The cauda equina contains the nerve roots from l1 l2

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The cauda equina contains the nerve roots from L1-L2 and S1-S5. The conus medullaris tapers into filum terminate a thin strand of connective tissue running in the centre of the cauda equina. The roots of the cauda equina are organized such that the most centrally located roots are from the most caudal segments of the spinal cord. 125
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Anatomical basis of difference in conus medullaris syndrome and cauda equina syndrome:- Remember that conus medullaris is the distal most part of the spinal cord i.e., it is the sacral segment of the spinal cord, Thus the nerve root affected in this segment are (S1 –S4). 127
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On the other hand caudaequina is a collection of nerve root below the conus medullaris. (It also contain the lumbar nerve roots along with sacral nerves). The cauda equina contains the nerve roots from L1-L5 and S1-S5. So cauda equina syndrome will affect nerve roots from L1 to S5. 128
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Thus in conus medullaris syndrome the knee jerks (L1 –L2 are preserved while ankle jerk S1-S2 is absent where as in cauda equina both are affected. Conus medullaris is the distal most part of the spinal cord and is in close proximity to the nerve root. 129
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Thus lesion of this area often yields a combination of upper motor neuron (UMN) and lower motor neuron (LMN) symptoms and signs in the dermatomes and myotomes in the affected segments. On the other hand cauda equina is made up of nerve roots only which are a part of the lower motor neuron system so the cauda equina syndrome gives only lower motor neuron symptoms. 130
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It also quiet obvious from the anatomy that symptoms in conus medullaris would be bilateral whereas symptoms in cauda equina would be usually unilateral. Radicular pain would be quiet severe in cauda equina due to involvement of the root where as radicular pain would be less severe in conus medullaris . 131
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All of the following statements about Conus syndrome are true except - (AIPGMEE 08) a) Saddle anaesthesia is present b) Flexor plantar response is seen c) Knee and ankle jerks are absent d) Bowel and bladder involvement is prominent C 133
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Early loss of bladder control is seen in - a) Conus medullaris (NBE/DNB Pattern) b) Cauda equina c) Gullain barre syndrome d) Amyotrophic lateral sclerosis 134
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Early loss of bladder control is seen in - a) Conus medullaris (NBE/DNB Pattern) b) Cauda equina c) Gullain barre syndrome d) Amyotrophic lateral sclerosis A 136
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Motor neuron disease 137
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Which is pathognomic for motor neuron disease - a) Fasciculation (Dec 95) b) Bladder, bowel involvement c) Pseudohypertrophy d) Sensory loss in patchy manner 138
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In Motor Neuron disease there is degeneration of motor neurons either upper motor neuron or lower motor neuron or both.
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  • Winter '16
  • jean grey

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