Where is the lesion?

Question 1

A man is in hospital 2 weeks after a car accident. He has paralysis of his legs, wrists and hands and weakness of shoulder abduction and elbow flexion. There is no biceps jerk reflex or brachioradialis deep tendon reflex.. What level must he have damaged his spinal cord?

Answer 1

Between C5 and C6 (C5 nerve damaged)
- Lost of movement in legs everything below C6
- Hands means loss of C6, C7, C8)
- Lost biceps reflec
Still some shoulder abduction (nerves C3, C4 must be ok)

Question 2

A person is quadraiplegic due to a spinal cord injury. What level was most likely injured?

Answer 2

At or above C5

Question 3

A women is in a wheelchair unable to walk due to a spinal cord injury. She has has no voluntary control of bowel or bladder. She has normal shoulder movement and can extend her elbows normally. What nerve has most likely been damaged.

Answer 3

C7

Question 4

A women is in a wheelchair unable to walk due to a spinal cord injury. She has has no voluntary control of bowel or bladder. However she is able to move her shoulders and arms and can grasp and release larger objects. What nerve has most likely been damaged?

Answer 4

C8

Question 5

A patient has paralysis of the legs and horners syndrome due to a spinal cord injury. What vertebral level must the injury be at?

Answer 5

Between C8 - T1

Question 6

A patient presents with sudden onset paralysis in both legs. They are also unable to sense pain or temperature below their tummy button. However they are still able to sense vibration an proprioception below this level.

Answer 6

Anterior cord syndrome.
Caused by ischemic injury to the anterior aspect of spinal cord due to occlusion of anterior spinal artery, which is most commonly occur as a consequence of non traumatic process, although it can be traumatic. The anterior two-thirds of the spinal cord contains corticospinal and spinothalamic tracts, which are affected in this syndrome.

Question 7

A 81 year old man who has a history or cervical spondylosis presents after falling and cutting his forehead. On examination you realise that he has weakness in his arms and loss of sensation across his chest. He says he has not passed urine for 6 hours.

Answer 7

Central cord syndrome

Question 8

A patient has loss of proprieoception, vibration sensation and loss of two point discrimination. What part of the spinal cord is damaged?

Answer 8

Posterior aspect

Question 9

A patient has loss of proprieoception, vibration sensation and loss of two point discrimination. What artery has most likely been occluded?

Answer 9

Posterior spinal artery