Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
SPINAL CORD <br />DISORDRS<br />ALI ABDULLAH ALBALUSHI<br />OMSB<br />EMERGENCY MEDICINE, R-4<br />
OUTLINE<br />ANATOMY<br />DIFFERENT SPINAL CORD DISORDERS<br />CONCLUSION<br />QUISTIONS<br />
ANATOMY<br />Spinal cord: foramen magnum  1st/2nd lumbar vertebrae. <br />Cervical enlargement:<br />C5-T1: gives rise to...
All are true about the anatomy of the spinal cord except :<br />It is 40 cm long<br />Supplied by a single anterior spinal...
2) All are true regarding complete spinal cord syndrom except:<br />It is a total loss of sensory, autonomic & voluntary m...
3) All are true about spinal shock except :<br />It is the loss of muscle tone & reflexes with complete cord syndrom durin...
4) Central cord syndrom, all are true except :<br />It is the post prevalent of the partial cord syndroms<br />Upper extre...
5) All are true about Brown- Sequard Syndrom except:<br />Usually, it results from penetration injuries<br />Characterized...
6) Regarding anterior cord syndrom, all of the following are true except :<br />Posterior column  is preserved<br />Most c...
7)  Regarding Conus Medullaris & Cauda Equina syndroms , What is false ?<br />It is very difficult to separate the two syn...
8) All of the following result from intrinsic lesions in the spinal cord except :<br />Multiple Sclerosis<br />Syrigomyeli...
All are true about MS except :<br />It is a demyelinating disease affecting CNS<br />Presents with patchy motor & sensory ...
10) All are true about Transverse Myelitis except :<br />Present with paraplegia , sensory level & sphincter disturbance<b...
11) All of the following are true about syringomyelia except ?<br />It is a condition of having a cavity lesion within the...
12) Which statement is true about Spinal Epidural Hematoma ?<br />It is common with incidence of 5 per 100000 pts<br />It ...
13) All statements are true about spinal epidural abscess Except :<br />It results from hematogenous spread of infection ,...
<ul><li>Urgent MRI must be done if diagnosis is suspected
If MRI is not available, CT Myelogram should be done
Neurological deficit rarely improve if surgical intervention is delayed more than 12 – 36 hrs after onset of paralysis
 Antibiotics : Vancomycin & Third generation Cephalosporine IV</li></ul>Rifampin oral<br />
14) All statements are true about Diskitis Except :<br />The most common causative organism is staph. Aurius<br />It is mo...
15) All are true about spinal cord neoplasm Except :<br />Neurological symptoms caused by compression, invasion & distruct...
Upcoming SlideShare
Loading in …5
×

Spinal cord disorders

8,386 views

Published on

Published in: Education
  • Be the first to comment

Spinal cord disorders

  1. 1. SPINAL CORD <br />DISORDRS<br />ALI ABDULLAH ALBALUSHI<br />OMSB<br />EMERGENCY MEDICINE, R-4<br />
  2. 2. OUTLINE<br />ANATOMY<br />DIFFERENT SPINAL CORD DISORDERS<br />CONCLUSION<br />QUISTIONS<br />
  3. 3. ANATOMY<br />Spinal cord: foramen magnum  1st/2nd lumbar vertebrae. <br />Cervical enlargement:<br />C5-T1: gives rise to brachial plexus, innervates UE;<br />L2-S3: gives rise to lumbosacral plexus, <br />Gray matter – central (cell bodies)<br />White matter – peripheral (ascending and descending tracts)<br />
  4. 4.
  5. 5. All are true about the anatomy of the spinal cord except :<br />It is 40 cm long<br />Supplied by a single anterior spinal artery & paired vertibral artery<br />The posterior column carry the afferent ascending fibers for properiocetion & vibration & cross at level of medulla<br />In the spinothalamic tract, sacral fibers are represented most medially<br />In corticospinal tract, the fibers cross at level of medulla & cervical fibers are located medially<br />
  6. 6. 2) All are true regarding complete spinal cord syndrom except:<br />It is a total loss of sensory, autonomic & voluntary motor innervation distal to the level of the spinal cord injury<br />Deep tendon reflexes my persist<br />The most common cause is trauma<br />99% of patients with persistent symptoms beyond 24 hrs do not have a functional recovery<br />1% of patients will have some evident of cord function below the level of injury<br />
  7. 7. 3) All are true about spinal shock except :<br />It is the loss of muscle tone & reflexes with complete cord syndrom during the acute phase of injury<br />The intensity of the spinal shock increases with the height of the level in the spinal cord<br />It typically lasts less than 24 hrs<br />Bulbocavernous reflex is present<br />The termination of spinal shock phase of injury is heralded by return of balbocavernous reflex<br />
  8. 8. 4) Central cord syndrom, all are true except :<br />It is the post prevalent of the partial cord syndroms<br />Upper extremities are affected more & distal muscles are affected to a greater degree<br />The most common mechanism is motor vehicle crush<br />It is caused most often by hyperextension<br />Elderly are affected more & prognosis is better in patients younger than 50 yrs<br />
  9. 9. 5) All are true about Brown- Sequard Syndrom except:<br />Usually, it results from penetration injuries<br />Characterized by ipsilateral motor weakness & vibration / position loss & contralateral pain/ tempreture loss<br />It can be associated with A-V malformation<br />Ipsilateral pain & tempreture loss may be noted 1 – 2 levels above the lesion<br />It has the worst prognosis of any incomplete spinal cord syndroms<br />
  10. 10. 6) Regarding anterior cord syndrom, all of the following are true except :<br />Posterior column is preserved<br />Most cases reposted after aortic surgeries<br />It can be caused by hypotension<br />Generally, the prognosis is good<br />
  11. 11. 7) Regarding Conus Medullaris & Cauda Equina syndroms , What is false ?<br />It is very difficult to separate the two syndroms clinically<br />Conus Medullaris usually presents with overflow incontinence or sexual dysfunction<br />Usually, Conus Medullaris presents unilaterally<br />Cauda Equina is a LMN picture with hyporeflexia <br />Saddle sensory loss is common in both syndroms<br />
  12. 12.
  13. 13. 8) All of the following result from intrinsic lesions in the spinal cord except :<br />Multiple Sclerosis<br />Syrigomyelia<br />Myelopathy<br />Spinal epidural abscess<br />Spinal cord infarction<br />
  14. 14.
  15. 15. All are true about MS except :<br />It is a demyelinating disease affecting CNS<br />Presents with patchy motor & sensory findings<br />Presents with UMN picture<br />Oligoclonal bands in CSF are significant only if present in the serum as well<br />Immunosuppresive therapy is the treatment of choice<br />
  16. 16. 10) All are true about Transverse Myelitis except :<br />Present with paraplegia , sensory level & sphincter disturbance<br />It is rare & progress slowly<br />Thoracic cord is affected most often & cervical rarely<br />The most essential aspect in management is to role out treatable causes<br />Steroids are of unknown benefit<br />
  17. 17. 11) All of the following are true about syringomyelia except ?<br />It is a condition of having a cavity lesion within the substance of the spinal cord<br />Disassociative anesthesia is the classic pattern of sensory deficit<br />CT is the diagnostic tool of choice<br />It is not necessary to perform an emergent imaging if f/u can be arranged<br />It is ass with Arnold – Chiari I Syndrom<br />It is treated with surgical removal If symptoms are progressive<br />
  18. 18. 12) Which statement is true about Spinal Epidural Hematoma ?<br />It is common with incidence of 5 per 100000 pts<br />It is not associated with anticoagulation therapy<br />Pain decreases by coughing or sneezing or straining<br />Patients usually present initialy with neurological deficit rather than pain<br />Emergent decompressive laminectomy is the treatment of choice <br />
  19. 19. 13) All statements are true about spinal epidural abscess Except :<br />It results from hematogenous spread of infection , mostly bacterial<br />Diabetics , IV drug users & HIV patients are at higher risk<br />Cervical site of infection predominate <br />Spread to subdural space & intraspinal area is uncommon<br />Urgent surgical consultation for decompression is required<br />
  20. 20. <ul><li>Urgent MRI must be done if diagnosis is suspected
  21. 21. If MRI is not available, CT Myelogram should be done
  22. 22. Neurological deficit rarely improve if surgical intervention is delayed more than 12 – 36 hrs after onset of paralysis
  23. 23. Antibiotics : Vancomycin & Third generation Cephalosporine IV</li></ul>Rifampin oral<br />
  24. 24. 14) All statements are true about Diskitis Except :<br />The most common causative organism is staph. Aurius<br />It is more common among pediatric age group, < 10 yrs<br />Lumbar spine is the most common site<br />Neurological deficit is common<br />Treated usually with antibiotics & surgery is often not necessary<br />
  25. 25. 15) All are true about spinal cord neoplasm Except :<br />Neurological symptoms caused by compression, invasion & distruction of the myelinated tracts by the tumors<br />Metastasis is the most common spinal cord tumers<br />Lumbar region is the most affected<br />Recumbency worsen the pain<br />Severe nighttime pain is charactrestic<br />
  26. 26.
  27. 27. CONCLUSION<br />
  28. 28. THANKS<br />

×