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Flashcards in spine and spinal cord Deck (55)
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1

Paresthesia

Abnormal sensation- burning, pricking, tickling or tingling.

2

Dysesthesia

impairment of sensation of short anesthesia

3

Paresis,

decreased strength

4

plegia

complete loss of strength

5

Dermatome,

cutaneous area served by individual sensory root

6

Myotome

Muscles innervated by an individual motor root

7

Radiculopathy,

sensory and/or motor dysfunction due to injury to a nerve root

8

Myelopathy

disorder resulting in spinal cord dysfunction

9

spinothalamic/anterolateral tract - function and where it crosses

pain and temperature, crosses 2-3 segments above root entry level in anterior spinal cord

10

posterior columns function and where it crosses

vibration and position, crosses in medulla

11

corticospinal tract function and where it crosses

motor, crosses in lower medulla

12

Know where the nerve roots exit

C1, 2, 3, 4, 5, 6, 7 roots exit above same numbered vertebra (e.g. C7 above C7). C8 below C7 and all other roots exit below same numbered vertebra (e.g. T1 exits below T1).

13

Know the spinal cord level that each vertebral body overlies (C6 bone overlies C7 cord.)

Upper cervical: vertebra # overlies same cord segment # (C2 bone, C2 cord) o Lower cervical: vertebra # overlies cord segment # + 1 (C6 bone, C7 cord) o Upper thoracic: vertebra # overlies cord segment # + 2 (T4 bone, T6 cord)
o Lower thoracic/lumbar: vertebra # overlies cord
segment # +2- 3 (T 11bone, L1-2 cord) o Lower edge of the L1 vertebral body overlies the cord tip (conus medullaris)Upper cervical: vertebra # overlies same cord segment # (C2 bone, C2 cord) o Lower cervical: vertebra # overlies cord segment # + 1 (C6 bone, C7 cord) o Upper thoracic: vertebra # overlies cord segment # + 2 (T4 bone, T6 cord)
o Lower thoracic/lumbar: vertebra # overlies cord
segment # +2- 3 (T 11bone, L1-2 cord) o Lower edge of the L1 vertebral body overlies the cord tip (conus medullaris)Upper cervical: vertebra # overlies same cord segment # (C2 bone, C2 cord) o Lower cervical: vertebra # overlies cord segment # + 1 (C6 bone, C7 cord) o Upper thoracic: vertebra # overlies cord segment # + 2 (T4 bone, T6 cord)
o Lower thoracic/lumbar: vertebra # overlies cord
segment # +2- 3 (T 11bone, L1-2 cord) o Lower edge of the L1 vertebral body overlies the cord tip (conus medullaris)Upper cervical: vertebra # overlies same cord segment # (C2 bone, C2 cord) o Lower cervical: vertebra # overlies cord segment # + 1 (C6 bone, C7 cord) o Upper thoracic: vertebra # overlies cord segment # + 2 (T4 bone, T6 cord)
o Lower thoracic/lumbar: vertebra # overlies cord
segment # +2- 3 (T 11bone, L1-2 cord) o Lower edge of the L1 vertebral body overlies the cord tip (conus medullaris)

14

somatotopic organization of tracts

Posterior columns: sacral medial, arms lateral. Spinothalamic and corticospinal: sacral lateral, arms medial

15

blood supply to spinal cord

2 posterior spinal arteries supply posterior columns, 1 anterior spinal artery supplies spinothalamic and corticospinal tracts. Gray matter requires more blood than white matter

16

Recognize the symptoms of a radiculopathy and

radiculopathy: dz affecting nerve roots. Pain
Lhermitte’s sign, Spurling’s sign (+foraminal compression test), Lasegue’s sign (+straight leg raising test, SLR). Paresthesia (abnl sensations), Sensory loss (hypoesthesia, anesthesia), Weakness (paresis, plegia), loss of fine motor control, Disorders of Bowel, bladder, or sexual dysfunction, Gait problems LMN signs. Relieving factors rest, graded therapy, NSAIDs, muscle relaxants. radiculopathy: dz affecting nerve roots. Pain
Lhermitte’s sign, Spurling’s sign (+foraminal compression test), Lasegue’s sign (+straight leg raising test, SLR). Paresthesia (abnl sensations), Sensory loss (hypoesthesia, anesthesia), Weakness (paresis, plegia), loss of fine motor control, Disorders of Bowel, bladder, or sexual dysfunction, Gait problems LMN signs. Relieving factors rest, graded therapy, NSAIDs, muscle relaxants. radiculopathy: dz affecting nerve roots. Pain
Lhermitte’s sign, Spurling’s sign (+foraminal compression test), Lasegue’s sign (+straight leg raising test, SLR). Paresthesia (abnl sensations), Sensory loss (hypoesthesia, anesthesia), Weakness (paresis, plegia), loss of fine motor control, Disorders of Bowel, bladder, or sexual dysfunction, Gait problems LMN signs. Relieving factors rest, graded therapy, NSAIDs, muscle relaxants. radiculopathy: dz affecting nerve roots. Pain
Lhermitte’s sign, Spurling’s sign (+foraminal compression test), Lasegue’s sign (+straight leg raising test, SLR). Paresthesia (abnl sensations), Sensory loss (hypoesthesia, anesthesia), Weakness (paresis, plegia), loss of fine motor control, Disorders of Bowel, bladder, or sexual dysfunction, Gait problems LMN signs. Relieving factors rest, graded therapy, NSAIDs, muscle relaxants.

17

understand Lhermitte's symptom.

Neck flexion results in "electric shock" sensation down the back and/or into arms. Attributed to posterior column disease (MS, disc, B12 def, mass).

18

spurlings sign

narrow foramen causes constriction of nerves exiting at that level

19

lasegues sign

straight leg sign- sretch sciatic nerve and shooting radicular pain occurs

20

Causes of radiculopathies

Common causes: Compression by degenerative joint disease (causing bony proliferation) or herniated disc near intervertebral foramen. Remember, discs can
herniate laterally. Posterior herniation would cause myelopathy. Less common causes: herpes zoster (shingles), carcinoma, lymphoma, sarcoidosis.Common causes: Compression by degenerative joint disease (causing bony proliferation) or herniated disc near intervertebral foramen. Remember, discs can
herniate laterally. Posterior herniation would cause myelopathy. Less common causes: herpes zoster (shingles), carcinoma, lymphoma, sarcoidosis.Common causes: Compression by degenerative joint disease (causing bony proliferation) or herniated disc near intervertebral foramen. Remember, discs can
herniate laterally. Posterior herniation would cause myelopathy. Less common causes: herpes zoster (shingles), carcinoma, lymphoma, sarcoidosis.

21

Know the neurologic signs used to distinguish lesions affecting the lower motor neurons versus those affecting the upper motor neurons.

LMN: atrophy, fasciculation, flaccidity, decreased DTRs and flexor plantar response. UMN: immediate muscle weakness and hypotonia, hyporeflexia followed by normal muscle bulk, no fasciculations, spasticity, increased DTRs, extensor or babinski plantar response

22

spinal shock

acute complete spinal cord transection. Has upper motor neuron damage signs. Acutely: Exam shows flaccid weakness, absent tone, absent DTR, & absent
autonomic function (bladder, sweat). By 3-4 months: Exam shows UMN spastic weakness, hyperactive DTRs, Babinski sign.acute complete spinal cord transection. Has upper motor neuron damage signs. Acutely: Exam shows flaccid weakness, absent tone, absent DTR, & absent
autonomic function (bladder, sweat). By 3-4 months: Exam shows UMN spastic weakness, hyperactive DTRs, Babinski sign.acute complete spinal cord transection. Has upper motor neuron damage signs. Acutely: Exam shows flaccid weakness, absent tone, absent DTR, & absent
autonomic function (bladder, sweat). By 3-4 months: Exam shows UMN spastic weakness, hyperactive DTRs, Babinski sign.

23

symptoms of cervical stenosis

Can result in UMN signs in legs +/- bladder dysfunction.

24

Complete cord transection tracts, deficit

Tracts: All ascending sensory & descending
motor/autonomic tracts. Deficit: Sensory + motor levels below lesion; may also have root signs at site. Note: Spinal shock followed by UMN signs.Tracts: All ascending sensory & descending
motor/autonomic tracts. Deficit: Sensory + motor levels below lesion; may also have root signs at site. Note: Spinal shock followed by UMN signs.Tracts: All ascending sensory & descending
motor/autonomic tracts. Deficit: Sensory + motor levels below lesion; may also have root signs at site. Note: Spinal shock followed by UMN signs.

25

central lesion tracts,examples, deficit

Tracts: Initially involve crossing ST. E.g.s: Syringomyelia (fluid-filled cavity in cord), ependymomas, cord contusion. Deficit: PP/Temp loss at level of lesion, with
sparing of position sensation. Note: Cape-like distribution if in C-spine.Tracts: Initially involve crossing ST. E.g.s: Syringomyelia (fluid-filled cavity in cord), ependymomas, cord contusion. Deficit: PP/Temp loss at level of lesion, with
sparing of position sensation. Note: Cape-like distribution if in C-spine.Tracts: Initially involve crossing ST. E.g.s: Syringomyelia (fluid-filled cavity in cord), ependymomas, cord contusion. Deficit: PP/Temp loss at level of lesion, with
sparing of position sensation. Note: Cape-like distribution if in C-spine.

26

Posterior column syndrome tracts, examples, and deficit

Tracts: PC. E.g.s. Tabes dorsalis (form of neurosyphilis)
Deficit: Bilateral loss of position & vibration sensationTracts: PC. E.g.s. Tabes dorsalis (form of neurosyphilis)
Deficit: Bilateral loss of position & vibration sensationTracts: PC. E.g.s. Tabes dorsalis (form of neurosyphilis)
Deficit: Bilateral loss of position & vibration sensation

27

Combined Anterior Horn Cell-Pyramidal Tract
Syndrome tracts, examples, deficitCombined Anterior Horn Cell-Pyramidal Tract
Syndrome tracts, examples, deficitCombined Anterior Horn Cell-Pyramidal Tract
Syndrome tracts, examples, deficit

Tracts: Cortico Spinal and LMN cells in cord. E.g.s: Amyotrophic lateral sclerosis (Lou Gehrig's disease). Deficit: Loss of bilateral strength. Note: Fasciculations, atrophy, decreased or increased DTR, normal sensation.

28

Brown-Sequard (Hemi-Section) tracts, eg, deficit

Tracts: Crossed ST + uncrossed PC + crossed CS. E.g.: Compression by herniated discs, tumor extramedullary abscess, etc. Deficit: Below lesion, loss of CL PP/Temp, IL Position, IL strength.

29

Posterolateral Column Syndrome tracts, eg, deficit

Tracts: PC + CS. E.g.: B12 deficiency (aka subacute combined degeneration). Deficit: Bilateral loss of position & vibration, and strength.

30

anterior horn cell syndrome tracts, eg, deficit

Tracts: None - lower motor neuron (cell). E.g.: Spinal muscular atrophy, polio virus. Deficit: Bilateral loss of strength. Note: Fasciculations, decrased tone + decreased DTRs with sparing of all sensory tracts and bladder functions