Spinal Cord Compression Flashcards Preview

Neurology > Spinal Cord Compression > Flashcards

Flashcards in Spinal Cord Compression Deck (38):
1

the corticospinal tract is a _ neurone tract?

2

2

where does upper motor neurone of corticospinal tract begin and end?

from motor cortex to anterior grey horn

decussates (crosses over) at medullary level

3

what is the lower motor neurone?

anterior horn cell

4

is corticospinal tract contralateral or ipsilateral?

ipsilateral

5

what symptoms do you get with an upper motor neurone lesion?

increased tone
muscle wasting not marked
no fasciculation
hyper-reflexia

6

what symptoms do you get with a lower motor neurone lesion?

decreased tone
muscle wasting
fasciculation
diminished reflexes

7

what do spinothalamic tracts control?

pain
temperature
crude touch

this is a sensory pathway

8

is spinothalamic tracts contralateral or ipsilateral?

contralateral

9

where do spinothalamic tract decussate (cross over to other side of CNS)?

spinal level

10

what do dorsal columns control?

fine touch
proprioception
vibration

11

are dorsal columns contralateral or ipsilateral?

ipsilateral

12

where do dorsal columns decussate (cross over to other side of CNS)?

medullary level

13

what causes acute spinal cord compression?

trauma
tumour - haemorrhage or collapse
infection
spontaneous haemorrhage

14

what causes chronic spinal cord compression?

degenerative disease - spondylosis, spinal cord stenosis
tumours - slowly compress
rheumatoid arthritis

15

acute spinal cord compression can either be complete or incomplete, what does this mean?

complete - all motor and sensory modalities affected

16

what are symptoms of an acute cord transection?

initially a flaccid arreflexic paralysis - spinal shock

upper motor neurone signs appear later

17

what occurs in brown-sequard syndrome (cord hemisection)?

no ipsilateral motor level

no ipsilateral dorsal column sensory level

no contralateral spinothalamic sensory level

18

how does central cord syndrome occur?

hyperflexion or extension injury to already stenotic neck

19

what are the symptoms of central cord syndrome?

predominantly distal upper limb weakness

"cape-like" spinothalamic sensory loss

lower limb power and dorsal columns preserved

20

what are symptoms of chronic spinal cord compression?

same as acute except upper motor neurone signs predominate

21

what kind of trauma causes spinal cord compression?

high energy injury
especially mobile segments of spine (cervical)

22

what types of extradural tumours cause spinal cord compression?

usually mets - lung, breast, kidney, prostate

23

what types of intradural tumours cause spinal cord compression?

extramedullary - meningioma, schwannoma

intramedullary - astrocytoma, ependymoma

24

what causes spinal canal stenosis?

osteophyte formation
bulging of intervertebral discs
facet joint hypertrophy
subluxation

25

what kind of infections can compress spinal cord?

epidural abscess - bloodborne staph or tuberculosis

surgery or trauma

26

what types of haemorrhage can compress spinal cord?

epidural
subdural
intramedullary

27

what can cause haemorrhage which suppresses spinal cord?

trauma
bleeding diatheses
anticoagulants
arterio-venous malformations

28

how do you treat spinal cord compression caused by trauma?

immobilise
investigate
decompress + stabilise
? methylprednisolone

29

what investigations should take place in spinal cord compression caused by trauma?

X-ray / CT
MRI

30

how do you decompress + stabilise spinal cord compression caused by trauma?

surgery
traction
external fixation

31

is the use of methylprednisolone in spinal cord compression caused by trauma disputed?

yes - this lecturer said probably no useful benefit

32

how do you treat spinal cord compression caused by tumour?

depends on pt and tumour
dexamethasone
radiotherapy
chemotherapy
surgical decompression + stabilisation

33

how do you treat spinal cord compression caused by infection?

antimicrobial therapy
surgical drainage
stabilisation where required

34

how do you treat spinal cord compression caused by haemorrhage?

reverse anticoagulation

surgical decompression

35

how do you treat spinal cord compression caused by degenerative disease?

surgical decompression +/- stabilisation

36

is acute spinal cord compression an emergency?

yes

37

chronic compression requires rapid treatment - true or false?

true

38

what is usually the outcome of treatment of spinal cord compression?

prevents further deterioration