UMN, LMN, or Both lesion? | Hyperreflexia

Answer 32

UMN

Question 33

UMN, LMN, or Both lesion? | Increased muscle tone

Answer 33

UMN

Question 34

UMN, LMN, or Both lesion? | Spastic Paralysis

Answer 34

UMN

Question 35

UMN, LMN, or Both lesion? | Flaccid Paralysis

Answer 35

LMN

Question 36

UMN, LMN, or Both lesion? | Clasp Knife spacticity/rigidity

Answer 36

UMN

Question 37

UMN starts at the pre-central gyrus, goes through the ______, into the inferior peduncle, decussates at the medullary pyramids, travels through the Cortical Spinal Tract, into the Ventral/Anterior horn of the spinal cord and synapses with the LMN which then travels to the NMJ

Answer 37

internal capsule

Question 38

UMN starts at the pre-central gyrus, goes through the internal capsule, into the ______, decussates at the medullary pyramids, travels through the Cortical Spinal Tract, into the Ventral/Anterior horn of the spinal cord and synapses with the LMN which then travels to the NMJ

Answer 38

inferior peduncle

Question 39

Guillane barre is associated with UMN or LMN symptoms?

Answer 39

LMN

Question 40

Multiple Sclerosis is associated with UMN or LMN symptoms?

Answer 40

UMN