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28 Cards in this Set

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C fiber, delta

small unmyelinated fibers (becomes STT)

Alpha fibers

large myelinated (dorsal columns)

sacral fibers in spinal cord are LATERAL for CST and STT

sacral are MEDIal in dorsal columns

small unmyelinated fibers come in through DRG, ascend for a bit with LIssaure's tract

synapse in dorsal horn (substantia gelatinosa), then CROSS IN THE VWC!!!

lesion of STT will ALWAYS BE CONTRA -wether in brain or spinal cord

cause i mean, how likely would it be that you hit it RIGHT before it crosses?

faciculus gracilis

legs, medial

spinal cord diseases with prominent UMN findings

1. compressive myelopathy


2. transverse myelitis


3. AIDS myelopathy


4. acute spinal cord trauma


5. ASA occlusion

most common causes of cord compression

-spondylolysis & disc herniation


-(less common: CA, abscess)

Next step after you suspect spinal cord compressive myelopathy?

MRI to localize

Sx in compressive spinal cord myelopathy

-SPASTICITY, UMN etc


-bowel/bladder*


-pain/radiculopathy at level of lesion


-Lhermitte's with neck flexion if posterior columns involved

most compressive myelopathies involve what portion of the sc?

CERVICAL

Tx for acute sc trauma

high dose steroids and surgery

acute inflammation of the spinal cord

transverse myelitis (usually due to MS***)

most common location of transverse myelitis

THORACIC!!!

acute "shock" loss of reflexes and flaccid paralysis, then within 24 hours spasticity hyper reflexia

transverse myelitis

tight band-like sensation at the level of the lesion

transverse myelitis

slowly progressive spastic weakness, gait instability, incontinence

AIDS myelopathy

anterior spinal artery occlusion (mid-thoracid in watershed artery of Adam)

usually from HTN DM

V/P OK!!!! only loss of STT and weakness

ASA occlusion: Next step MRI to r/o tumor

poliomyelitis

asymmetric weakness, atrophy, severe cramps, and fasciculations due to the loss of anterior horn cells

break out in crying without much stimulus

ALS

central spinal cord cavitation/syringomyelia

lack of pain and temperature sensation in both arms and shoulders due to involvement of the spinothalamic tracts as they cross in the central spinal cord

central spinal cord tumor

syringomyelia but with "sacral sparing". Sacral sparing is due to the fact that the sacral fibers lie outermost in the spinothalamic pathway

B12 deficiency

"subacute combined degeneration" -degeneration in the spinal cord and in the peripheral nerves

tabes dorsalis: posterior columns & dorsal roots (PAIN!!!)

profound loss of vibration and proprioception and a slapping gait

posterior spinal artery occlusion

sudden loss of vibration and proprioception sensation below the level of the lesion.

posterior spinal artery occlusion

Patients have difficulty walking due to a severe loss of proprioception and often walk with a slapping or stomping gait in order to try and receive some idea as to the position of the legs in space. Patients do not have weakness. and pain and temperature sensation is normal, since the corticospinal tract and the spinothalamic pathways are preserved.

atrophy of spinocerebellar pathways (and post columns), onset at 8-16 years

Friedrichs ataxia (basically entire back half of spinal cord is wiped out)