Spinal Cord Compression

The lateral corticospinal tracts decussate in the [blank_start]medulla[blank_end], then move down the spinal cord and synapse at the anterior horn on the [blank_start]contralateral[blank_end] side to their origin (the primary motor cortex). Despite this, the tracts are considered to be [blank_start]ipsilateral[blank_end] 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.

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

In terms of the main sensory and motor pathways: Dorsal Column pathway: [blank_start]Ipsilateral[blank_end] Spinothalamic Tract: [blank_start]Contralateral[blank_end] Corticospinal tract: [blank_start]Ipsilateral[blank_end]

The dorsal column/medial lemniscus pathway is considered an ipsilateral pathway as it also decussates at the [blank_start]medulla[blank_end]

Define Spondylosis

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

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.

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 - [blank_start]Right[blank_end] Loss of motor function - [blank_start]Right[blank_end] Loss of response to painful & thermal stimuli - [blank_start]Left[blank_end]

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?

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

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

High energy traumatic injuries tend to damage the most mobile segments of the spine, most frequently the [blank_start]cervical[blank_end] spine.

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?

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

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