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Neurosurgery Resource > Spine > Flashcards

Spine Flashcards

(55 cards)

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1
Q

The spinal cord extends from which structure?

A

Medulla

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2
Q

At what level does the spinal cord terminate?

A

L1/L2

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3
Q

What information is received by the dorsal horns of grey matter?

A

Somatosensory

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4
Q

What is contained within the ventral horns of grey matter?

A

Motor neurones

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5
Q

At what levels is the lateral horn of grey matter found?

A

T1-L2

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6
Q

What is contained within the lateral horn of grey matter?

A

Autonomic neurones

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7
Q

What are the main ascending tracts of the spinal cord?

A

Dorsal column medial lemniscus (DCML)

Spinothalamic

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8
Q

What sensory modalities are carried within the DCML pathway?

A

Fine touch
Pressure
Vibration

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9
Q

DCML fibres from below T6 travel up the spinal cord in what?

A

Fasciculus gracilis

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10
Q

DCML fibres from T6 and above travel up the spinal cord in what?

A

Fasciculus cuneatus

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11
Q

Where do first order DCML fibres synapse?

A

Medulla

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12
Q

The DCML fibres decussate to which structures?

A

Contralateral medial lemniscus

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13
Q

After decussating to the contralateral medial lemniscus, what happens?

A

The fibres synapse in the thalamus before signal is relayed to the somatosensory cortex

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14
Q

What sensory modalities are carried within the spinothalamic tract?

A

Pain

Temperature

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15
Q

Where do the first order neurones of the spinothalamic tract synapse?

A

Dorsal horn

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16
Q

The spinothalamic fibres decussate after synapsing in the dorsal horn. True/false?

A

True

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17
Q

Where do the second order neurones of the spinothalamic tract synapse?

A

Thalamus

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18
Q

What is the function of the spinocerebellar pathways?

A

Provide unconscious proprioceptive information to cerebellum

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19
Q

The dorsal spinocerebellar pathway carries proprioceptive information from where?

A

Muscle spindles of lower limbs

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20
Q

The cuneocerebellar pathway carries proprioceptive information from where?

A

Upper limbs

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21
Q

The ventral spinocerebellar pathway carries proprioceptive information from where?

A

Golgi tendons of lower limbs

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22
Q

The spinocerebellar tracts transmit information to the ipsi-/contra-lateral cerebellum

A

Ipsilateral

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23
Q

What are the main pyramidal tracts?

Study These Flashcards
A

Corticospinal

Corticobulbar

24
Q

The corticospinal tract is responsible for what?

Study These Flashcards
A

Voluntary movements

25
The majority of the corticospinal tract fibres decussate at the medullary pyramids. True/false?
True
26
What do decussated corticospinal tract fibres descend within?
Lateral corticospinal tract
27
What do undecussated corticospinal tract fibres descend within?
Anterior corticospinal tract
28
What is contained with corticobulbar tracts?
UMN of cranial nerves
29
Pyramidal tracts originate at the brainstem and extra-pyramidal tracts originate at the motor cortex. True/false?
False - pyramidal tracts originate at motor cortex and extra-pyramidal at brainstem
30
What does the vestibulospinal tract control?
Balance and posture (innervates anti-gravity muscles)
31
What do the reticulospinal tracts control?
Reflex responses | Tone
32
What does the rubrospinal tract do?
Excites flexor muscles and inhibits extensor muscles of upper body
33
What does the tecto-spinal tract co-ordinate?
Movement of head and neck
34
What are the innervations of the ankle, triceps, biceps and knee reflexes?
Biceps - C5/6 Triceps - C7/8 Knee - L3/4 Ankle - S1/2
35
What occurs in disc herniation?
The nucleus pulposis herniates through a tear in the annulus ring
36
A paramedian herniated disc typically compresses the transversing/exiting nerve
Transversing (the nerve root that exits below the level or prolapse)
37
A lateral herniation at L4/L5 will damage which nerve?
L4
38
What is radiculopathy?
Dysfunction of a nerve root causing dermatomal sensory deficit
39
Give some clinical features of cauda equina syndrome
Painless urinary retention Saddle paraesthesia Incontinence Lower back pain
40
What is treatment for cauda equina syndrome?
Surgical decompression
41
What is spinal stenosis?
A narrowing of the spinal cord leading to neurogenic claudication
42
Give some clinical features of spinal stenosis
Hip/buttock/lower extremity pain Burning sensation Relieved by walking uphill
43
How is spinal stenosis treated?
Conservatively (physio and analgesia) | Lumbar laminectomy
44
What occurs in cervical spondylosis?
Degenerative arthritic process of the cervical spine
45
How can patients with cervical spondylosis present?
Degenerative cervical myelopathy (UMN signs) | Radiculopathy (LMN signs)
46
How is cervical spondylosis treated?
Surgery (laminectomy/disectomy)
47
What are some clinical features of degenerative cervical myelopathy?
Imbalance of gait Clumsy hands Pain Hyperreflexia
48
What investigation is the gold standard for cervical myelopathy?
MRI
49
What occurs in anterior cord syndrome?
There is cord infarction in the area supplied by the anterior spinal artery
50
What sensations are lost in anterior cord syndrome?
Pain and temperature below level of injury
51
How do patients with cord transection present initially?
Flaccid arreflexic paralysis
52
What sensation is lost ipsilaterally in Brown-Sequard syndrome?
Proprioception
53
What sensations are lost contralaterally in Brown-Sequard syndrome?
Pain and temperature
54
What is the cause of central cord syndrome?
Acute extension injury to already stenotic neck
55
Give some clinical features of central cord syndrome
Bilateral upper limb weakness | "Cape-like" spinothalamic sensory loss

Neurosurgery Resource (5 decks)

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