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Transcript
Internal Medicine
2. Diseases of the Spinal cord
Learning objectives: at the end of this lesson the student will be able to:
1. Identify the characteristic features of diseases of the spinal cord.
2. Describe the Etiologies of diseases of the spinal cord.
3. Identify the clinical manifestation of common diseases of the spinal cord.
4.
Understand the diagnostic wok up for common diseases of the spinal cord.
5. Understand the management of common diseases of the spinal cord.
•
Spinal Cord is part of the central nervous system contained in the spinal canal.
The adult
spinal cord is 18 cm long, oval or round in shape in cross section. It has two parts, white
matter and gray matter, with central canal at the center. The white matter contains ascending
sensory and descending motor fibers and gray matter contains nerve cell bodies. Spinal cord
is organized into 31 somatotropic segments, i.e. 8 cervical, 12 thoracic, 5 Lumbar, 5 sacral
and 1 coccygeal segments.
•
Diseases of the spinal cord are frequently devastating, because the spinal cord contains, in a
small cross-sectional area, almost the entire motor output and sensory input of the trunk and
the limbs.
Generally diseases of spinal cord are characterized by:
•
The presence of a level below which motor/sensory and/or autonomic function is
disturbed.
1. Motor disturbance causes weakness (paraplegia, quadriplegia), spasticity,
hypereflexia and extensor plantar response, which is due to disruption of
descending corticospinal fibers.
2. Impaired sensation results from disordered function of ascending spinothalamic
and dorsal column pathways.
3. Autonomic disturbance leads to disturbed sweating, bladder, bowel and sexual
dysfunction.
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