Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NMF: Neurology > SPINE > Flashcards

SPINE Flashcards

1
Q

Where are motor neurons found in the spinal cord?

A

the ventral (anterior) horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is somatosensory information received in the spinal cord?

A

the dorsal (posterior) horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which vertebral levels have a lateral horn containing the autonomic neurons?

A

T1-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which spinal tract controls fine touch, pressure and vibration?

A

Dorsal column-medial leminiscus (DCML)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which spinal tract controls pain and temperature?

A

Lateral Spinothalamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which spinal tract controls crude touch?

A

anterior spinothalamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do the spinocerebellar pathways do?

A

provide unconscious proprioceptive information to the cerebellum in order to coordinate posture and the movement of the lower limb and upper limb musculature.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which spinocerebellar pathways provide info from the upper limbs?

A

cuneocerebellar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which spinocerebellar pathways provide information for the lower limbs?

A

dorsal and ventral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the two pyramidal descending tracts

A

corticospinal and corticobulbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of movement does the corticospinal tract control?

A

voluntary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the function of the corticobulbar tract?

A

it contains UMN of the CN to innervate face head and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is the forehead unaffected in an UMN or LMN lesion of the facial nerve?

A

unaffected if UMN –> facial palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name the extrapyramidal tracts

A

vestibulospinal, reticulospinal, rubrospinal, tectospinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do the extrapyramidal tracts originate from?

A

the brainstem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the vestibulospinal tract control?

A

balance and posture by innervating the anti-gravity muscles (extensors for legs and flexors for arms).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the two parts of the reticulospinal tract?

A

pontine and medullary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which part of the reticulospinal tract facilitates movement?

A

the pontine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which spinal tract excites flexor muscles and inhibits extensor muscles of the upper body?

A

Rubrospinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which spinal tract co-ordinates movements of head and neck to vision stimuli?

A

tectospinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Reflex pneumonic

A

1,2 buckle my shoe: ankle reflex S1,2

3,4 kick the door: patellar reflex L3,4

5,6 pick up sticks: biceps reflex C5,6

7,8 shut the gate: triceps reflex C7,8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

describe C1

A

THE ATLAS no body or spinous process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What part of the vertebrae is only present in c2?

A

dens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name the 2 parts of the intervertebral disc

A

annulus fibrosis (outer fibrocartilage)

Nucleus pulpsosis (water, dehydrates with age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Ligaments spine
Anterior longitudinal ligament: Connects the anterolateral aspects of vertebral bodies and IV discs. Posterior longitudinal ligament: It runs within the vertebral canal posterior to the vertebral bodies. Ligamentum flavum: It is so called because it is rich in elastin and therefore appears yellow. It runs vertically connecting the lamina of adjacent vertebrae. It helps maintain an upright posture and assist straightening the spine after flexion. Supraspinous ligament: Runs along the tips of the spinous processes. Interspinous ligament: Runs between the spinous processes.
26
Layers lumbar puncture goes through starting from the skin
* Skin * Fascia * Supraspinous ligament * Interspinous ligament * Ligamentum flavum * Epidural space * Dura
27
Signs that back pain is mechanical
Morning stiffness that resolves with movement, pain worse on sitting and when rising from a seated position
28
What are the most common locations for lumbar disc herniation?
L4/5 level and L5/S1
29
When do herniated discs occur in a) young and b) elderly patients?
young - sprain on the spine eg carrying a heavy load old - degeneration of the vertebrae or spondylosis
30
Which nerve root is damaged in a a paramedian (posterolateral) herniation?
the transversing nerve ie. the nerve root that exists below the level of prolapsed disc
31
Which nerve root is damaged when a far lateral (extraforaminal) herniation occurs?
the exiting nerve (the nerve root that exists at that level)
32
Name two consequences of a central disc herniation
Lumbar stenosis or cauda equina
33
What is radiculopathy?
dysfunction of a nerve root causing a dermatomal sensory deficit with weakness of the muscle groups supplied by that nerve.
34
Which nerve roots are compressed in sciatica?
L4-S3
35
Describe the general clinical features of sciatica
* shooting pain radiating from the buttocks to posterior knee * pain exaggerated by coughing/ sneezing * numbness or tingling along nerve distribution * weakness * straig leg raise +ve (leg raised to \<45 causes pain)
36
What features would be present if S1 root is compressed
Pain along the posterior thigh with radiation to the heel. Weakness of plantar flexion (on occasion). Sensory loss in the lateral foot. Reduced or absent ankle jerk.
37
What features would be present if L5 was compressed?
Pain along the posterior or posterolateral thigh with radiation to the dorsum of the foot and great toe. Weakness of dorsiflexion of the toe or foot. Paraesthesia and numbness of the dorsum of the foot and great toe. Reflex changes unlikely.
38
What features would be present if L4 was compressed?
Pain in the anterior thigh. Wasting of the quadriceps muscle. Weakness of the quadriceps function and dorsiflexion of foot. Diminished sensation over anterior thigh, knee and medial aspect of lower leg. Reduced knee jerk.
39
What are the indications for discectomy?
Failure of conservative treatment (physiotherapy and analgesia) - First line management Pain Central disc prolapse: Patients with bilateral sciatica or other features indicating a central disc prolapse, such as sphincter disturbance and diminished perineal sensation, should be investigated promptly. Tumour Neurological deficits
40
What are the clinical features of cauda equina?
* urinary retention * saddle paraesthesia * incontinence (both internal and external anal sphincters) * low back pain * bilateral sciatic leg pain
41
Why do some patients with cauda equina syndrome have bladder incontinence?
Their bladder problems will be intermittent. Severe exacerbation of lower back pain can cause bladder spasm and incontinence. Look for absent ankle reflexes to confirm cauda equina syndrome.
42
How do you investigate cauda equina?
MRI lumbrosacral spine and PR exam (lack of anal sphincter tone and perianal numbness)
43
Treatment of cauda equina
If it was due to a herniated disc --\> discectomy If it was due to a fracture --\> decompression +\- fixation If it was due to a hematoma --\> evacuation
44
What is the risk of permanent incontinence and/or impotence even if there is prompt surgery for cauda equina?
10%
45
What is spinal stenosis?
narrowing of the spinal canal which compresses the lowest most spinal cord, conus medullaris, nerve roots, the latest will lead to symptoms of neurogenic claudication. Symptomatic lumbar stenosis occurs most commonly at the L4/5 level followed by L3/4. Occurs mainly in older patients \>50 years old.
46
What are the clinical features of lumbar spinal stenosis?
* insidious and progressive unilateral or bilateral hip/buttocks/lower extremity pain or burning - precipitated by standing or back extension - relieved by sitting, lumbar flexion or walking uphill * neurogenic claudication: leg weakness, tingling, numbness and paraesthesia
47
Treatment of lumbar spinal stenosis
conservative: physio and analgesia surgery once symptoms untolerable and pain uncontrolled by analgesia: lumbar surgical decompression by laminectomy
48
What is cervical spondylosis?
A degenerative arthritic process involving the cervical spine Affects the intervertebral disc and zygapophyyseal joints Most patients are over 50 Degeneration causes stress on the articular cartilage causing osteophytic spurs to develop around the margins that can grow posteriorly into the spinal canal and arteriorly into the prevertebral space
49
How do patients with cervical spondylosis present?
either present as degenerative cervical myelopathy (UMN signs) or radiculopathy (LMN signs).
50
What are the clinical features of cervical spondylosis?
Radiculopathy: LMN signs in the upper and lower limbs, neck pain Myelopathy
51
What are the radiographic findings of cervical spondylosis?
Narrowed disc space (C5/6 and C6/7) Osteophyte formation
52
Treatment of cervical spondylosis
* Multi-level pathologies/posterior compression due to osteophyte or ligamentum flavum hypertrophy --\> decompressive cervical laminectomy * Predominant anterior compression due to disc --\> anterior cervical discectomy * Unilateral nerve root compression can be approached through a posterior cervical foraminotomy
53
What is degenerative cervical myelopathy?
Spinal cord compression causing UMN signs (Especially in the lower limbs) Older patients
54
Clinical features of degenerative cervical myelopathy
* imbalance and disturbance in gait --\> falls * clumsy hands * urinary or faecal incontinence (Rare) * pain (non-dermatomal) * legs jump at night (hyperreflexia)
55
Why does degenerative cervical myelopathy cause falls?
due to hypertonia causing spasticity and decreased proprioception
56
What is found on examination of degenerative cervical myelopathy?
* weakness, hyperreflexia and spasticity * positive babinksi and hoffman's signs * loss of dexterity using fingers
57
How do you investigate degenerative Cervical myelopathy?
MRI of the cervical spine is the gold standard: may reveal disc degeneration and ligament hypertrophy +/- spinal cord signal change.
58
How is degenerative cervical myelopathy treated?
Decompressive spinal surgery to prevent deterioration
59
What is anterior cord syndrome?
anterior spinal artery infarction paralysis and loss of pain and temperature below preserved proprioception and vibration
60
Describe presentation of a complete cord transection
INITIAL: flaccid, arreflexic then UMN signs
61
What is Brown-Sequard syndrome?
cord hemisection ipsilateral UMN paralysis and loss of proprioception below contralateral loss of pain and temperature 1 or 2 segments below
62
What is central cord syndrome?
bilateral uper limb weakness \> lower limb cape like loss of pain and temperature dorsal column preserved
63
Name 3 potential causes of central cord syndrome
acute extension injury to a stenotic neck syringomyelia tumour
64
Burning down back of legs that is not as bad uphill
Spinal stenosis
65
A 66 year old has several falls over a few months. He has symetrical weakness of his legs and mild weakness of his hand. He had an abnormal gait. His reflexes were extremely brisk in his legs with upgoing plantars bilaterally.
Degenerative cervical myelopathy due to cervical spondylosis
66
Stab wound to the back causing R weakness at T5 and left sided loss of pinprick and temperature at T7.
Brown-sequard syndrome
67
A 39-year-old woman presented with severe headaches whenever she sneezed. She also had decreased sensation to pinprick over her upper back, shoulders, and upper arms. Her power in her arms was 2/5 but her lower body power was 5/5.
syringomelia
68
Which cervical nerve root comes out below the verebrae?
C8

NMF: Neurology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions