Test 2 - cervical myelopathy Flashcards Preview

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Flashcards in Test 2 - cervical myelopathy Deck (25)
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what covers the medial posterior surface of the vertebral bodies and annular fibers of the discs

posterior longitudinal ligament


what decreases the posterior medial disc buldge/herniation

posterior longitudinal ligament


degeneration of the disc height from aging or trauma can lead to compression of the ________ decreasing perfusion of the spinal cord

anterior spinal artery


what artery serves as one for the dorsal column and dorsal horn

posterior spinal artery


what artery serves the anterior 2/3 of the spinal cord

anterior spinal artery


decreased blood flow to _____ decreases this tracts function, therefore could see UMN signs in the lower limbs

watershed zone: posterior lateral white matter where the lateral corticospinal tract is located


with spondylosis, ______ thickens, decreasing anterior and posterior diameter of the spinal canal

ligamentum flavum


what results in sliding of superior articular process over the inferior decreasing the vertical and anterior/posterior dimensions of the IVF



_____ of the neck and head may decrease signs and symptoms of myelopathy while increasing signs and symptoms of cervical radiculopathy

flexion: increases the a-p diameter of the cervical spinal canal, but stretches nerve roots


myelopathy sign: UMN signs of lower extremity (uni or bilaterally) 

- spasticity in quads and triceps surae

- weakness in hamstrings and tib anterior 

- hyperreflexia in patella and ankle

- clonus (repetitive contraction with stretch and hold of ankle)

- pathological reflex (extensor plantar response)



myelopathy signs: dorsal column dysfunction

dysequilibrium (decreased proprioception)

decreased touch and vibration


myelopathy sign: LMN signs in upper limb

- weakness

- atrophy

- twitches (fasciculations)


how to test for myelopathy

- touch and vibration with patients head in neutral pos

- test ankle reflex and plantar response

- patient extend their head and neck

- retest touch, vibration, ankle and plantar reflexes

- if normal in neutral and abnormal in extension, consider myelopathy


trauma causing cervical myelopathy

- sudden extreme extension

- severe whiplash

- extension of head with tooth extraction

- cervical manipulation 


symptoms of cervical myelopathy

painful, stiff neck

shoulder arm pain

spastic weakness in legs (UMN)


what is the finger escape sign

unable to maintain full finger extension and adduction of the ulnar digits


symptoms of cord compression in LE

legs feel stiff and heavy

gives out quickly after exercise

toe scrapes floor during swing phase of gait



exam reveeals of cervical myelopathy in LE

spasticity more than weakness

increased muscle stretch reflexes

Pt may believe only onel leg is affected but is common to see extensor plantar response bilaterally


sensory changes in LE 

numbness and/or tingling of soles of feet and around ankles 

impaired vibration and position sense (dorsal columns)




AP diameter of spinal canal less than ____ mm leaves insufficient room for the cord



diameter decrease does no correlate well with presence and degree of spinal cord injury


is there vision trouble in CM



what three tracts are affected by MS

DC - paresthesias in all limbs and with loss of JPS ataxia

CST - lesion spastic legs, ext plantar response

SPTT - deep achiness and pain and thermal loss


amyotrophic lateral sclerosis signs

LMN sings in UE

UMN signs in LE

preservation of reflexes in presence of weakness and atrophy


could be due to a B12 problem/deficiency 

peripheral nn early with ataxia developing later d/t sensory loss

extensor plantar response with absent reflexes d/t loss of peripheral fibers

subacute combined degeneration

DC degeneration

CST degeneration