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Neurology > Spinal cord compression > Flashcards

Spinal cord compression Flashcards

1
Q

where is the DCML located in the spinal cord

A

posteriorly/dorsal

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2
Q

functions of DCML

A

fine touch
proprioception
vibration

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3
Q

where do fibres of the DCML cross over

A

cross over to the contralateral side at the medulla

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4
Q

where is the STT located in the spinal cord

A

anterolateral

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5
Q

functions of STT

A

pain
temperature
deep pressure

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6
Q

where do fibres of the STT cross over

A

segmentally at the spinal level it enters

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7
Q

where is the CST located in the spinal cord

A

laterally

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8
Q

function of CST

A

fine movement

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9
Q

where do fibres of the CST cross over

A

cross over at the medullary pyramids

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10
Q

where is the UMN found

A

motor cortex to anterior grey horn

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11
Q

where is the LMN found

A

anterior horn cell to muscle

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12
Q

how can spinal cord compression be classified

A

acute vs chronic

complete vs incomplete

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13
Q

causes of acute SCC

A

trauma
tumour
haemorrhage
infection

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14
Q

causes of chronic SCC

A

degenerative
tumour
rheumatoid arthritis

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15
Q

at what vertebral levels can rheumatoid arthritis cause SCC

A

C1/2 synovial joint

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16
Q

how does a complete acute SCC present

A

all motor and sensory modalities are affected

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17
Q

how does an incomplete acute SCC present

A

partial preservation of power and sensation

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18
Q

what is spinal shock

A

temporary hypo/areflexia, flaccid paralysis and autonomic dysfunction

19
Q

hypo/hypertension occurs in spinal shock

A

hypotension from lost vasomotor tone in blood vessels

20
Q

what is Brown Séquard syndrome

A

hemisection of the spinal cord

21
Q

features of Brown Séquard syndrome

A

ipsilateral DCML and CST loss

contralateral STT loss

22
Q

causes of cord hemisection

A

knife injury

demyelination

23
Q

what causes central cord syndrome

A

hyperflexion or extension injury to an already stenotic neck

24
Q

presentation of central cord syndrome

A

distal upper limb weakness

cape like STT sensory loss

25
Q

what is preserved in central cord syndrome

A

DCML

lower limb power

26
Q

how does chronic SCC present

A

same as acute SCC but with UMN signs predominating

27
Q

tumour causes of SCC

A

meningioma
metastases
astrocytoma
schwannoma

28
Q

degenerative causes of SCC

A

osteophytes
bulging discs
facet joint hypertrophy
subluxation

29
Q

haemorrhagic causes of SCC

A

epidural
subdural
intramedullary

30
Q

infectious causes of SCC

A

epidural abscess

TB

31
Q

management of trauma to the spine

A

immobilise spinal column with blocks
Imaging - Xray, CT, MRI
decompress and stabilise
steroids sometimes used

32
Q

management of malignant SCC

A

dexamethasone IV
radiotherapy
chemo is appropriate
rarely operate

33
Q

management of infectious SCC

A

antimicrobial therapy

surgical drainage

34
Q

management of haemorrhagic causes of SCC

A

reverse anticoagulation

surgical decompression

35
Q

management of degenerative causes of SCC

A

surgical decompression +- stabilisation

36
Q

what is syringomyelia

A

fluid filled cavity/cyst in the spinal cord associated with Chiari malformation

37
Q

what is acute degenerative cervical myelopathy

A

degenerative condition with compression of the spinal cord

38
Q

what kind of SCC does syringomyelia cause

A

central cord syndrome

39
Q

pathology/causes of degenerative cervical myelopathy

A 
osteophytes
degenerative cervical spondylosis
ligament hypertophy 
stenosis 
tumour 
epidural abscess
40
Q

symptoms of degenerative cervical myelopathy

A 
neck pain and stiffness 
clumsiness and weakness 
occipital headaches
gait instability 
paraesthesias of extremities
41
Q

management of degenerative cervical myelopathy

A

surgical decompression

42
Q

what is Hoffman’s sign

A

presence of UMN lesion from spinal cord compression

flicking of middle distal phalynx causes overflexion of index finger and thumb

43
Q

what is subacute combined degeneration of the cord

A

degeneration of the posterior and lateral columns of the spinal cord due to a B12 deficiency

Neurology (25 decks)

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