Matthew Coulson
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Spinal Cord Compression lecture given on 25/09/2018

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Matthew Coulson
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Spinal Cord Compression

Frage 1 von 15

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The lateral corticospinal tracts decussate in the ( medulla, midbrain, pons ), then move down the spinal cord and synapse at the anterior horn on the ( contralateral, ipsilateral ) side to their origin (the primary motor cortex). Despite this, the tracts are considered to be ( ipsilateral, contralateral ) tracts due to the fact that they do not decussate at their level of entry and travel down the spinal cord on the same side as the structure they are innervating.

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Frage 2 von 15

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Do upper motor neuron lesions tend to cause hyper or hyporeflexia?

Wähle eine der folgenden:

  • Hyporeflexia

  • Hyperreflexia

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Frage 3 von 15

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In terms of the main sensory and motor pathways:
Dorsal Column pathway: ( Ipsilateral, Contralateral )
Spinothalamic Tract: ( Contralateral, Ipsilateral )
Corticospinal tract: ( Ipsilateral, Contralateral )

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Frage 4 von 15

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The dorsal column/medial lemniscus pathway is considered an ipsilateral pathway as it also decussates at the ( medullary level, relevant spinal level, level of the pons, level of the midbrain )

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Frage 5 von 15

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Define Spondylosis

Wähle eine der folgenden:

  • A painful condition of the spine resulting from the degeneration of the intervertebral discs.

  • a painful condition of the spine resulting from the degeneration of the vertebral body

  • a painful condition of the spine resulting from the degeneration of the spinous processes

  • a painful condition of the spine resulting from the degeneration of the articular processes

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Frage 6 von 15

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Which of the following conditions causes complete sensory and motor loss below the site of the lesion?

Wähle eine der folgenden:

  • Spinal Cord Transection

  • Brown-Sequard Syndrome

  • Central Cord Syndrome

  • Anterior Cord Syndrome

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Frage 7 von 15

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A patient presents to A&E with a stab wound in the left side of his back. He has the following signs:

- Extreme weakness and complete loss of pinprick sensation on the left side from T7 downwards
- Extreme pain on his left side
- No response to painful or thermal stimuli on his right side from T6 downwards

Diagnose this patient.

Wähle eine der folgenden:

  • Central Cord syndrome

  • Lateral Cord syndrome

  • Anterior Cord syndrome

  • Brown Sequard Syndrome

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Frage 8 von 15

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A patient presents to A&E with a stab would in the right lower thoracic area of his back. On which side of his body would you expect him to have the following deficits?
Loss of sensory function and proprioception - ( Right, Left )
Loss of motor function - ( Right, Left )
Loss of response to painful & thermal stimuli - ( Left, Right )

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Frage 9 von 15

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An elderly man presents to A&E with a large bruised lump in the centre of his forehead. His wife describes that he tripped over a curb outside his house and fell straight onto his face. He complains that he cannot move his hands at all and has horrible tingly pains in these areas.
What is this man likely suffering from?

Wähle eine der folgenden:

  • Central cord syndrome

  • Brown Sequard syndrome

  • Anterior cord syndrome

  • Lateral cord syndrome

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Frage 10 von 15

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Central cord syndrome is a typically hyperflexion/hyperextension injury to an already stenotic neck, typically affecting the upper limbs while sparing the lower limbs

Wähle eins der folgenden:

  • WAHR
  • FALSCH

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Frage 11 von 15

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Patients with central cord syndrome tend to experience both sensory and motor deficits of the upper limbs.

Wähle eins der folgenden:

  • WAHR
  • FALSCH

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Frage 12 von 15

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High energy traumatic injuries tend to damage the most mobile segments of the spine, most frequently the ( cervical, thoracic, lumbar, sacral, coccygeal ) spine.

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Frage 13 von 15

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Tumours causing spinal cord compression tend to be metastases from other metastatic processes in the body. What are the four most common organs that metastasize to the spine?

Wähle eine oder mehr der folgenden:

  • Breast

  • Lung

  • Kidney

  • Prostate

  • Ovarian

  • Testicular

  • Colorectal

  • Bladder

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Frage 14 von 15

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The most common causative organism in spinal epidural abscess is ...

Wähle eine der folgenden:

  • Staphylococcus aureus

  • Streptococcus Pneumoniae

  • Pseudomonas Aeruginosa

  • Listeria

  • Streptococcus Viridans

  • Enterococci

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Frage 15 von 15

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Empirical treatment (until causative agent is identified) for an epidural abscess is ...

Wähle eine der folgenden:

  • Vancomycin + Metronidazole + Cefotaxime

  • Amoxicillin + Metronidazole + Cefotaxime

  • Amoxicillin + Metronidazole + Gentamicin

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