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Spinal Cord Pathology & Neuroanatomy, Anterior Cord Syndrome, Chiari…
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- Anterior spinal artery (ASA) infarction or anterior compression
- Spares posterior 1/3 of cord
- Spinothalamic tracts (bilateral)
- Lateral and anterior corticospinal tracts (bilateral)
- Anterior horn motor neurons (at level)
- Bilateral loss of pain and temperature below lesion
- Bilateral paraplegia or quadriplegia (UMN signs below lesion)
- Flaccid paralysis at level (LMN)
- Complete preservation of dorsal columns (vibration and proprioception intact)
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- Congenital hindbrain herniation of cerebellar vermis, tonsils, and brainstem through foramen magnum
- Myelomeningocele (nearly 100% association)
- Obstructive hydrocephalus (aqueductal stenosis)
- Syringomyelia (due to disrupted CSF flow dynamics)
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- Spinal Reflexes: GTO vs Muscle Spindle
- Muscle Spindle (Stretch Reflex)
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- Receptor stimulus: Change in muscle length (stretch)
- Afferent: Ia sensory fibers
- Efferent: Alpha motor neuron
- Effect: Contraction of agonist muscle, reciprocal inhibition of antagonist
- Function: Maintains posture and muscle tone
- Golgi Tendon Organ (Inverse Myotatic Reflex)
- Synapses: Polysynaptic (via inhibitory interneuron)
- Receptor stimulus: Increase in muscle tension (active contraction)
- Afferent: Ib sensory fibers
- Efferent: Inhibitory interneuron inhibits alpha motor neuron
- Effect: Relaxation of contracting agonist muscle, activation of antagonist
- Function: Prevents over-contraction and tendon avulsion
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