AHE: BLOCK 2: CNS OVERVIEW & CLINICAL CONNECTIONS

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Questions and Answers

What symptom would you expect from a lesion affecting the anterior spinocerebellar tract?

Loss of pain sensation on the same side

Contralateral dystaxia (correct)

Loss of proprioception on the affected side

Ipsilateral dystaxia

Which of the following is primarily affected by a lesion in the dorsal column?

Crude touch and pressure

Unconscious proprioception

Discriminative touch and vibration (correct)

Pain and temperature sensations

In Brown-Sequard syndrome, what is a key characteristic symptom observed?

Ipsilateral motor paralysis (correct)

Ipsilateral loss of pain and temperature sensation

Loss of proprioception on the contralateral side

Contralateral loss of vibratory sense

What would spinal stenosis most likely affect?

Motor neurons in the anterior spinal cord Signup and view all the answers

A patient with myelopathy might exhibit which of the following symptoms?

Contralateral pain sensation loss Signup and view all the answers

Which pathway is primarily responsible for conveying pain and temperature information?

Anterolateral pathway Signup and view all the answers

What would a lesion at T6 likely cause in terms of sensory dysfunction?

Loss of proprioception below the lesion level Signup and view all the answers

What is the likely impact of compression in the posterior spinocerebellar tract?

Ipsilateral loss of coordination Signup and view all the answers

What type of symptoms would a lesion affecting the posterior spinocerebellar tracts cause?

Ipsilateral dystaxia Signup and view all the answers

In Brown-Sequard syndrome, damage on one side of the spinal cord typically causes which of the following?

Ipsilateral loss of fine touch and vibration Signup and view all the answers

Which pathway decussation occurs at the level of the lower medulla?

Dorsal columns Signup and view all the answers

What is a common consequence of upper motor neuron lesions below the level of injury?

Spasticity and hyperreflexia Signup and view all the answers

What type of sensation is primarily affected by the spinothalamic tracts?

Pain and temperature Signup and view all the answers

Which of the following best describes the effect of a lesion to upper motor neurons?

Increased muscle tone and spasms Signup and view all the answers

After a spinal cord injury, which change is typically observed below the level of the lesion?

Hyperactive reflexes Signup and view all the answers

What would a lesion in the anterior spinocerebellar tract likely cause?

Contralateral dystaxia Signup and view all the answers

Which of the following is a potential cause of myelopathy?

Cervical spondylosis Signup and view all the answers

What is a common symptom of myelopathy?

Numbness in limbs Signup and view all the answers

In Brown-Sequard Syndrome, which type of sensation is affected on the ipsilateral side of the lesion?

Fine touch and vibration Signup and view all the answers

How do spinothalamic tracts convey pain and temperature sensations in relation to lesion location?

They decussate and then ascend contralaterally. Signup and view all the answers

What aspect of spinal cord pathways is crucial for interpreting sensory and motor symptoms?

Location of pathway decussation Signup and view all the answers

Which symptom is least likely associated with myelopathy?

Severe back pain Signup and view all the answers

When characterizing motor and sensory dysfunction in myelopathy, which pathway aspect plays a pivotal role?

Decussation and pathway mapping Signup and view all the answers

What is the primary function of the dorsal columns in the spinal cord?

Transmitting fine touch and proprioception Signup and view all the answers

Study Notes

Myelopathy

Damage or dysfunction of the spinal cord.
Caused by compression, injury, degenerative conditions, tumors, or infections.
Symptoms include weakness, numbness, sensory changes, balance problems, coordination issues, bladder and bowel control problems.
Understanding the location of pathway decussation is crucial for interpreting sensory and motor symptoms.

Brown-Sequard Syndrome

Rare condition affecting one side of the spinal cord.
Dorsal columns (fine touch, vibration, two-point discrimination, and conscious proprioception) are affected on the same side of the lesion (ipsilateral) as they ascend ipsilaterally before decussating in the lower medulla.
Spinothalamic tracts (pain, temperature, and crude touch) are affected on the opposite side of the lesion (contralateral) as the fibers cross to the opposite side of the spinal cord.
Spinocerebellar tracts (unconscious proprioception) are affected on the same side of the lesion (ipsilateral) for the posterior spinocerebellar tracts, and on the opposite side (contralateral) for the anterior spinocerebellar tracts due to decussation.
The side of the spinal cord with the lesion determines potential symptoms.

Herniated Disc

Can compress the anterior spinothalamic pathway, causing loss of pain contralateral (opposite side) to the lesion.

Spinal Cord Contusion/Laceration/Fracture

Can affect any spinal cord pathway based on the location and severity of the injury.
Dorsal columns carry fine touch, vibration, two-point discrimination, and conscious proprioception.
Spinothalamic tracts carry pain, temperature, and crude touch.
Spinocerebellar tracts carry unconscious proprioception.

Spinal Stenosis

Narrowing of the vertebral canal, compressing the spinal cord.
Can affect the dorsal columns (discriminative touch, vibration, pressure) and spinocerebellar tracts (unconscious proprioception).

Spinal Cord Vascular Supply

Anterior Spinal Artery: Single, midline artery that supplies the anterior two-thirds of the spinal cord, including motor neurons.
Posterior Spinal Arteries: Two smaller arteries that run on each side of the spinal cord and supply the posterior one-third of the spinal cord, including the dorsal columns and posterior white matter.

Radiculopathy vs. Myelopathy

Radiculopathy: Affects the spinal nerve roots where they exit the spinal cord.
Myelopathy: Affects the spinal cord itself.

Injury to Tracts in the Midbrain

Dorsal columns are affected contralaterally to the lesion as they ascend and decussate in the lower medulla.
Spinothalamic tracts are affected contralaterally to the lesion because they ascend, cross to the opposite side of the spinal cord, and then continue ascending.

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Description

Explore the intricacies of myelopathy and Brown-Sequard syndrome. This quiz covers spinal cord dysfunction, symptoms, and the effects of lesions. Test your understanding of sensory pathways and clinical manifestations in these neurological conditions.