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Spinal Cord Disorders Overview
31 Questions
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Spinal Cord Disorders Overview

Created by
@PatientGuqin8861

Questions and Answers

What is the origin point of the spinal cord?

  • Lumbar region
  • Conus medullaris
  • Medulla (correct)
  • Cervical region

    • The white matter tracts of the spinal cord are located centrally.

    False

    What are the two enlarged regions of the spinal cord called?

    Cervical and lumbar regions

    The spinal cord continues caudally to the ______ at the lumbar level.

    <p>conus medullaris</p> Signup and view all the answers

    Match the following spinal cord components with their characteristics:

    <p>Pia mater = Innermost protective layer Arachnoid = Middle protective layer Dura mater = Outermost protective layer Central canal = Contains cerebrospinal fluid</p> Signup and view all the answers

    What does a positive Babinski’s sign indicate?

    <p>Extensor plantar responses</p> Signup and view all the answers

    Hyporeflexia or areflexia indicates heightened reflex response.

    <p>False</p> Signup and view all the answers

    What is the sensory level in relation to spinal cord lesions?

    <p>A level below which there is loss of all sensory modalities.</p> Signup and view all the answers

    Spinal shock may last up to ______ weeks following a severe spinal cord injury.

    <p>2-3</p> Signup and view all the answers

    Match the anatomical reference points with their corresponding spinal levels:

    <p>Louis Angle = T2 Xiphisternum = T6 Umbilicus = T10 Inguinal ligaments = L1</p> Signup and view all the answers

    Which of the following can cause myelopathy?

    <p>Spinal stenosis</p> Signup and view all the answers

    One of the causes of myelopathy is a herniated disc.

    <p>True</p> Signup and view all the answers

    What term is used to describe an intramedullary fluid-filled cavity in the spinal cord?

    <p>Syrinx</p> Signup and view all the answers

    Myelopathy can result from autoimmune disorders or other __________.

    <p>trauma</p> Signup and view all the answers

    Match the type of myelopathy with its example:

    <p>Compressively caused = Herniated Disc Neurological = Multiple Sclerosis Vascular = Stroke Metabolic = B12 Deficiency</p> Signup and view all the answers

    Which horn contains sensory neurons?

    <p>Dorsal Horn</p> Signup and view all the answers

    The dorsal column-medial lemniscus tract carries sensory information from the contralateral side of the body.

    <p>False</p> Signup and view all the answers

    What type of neurons are found in the ventral horn?

    <p>Motor Neurons</p> Signup and view all the answers

    The ___________ tract is responsible for transmitting pain, temperature, and crude touch sensations.

    <p>spinothalamic</p> Signup and view all the answers

    Match the type of spinal cord lesion with the affected limbs and associated motor neuron type:

    <p>Above C5 = Quadriparesis, UMN C5 – T1 = Quadriparesis, LMN T1 – L1 = Paraparesis, UMN Below L1 = Paraparesis, LMN</p> Signup and view all the answers

    What is the characteristic tone in Upper Motor Neuron (UMN) lesions?

    <p>Hypertonia (Spasticity)</p> Signup and view all the answers

    A lesion at the spinal cord results in ipsilateral effects from the spinothalamic tract.

    <p>False</p> Signup and view all the answers

    How does the corticospinal tract decussate?

    <p>At the level of the pyramids in the medulla</p> Signup and view all the answers

    What is the most common condition associated with syringomyelia?

    <p>Chiari type 1 malformation</p> Signup and view all the answers

    Decreased pain and temperature sensation in the cape-like distribution occurs due to disruption of the crossing corticospinal tracts.

    <p>False</p> Signup and view all the answers

    What is the best imaging modality for diagnosing spinal cord disease?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    A common clinical feature of cervicothoracic syringomyelia is a cape-like distribution of decreased pain and temperature sensation in the back, arms, and _____

    <p>hands</p> Signup and view all the answers

    Match the following clinical features with their corresponding characteristics:

    <p>Central Cord Syndrome = Weakness in arms and legs Horner syndrome = Sympathetic chain involvement Cervical anterior horn cells = Lower motor neuron type weakness Lateral corticospinal fibers = Upper motor neuron type weakness</p> Signup and view all the answers

    Which of the following may be preserved in cases of syringomyelia?

    <p>Bowel and bladder function</p> Signup and view all the answers

    The dorsal column is affected in patients with cervicothoracic syringomyelia.

    <p>False</p> Signup and view all the answers

    What type of management is typically warranted in cases with no or only minor symptoms of syringomyelia?

    <p>Conservative observation</p> Signup and view all the answers

    Study Notes

    Overview of Spinal Cord Neuroanatomy

    • Spinal cord extends from the medulla to the conus medullaris at lumbar levels L1-L2.
    • Enlargements occur in cervical and lumbar regions for upper and lower limb innervation.
    • White matter contains ascending sensory and descending motor pathways peripherally; grey matter (four-leaf clover shape) contains nerve cell bodies around the central canal.
    • Membranes (pia, arachnoid, dura) covering the spinal cord are continuous with those of the brain.

    Grey Matter and White Matter Structures

    • Dorsal Horn: Contains sensory neurons.
    • Ventral Horn: Contains motor neurons (anterior horn cells).
    • Lateral Horn: Contains sympathetic neurons.
    • Dorsal Funiculus: Dorsal column-medial lemniscus tract, involved in sensory (vibration, proprioception, fine touch) from ipsilateral body side.
    • Lateral Funiculus: Lateral corticospinal tract, responsible for motor movements of limbs.
    • Ventral Funiculus: Spinothalamic tract, sensory for pain, temperature, and crude touch from the contralateral side.

    Spinal Cord Lesion Localization

    • Above C5: Causes quadriparesis (upper motor neuron - UMN) and lower motor neuron (LMN) symptoms in upper limbs.
    • C5-T1: Quadriparesis with UMN signs in lower limbs.
    • T1-L1: Paraparesis with UMN signs.
    • Below L1: Paraparesis with LMN signs.

    Signs of Upper and Lower Motor Neuron Lesions

    • Weakness: UMN affects muscle groups; LMN affects single muscle fibers.
    • Atrophy: UMN does not cause atrophy; LMN causes atrophy and fasciculations.
    • Tone: UMN shows hypertonia (spasticity); LMN shows hypotonia.
    • Reflexes: UMN has hyperreflexia; LMN has hyporeflexia or areflexia (negative Babinski’s sign).

    Sensory Levels and Spinal Shock

    • Sensory Level: The level below which all sensory modalities are lost. Notable landmarks: Louis Angle (T2), Xiphisternum (T6), Umbilicus (T10), Inguinal ligaments (L1).
    • Spinal Shock: Loss of neurological activity below injury level after severe cord injury lasting 2-3 weeks. It presents with lower motor neuron signs.

    Causes and Differential Diagnosis of Myelopathy

    • Neurosurgical Causes: Trauma, tumors, abscess, herniated disc, cervical spondylosis, syrinx cavity.
    • Neurological Causes: Inflammatory (transverse myelitis, MS, NMO), infections (HIV, TB), vitamin B12 deficiency, vascular issues (stroke), hereditary conditions (spastic paraplegia).

    Syringomyelia

    • Syrinx forms an intramedullary fluid-filled cavity commonly in cervical to midthoracic spine, typically filled with CSF.
    • Primary Syringomyelia: Congenital or associated with Chiari type 1 malformation.
    • Secondary Syringomyelia: Due to spinal cord tumors or chronic phase post-trauma.
    • Clinical features include cape-like distribution of decreased pain/temperature sensation, weakness in arms/legs, and possible Horner syndrome if lateral columns are affected.

    Imaging and Treatment

    • Best diagnostic tool for spinal cord disease: Magnetic Resonance Imaging (MRI). It visualizes syrinx and associated abnormalities.
    • Conservative Treatment: Observation for minor symptoms, neuropathic pain medications for nonoperative management.

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    Description

    This quiz covers essential aspects of spinal cord disorders, focusing on myelopathy and its localization. It includes an overview of spinal cord neuroanatomy, differential diagnoses, and a clinical approach to various neurological disorders like syringomyelia and transverse myelitis. Test your knowledge on these critical topics in neurology.

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