Spinal cord compression Flashcards Preview

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Flashcards in Spinal cord compression Deck (43):
1

where is the DCML located in the spinal cord

posteriorly/dorsal

2

functions of DCML

fine touch
proprioception
vibration

3

where do fibres of the DCML cross over

cross over to the contralateral side at the medulla

4

where is the STT located in the spinal cord

anterolateral

5

functions of STT

pain
temperature
deep pressure

6

where do fibres of the STT cross over

segmentally at the spinal level it enters

7

where is the CST located in the spinal cord

laterally

8

function of CST

fine movement

9

where do fibres of the CST cross over

cross over at the medullary pyramids

10

where is the UMN found

motor cortex to anterior grey horn

11

where is the LMN found

anterior horn cell to muscle

12

how can spinal cord compression be classified

acute vs chronic
complete vs incomplete

13

causes of acute SCC

trauma
tumour
haemorrhage
infection

14

causes of chronic SCC

degenerative
tumour
rheumatoid arthritis

15

at what vertebral levels can rheumatoid arthritis cause SCC

C1/2 synovial joint

16

how does a complete acute SCC present

all motor and sensory modalities are affected

17

how does an incomplete acute SCC present

partial preservation of power and sensation

18

what is spinal shock

temporary hypo/areflexia, flaccid paralysis and autonomic dysfunction

19

hypo/hypertension occurs in spinal shock

hypotension from lost vasomotor tone in blood vessels

20

what is Brown Séquard syndrome

hemisection of the spinal cord

21

features of Brown Séquard syndrome

ipsilateral DCML and CST loss
contralateral STT loss

22

causes of cord hemisection

knife injury
demyelination

23

what causes central cord syndrome

hyperflexion or extension injury to an already stenotic neck

24

presentation of central cord syndrome

distal upper limb weakness
cape like STT sensory loss

25

what is preserved in central cord syndrome

DCML
lower limb power

26

how does chronic SCC present

same as acute SCC but with UMN signs predominating

27

tumour causes of SCC

meningioma
metastases
astrocytoma
schwannoma

28

degenerative causes of SCC

osteophytes
bulging discs
facet joint hypertrophy
subluxation

29

haemorrhagic causes of SCC

epidural
subdural
intramedullary

30

infectious causes of SCC

epidural abscess
TB

31

management of trauma to the spine

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

32

management of malignant SCC

dexamethasone IV
radiotherapy
chemo is appropriate
rarely operate

33

management of infectious SCC

antimicrobial therapy
surgical drainage

34

management of haemorrhagic causes of SCC

reverse anticoagulation
surgical decompression

35

management of degenerative causes of SCC

surgical decompression +- stabilisation

36

what is syringomyelia

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

37

what is acute degenerative cervical myelopathy

degenerative condition with compression of the spinal cord

38

what kind of SCC does syringomyelia cause

central cord syndrome

39

pathology/causes of degenerative cervical myelopathy

osteophytes
degenerative cervical spondylosis
ligament hypertophy
stenosis
tumour
epidural abscess

40

symptoms of degenerative cervical myelopathy

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

41

management of degenerative cervical myelopathy

surgical decompression

42

what is Hoffman's sign

presence of UMN lesion from spinal cord compression
flicking of middle distal phalynx causes overflexion of index finger and thumb

43

what is subacute combined degeneration of the cord

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