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What are the four clinically important descending or ascending tracts?
1) Dorsal column-medial lemniscus: discriminative touch, vibration, and joint posistion; cross in medulla
2) Lateral spinothalamic tract: pain, temperature, and crude touch; cross immediately
3) Spinocerebellar tract: position of the body in space; ipsilateral
4) Corticospinal tract: lateral columns
What organizational feature aids diagnosis and treatment of chronic pain?
Somatotopic organization
Which fibers are somatotopically organized?
CST, posterior columns, and STT
What happens with transverse spinal lesion?
Function is lost below the level
Which (motor or sensory) are better for determining site of spinal cord lesion?
Sensory abnormalities
What is the difference between intra-axial vs extra-axial spinal lesions?
Intra-axial: within the spinal cord
Extra-axial: pain more common
What disease are evoked potentials beneficial for diagnosis?
MS
Describe transverse myelitis.
Complete transection
Inflammatory condition
Loss of all sensation and all voluntary movement below the lesion
Describe partial transection.
Some ascending or descending tracts may be spared
What is Brown-Sequard Syndrome?
Hemisection
1) Ipsilateral lesion in CST (weakness)
2) Ipsilateral lesion in poosterior columns (loss of position sense and vibratory sensation)
3) Contralateral loss of pain and temperature perception
4) Loss of autonomic function results in Horner's syndrome-constricted pupil and lid-drop- ipsilateral
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