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Questions and Answers
What is one of the late signs of spinal cord dysfunction?
What is one of the late signs of spinal cord dysfunction?
Which tracts are most vulnerable to mechanical pressure in spinal cord dysfunction?
Which tracts are most vulnerable to mechanical pressure in spinal cord dysfunction?
What percentage of patients may be paraplegic at the time of diagnosis for spinal cord compression due to a tumor?
What percentage of patients may be paraplegic at the time of diagnosis for spinal cord compression due to a tumor?
What type of sensations are evaluated by the sensory system during muscle testing?
What type of sensations are evaluated by the sensory system during muscle testing?
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How do normally innervated muscles respond to faradic current?
How do normally innervated muscles respond to faradic current?
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How can neoplasms affect the spinal cord beyond physical compression?
How can neoplasms affect the spinal cord beyond physical compression?
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What is a common symptom associated with pathologic vertebral fractures?
What is a common symptom associated with pathologic vertebral fractures?
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What happens to a muscle when the lower motor neuron is cut?
What happens to a muscle when the lower motor neuron is cut?
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What type of current causes contraction only when it is turned on or off?
What type of current causes contraction only when it is turned on or off?
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After how many days does the response to direct current cease following the section of the nerve?
After how many days does the response to direct current cease following the section of the nerve?
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What involves the cortex in terms of sensory evaluation?
What involves the cortex in terms of sensory evaluation?
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Which pathways are responsible for transmitting pain and temperature sensations?
Which pathways are responsible for transmitting pain and temperature sensations?
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What is the primary sensation not reliant on the cortex according to the content?
What is the primary sensation not reliant on the cortex according to the content?
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What anatomical structures comprise a reflex arc in its simplest form?
What anatomical structures comprise a reflex arc in its simplest form?
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Which reflex is referred to as a monosynaptic reflex arc?
Which reflex is referred to as a monosynaptic reflex arc?
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How are reflexes graded according to their response?
How are reflexes graded according to their response?
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What characterizes lesions of the corticospinal tracts in relation to reflexes?
What characterizes lesions of the corticospinal tracts in relation to reflexes?
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What is the result of lesions in the descending tracts other than the corticospinal tract?
What is the result of lesions in the descending tracts other than the corticospinal tract?
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Which of the following statements about the assessment of the motor system is true?
Which of the following statements about the assessment of the motor system is true?
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What tool should be properly selected for assessing reflexes?
What tool should be properly selected for assessing reflexes?
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What indicates a brisker than average reflex response on the grading scale?
What indicates a brisker than average reflex response on the grading scale?
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Which reflex is least likely to be affected by lesions in the corticospinal tract?
Which reflex is least likely to be affected by lesions in the corticospinal tract?
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Which option describes the role of reflex arcs in the spinal cord?
Which option describes the role of reflex arcs in the spinal cord?
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Which reflex assessment indicates a lack of control at the distal ends of limbs?
Which reflex assessment indicates a lack of control at the distal ends of limbs?
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When is the flat end of a reflex hammer most appropriately used?
When is the flat end of a reflex hammer most appropriately used?
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What is indicated by a score of 4+ on the reflex grading scale?
What is indicated by a score of 4+ on the reflex grading scale?
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What happens during a clasp-knife reaction?
What happens during a clasp-knife reaction?
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Which of the following is a common sign in upper motor neuron lesions?
Which of the following is a common sign in upper motor neuron lesions?
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What is the termination point of the spinal cord in adults?
What is the termination point of the spinal cord in adults?
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Which region of the spinal cord contains the largest amount of gray matter?
Which region of the spinal cord contains the largest amount of gray matter?
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What type of neurons are associated with the anterior gray column?
What type of neurons are associated with the anterior gray column?
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Which description best fits the substantia gelatinosa?
Which description best fits the substantia gelatinosa?
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Which area of the spinal cord contains the nucleus dorsalis?
Which area of the spinal cord contains the nucleus dorsalis?
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What is the function of the lateral gray column?
What is the function of the lateral gray column?
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In which type of white matter tract does proprioceptive information ascend?
In which type of white matter tract does proprioceptive information ascend?
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What is primarily conveyed in the anterior spinothalamic tract?
What is primarily conveyed in the anterior spinothalamic tract?
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What characterizes the posterior funiculus of the spinal cord?
What characterizes the posterior funiculus of the spinal cord?
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Which group of nerve cells is believed to receive visceral afferent information?
Which group of nerve cells is believed to receive visceral afferent information?
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Which of the following is true about cerebrospinal fluid in relation to the spinal cord?
Which of the following is true about cerebrospinal fluid in relation to the spinal cord?
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What can be said about the anterior median fissure of the spinal cord?
What can be said about the anterior median fissure of the spinal cord?
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What role do gamma efferents play in the spinal cord?
What role do gamma efferents play in the spinal cord?
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The thoracic and upper lumbar segments of the spinal cord are characterized by which unique feature?
The thoracic and upper lumbar segments of the spinal cord are characterized by which unique feature?
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What indicates the existence of spinal shock in a patient with suspected spinal cord compression?
What indicates the existence of spinal shock in a patient with suspected spinal cord compression?
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Which age group is most likely to experience the peak incidence of primary spinal cord tumors?
Which age group is most likely to experience the peak incidence of primary spinal cord tumors?
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In which region are metastatic spinal lesions most commonly observed?
In which region are metastatic spinal lesions most commonly observed?
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What is typically the first symptom of spinal cord compression due to neoplastic disease?
What is typically the first symptom of spinal cord compression due to neoplastic disease?
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Which of the following cancers is most likely to contribute to spinal cord metastasis?
Which of the following cancers is most likely to contribute to spinal cord metastasis?
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Which symptom typically emerges early in conus medullaris syndrome?
Which symptom typically emerges early in conus medullaris syndrome?
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What is a likely consequence of spinal cord compression that occurs without early detection and intervention?
What is a likely consequence of spinal cord compression that occurs without early detection and intervention?
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Which statement best defines the nature of primary spinal cord tumors?
Which statement best defines the nature of primary spinal cord tumors?
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In advanced stages of spinal cord compression, what occurs?
In advanced stages of spinal cord compression, what occurs?
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Which factors are effective in predicting ultimate disability in patients with spinal cord compression?
Which factors are effective in predicting ultimate disability in patients with spinal cord compression?
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What is a common complaint in adults with spinal cord neoplasms?
What is a common complaint in adults with spinal cord neoplasms?
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What is the most frequent consequence of metastatic lesions affecting the spinal region?
What is the most frequent consequence of metastatic lesions affecting the spinal region?
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Which statement is true regarding intramedullary tumors?
Which statement is true regarding intramedullary tumors?
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What clinical sign indicates meningeal irritation, often associated with spinal cord neoplasms?
What clinical sign indicates meningeal irritation, often associated with spinal cord neoplasms?
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What type of spinal cord disorder arises from lateral spinal cord compression?
What type of spinal cord disorder arises from lateral spinal cord compression?
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What imaging modality provides the best definition of spinal lesions?
What imaging modality provides the best definition of spinal lesions?
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What is a typical consequence of tumors located in the region of the foramen magnum?
What is a typical consequence of tumors located in the region of the foramen magnum?
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What factor is crucial in managing spinal cord compression secondary to cancer?
What factor is crucial in managing spinal cord compression secondary to cancer?
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Which symptom may occur in about 10% of patients with leptomeningeal metastasis?
Which symptom may occur in about 10% of patients with leptomeningeal metastasis?
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What may an isolated sensory loss in the upper extremities indicate?
What may an isolated sensory loss in the upper extremities indicate?
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What is the role of steroids in the management of cord compression due to neoplasms?
What is the role of steroids in the management of cord compression due to neoplasms?
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Which treatment approach should be pursued after appropriate imaging for an epidural tumor compression?
Which treatment approach should be pursued after appropriate imaging for an epidural tumor compression?
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What condition can result from the presence of multiple spinal metastases?
What condition can result from the presence of multiple spinal metastases?
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Which surgical procedure provides immediate relief of spinal cord compression?
Which surgical procedure provides immediate relief of spinal cord compression?
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What does an MRI help differentiate between in spinal conditions?
What does an MRI help differentiate between in spinal conditions?
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In which patient scenario should chemotherapy be administered at the discretion of the consultant?
In which patient scenario should chemotherapy be administered at the discretion of the consultant?
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Study Notes
Gross Anatomy of the Spinal Cord
- Cylindrical shape, extending from foramen magnum to L1 vertebra.
- Surrounded by meninges (dura, arachnoid, pia).
- Cerebrospinal fluid in subarachnoid space.
- Cervical and lumbar enlargements for innervation of limbs.
- Conus medullaris is the tapered inferior end.
- Filum terminale extends from conus and anchors the cord.
- Anterior median fissure and posterior median sulcus mark the midline.
- 31 pairs of spinal nerves attach, anterior (motor) and posterior (sensory) roots.
- Each root connects to the cord by rootlets.
- Posterior root ganglion houses sensory neuron cell bodies.
Anatomy of the Gray Matter
- Central H-shaped core of gray matter is surrounded by white matter.
- Anterior and posterior gray horns are joined by a thin gray commissure.
- A lateral gray horn exists in thoracic and upper lumbar segments.
- Gray matter size is related to muscle innervation, largest in cervical and lumbosacral enlargements.
Nerve Cell Groups in the Anterior Gray Column
- Primarily large, multipolar neurons whose axons form alpha efferent fibers to skeletal muscles.
- Smaller neurons form gamma efferent fibers to intrafusal muscle fibers of neuromuscular spindles.
Nerve Cell Groups in the Posterior Gray Column
- Four groups of nerve cells, some extending the full length of the cord, others to thoracic/lumbar.
- Substantia gelatinosa: receives pain, temperature, and touch signals from posterior root.
- Nucleus proprius: receives proprioceptive, two-point discrimination and vibration signals from posterior white column.
- Nucleus dorsalis (Clark's column): receives proprioceptive input (neuromuscular & tendon spindles) from C8-L3/L4.
- Visceral afferent nucleus: receives visceral afferent information (medium-sized cells) from T1-L3.
Anatomy of the White Matter
- Composed of anterior, lateral, and posterior white columns.
- Contains ascending and descending tracts and intersegmental tracts.
- Ascending tracts carry sensory information, descending carry motor.
Ascending Tracts and Their Functions
- Lateral spinothalamic tract: pain and temperature.
- Anterior spinothalamic tract: light touch and pressure.
- Posterior white columns: discriminative touch, vibration, and conscious muscle joint sense.
- Spinocerebellar tracts (anterior and posterior): unconscious proprioceptive and sensory information to cerebellum.
- Spinotectal tract: relays pain, thermal, and tactile info to superior colliculus (spinovisual reflexes).
- Spino-olivary tract: info to the cerebellum.
Descending Tracts and Their Functions
- Corticospinal tract: voluntary, skilled movements (especially distal limbs).
- Reticulospinal tract: facilitates or inhibits alpha and gamma motor neuron activity.
- Tectospinal tract: reflex postural movements in response to visual stimuli.
- Rubrospinal tract: facilitates flexor muscles, inhibits extensor muscles.
- Vestibulospinal tract: facilitates extensors, inhibits flexors, related to balance.
- Autonomic descending fibers control visceral activity.
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Description
Explore the key features of spinal cord anatomy, including its structure, surrounding meninges, and the arrangement of gray and white matter. This quiz covers essential concepts such as spinal nerve pairs, the significance of cervical and lumbar enlargements, and the organization of nerve cell groups.
