Medulla Spinalis

(Spinal Cord)
dr. Ni Made Susilawathi,Sp.S
Bag./SMF Neurologi RSUP Sanglah/FK Unud
The Anatomy
anantomySpinal cord Cord
of Spinal
Diseases of the Spinal Cord
 Etiological causes of Diseases
V = vascular
I = infection
T = trauma
Onset A = autoimune
Acute M = metabolic
Chronic I = idiopathic
N = neoplasm

D = drug
 Diseases of the Spinal Cord
TRAUMA
Transverse Myelopathy
Spinal Cord Concussion
Central Cord Syndrome
MYELITIS
Myelitis due to viruses
Bacterial, Fungal, Parasitic & Granuloma
Noninfectious inflammatory type ..i.e. Post-
infectious/postvaccinal myelitis, acute MS,
paraneoplastic myelitis, etc...
 Diseases of the Spinal Cord
VASCULAR DISEASES
Infarction of the spinal cord
Spinal cord hemorrhage (Hematomyelia)
Vascular malformation of the spinal cord
Caisson disease/Decompression sickness
Spinal subdural hemorrhage

TUMORS
Meningioma, Ependymoma, Neurofibroma, Astrocytoma, Lipoma
Metastatic tumors

Degenerative
Cervical Spondylosis with myelopathy
 Main Spinal Cord Syndromes
Transverse Myelopathy ( complete or partial)
Hemisection (Brown-Sequard Syndrome)
Ventral or Anterior Cord Syndrome
Central Cord Syndrome(Syringomyelia)
Posterior Spinal Cord Syndrome
Syndrome of the Conus Medullaris
Syndrome of the Cauda Equina
Gray matter syndrome
 Posterior column syndrome

Vitamin B12 deficiency, AIDS-associated vacuolar myelopathy,

and spinal cord compression (e. g., in cervical spinal stenosis),
tabes dorsalis due to syphilis
Gray matter syndrome
Syndrome of the dorsal root ganglion

herpes zoster
Myastenia gravis
 Where does the disease take place?
Myasthenia Gravis takes place a the
neuromuscular junction.
 Clinical Presentation
Fluctuating weakness increased by exertion
Weakness increases during the day and improves
with rest
Extraocular muscle weakness
Ptosis is present initially in 50% of patients and
during the course of disease in 90% of patients
Head extension and flexion weakness
Weakness may be worse in proximal muscles
www.nanosweb.org/.../images/mythenia_1.jpg
Ocular Examination for Suspected MG

Limitation of adduction

Eyelid drooping (ptosis)

Normal pupil size and reaction

 Phisical complication of Myastenia
Gravis
Myasthenic crisis
acute muscle weakness leading to respiratory
failure
Acute respiratory failure
- if the breathing muscles adversely affected.
Thymus tumors
Multiple Sclerosis
 What is Multiple Sclerosis?
It is an Auto Immune Disease which is when the body starts to destroy itself.
It is a life-long disease with no cure.

In MS, the body attacks and destroys the fatty tissue called myelin that insulates
an axon/nerve, and is called demyelination.
If damage is severe it can also destroy the nerve/axon itself.

MS affects the central nervous system and inflames the white matter in the
brain which creates plaques. White matter is below the top layer of our
brain and spinal cord. Plaques block a signal from being passed from
the body to the spinal cord and brain.

Currently in the US, 250,000-300,000 people have been diagnosed with MS and
there are 200 new cases diagnosed every week.
Type of MS
multiple sclerosis
 Fatigue
Loss of mobility and spasticity
Pain
Bowel, sexual and urinary dysfunction
Difficulty swallowing
Speech and hearing problems
Problems in the lungs
Osteoporosis
Nursing Issues following spinal
cord problem
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