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

Question 1 of 15

1

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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.

Explanation

Question 2 of 15

1

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

Select one of the following:

  • Hyporeflexia

  • Hyperreflexia

Explanation

Question 3 of 15

1

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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 )

Explanation

Question 4 of 15

1

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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 )

Explanation

Question 5 of 15

1

Define Spondylosis

Select one of the following:

  • 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

Explanation

Question 6 of 15

1

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

Select one of the following:

  • Spinal Cord Transection

  • Brown-Sequard Syndrome

  • Central Cord Syndrome

  • Anterior Cord Syndrome

Explanation

Question 7 of 15

1

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.

Select one of the following:

  • Central Cord syndrome

  • Lateral Cord syndrome

  • Anterior Cord syndrome

  • Brown Sequard Syndrome

Explanation

Question 8 of 15

1

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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 )

Explanation

Question 9 of 15

1

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?

Select one of the following:

  • Central cord syndrome

  • Brown Sequard syndrome

  • Anterior cord syndrome

  • Lateral cord syndrome

Explanation

Question 10 of 15

1

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

Select one of the following:

  • True
  • False

Explanation

Question 11 of 15

1

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

Select one of the following:

  • True
  • False

Explanation

Question 12 of 15

1

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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.

Explanation

Question 13 of 15

1

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?

Select one or more of the following:

  • Breast

  • Lung

  • Kidney

  • Prostate

  • Ovarian

  • Testicular

  • Colorectal

  • Bladder

Explanation

Question 14 of 15

1

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

Select one of the following:

  • Staphylococcus aureus

  • Streptococcus Pneumoniae

  • Pseudomonas Aeruginosa

  • Listeria

  • Streptococcus Viridans

  • Enterococci

Explanation

Question 15 of 15

1

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

Select one of the following:

  • Vancomycin + Metronidazole + Cefotaxime

  • Amoxicillin + Metronidazole + Cefotaxime

  • Amoxicillin + Metronidazole + Gentamicin

Explanation

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