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28 Cards in this Set
- Front
- Back
C fiber, delta |
small unmyelinated fibers (becomes STT) |
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Alpha fibers |
large myelinated (dorsal columns) |
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sacral fibers in spinal cord are LATERAL for CST and STT |
sacral are MEDIal in dorsal columns |
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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!!! |
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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? |
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faciculus gracilis |
legs, medial |
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spinal cord diseases with prominent UMN findings |
1. compressive myelopathy 2. transverse myelitis 3. AIDS myelopathy 4. acute spinal cord trauma 5. ASA occlusion |
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most common causes of cord compression |
-spondylolysis & disc herniation -(less common: CA, abscess) |
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Next step after you suspect spinal cord compressive myelopathy? |
MRI to localize |
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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 |
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most compressive myelopathies involve what portion of the sc? |
CERVICAL |
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Tx for acute sc trauma |
high dose steroids and surgery |
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acute inflammation of the spinal cord |
transverse myelitis (usually due to MS***) |
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most common location of transverse myelitis |
THORACIC!!! |
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acute "shock" loss of reflexes and flaccid paralysis, then within 24 hours spasticity hyper reflexia |
transverse myelitis |
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tight band-like sensation at the level of the lesion |
transverse myelitis |
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slowly progressive spastic weakness, gait instability, incontinence |
AIDS myelopathy |
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anterior spinal artery occlusion (mid-thoracid in watershed artery of Adam) |
usually from HTN DM |
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V/P OK!!!! only loss of STT and weakness |
ASA occlusion: Next step MRI to r/o tumor |
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poliomyelitis |
asymmetric weakness, atrophy, severe cramps, and fasciculations due to the loss of anterior horn cells |
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break out in crying without much stimulus |
ALS |
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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 |
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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 |
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B12 deficiency |
"subacute combined degeneration" -degeneration in the spinal cord and in the peripheral nerves |
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tabes dorsalis: posterior columns & dorsal roots (PAIN!!!) |
profound loss of vibration and proprioception and a slapping gait |
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posterior spinal artery occlusion |
sudden loss of vibration and proprioception sensation below the level of the lesion. |
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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. |
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atrophy of spinocerebellar pathways (and post columns), onset at 8-16 years |
Friedrichs ataxia (basically entire back half of spinal cord is wiped out) |