11: Spinal Injuries Flashcards
Which spinal tract is contralateral?
Spinothalamic tract
Carries pain and temperature
Where are most spinal injuries?
Half at C6 or C7
In complete cord transection, how will this affect someone’s motor and sensory function?
Compete paralysis and loss of sensation below the lesion
What is Brown Sequard syndrome?
Damage to one half of the spinal cord
How does Brown Sequard syndrome present?
Ipsilateral hemiplegia
Ipsilateral loss of conscious proprioception, fine touch and vibration
Contralateral pain and temperature sensation deficits
What can cause anterior cord syndrome?
- ischaemia/ infarction of the anterior spinal artery
- flexion injury
How would anterior cord syndrome present?
Would affect corticospinal and spinothalamic tracts, but DCML tracts would be spared
So: loss of motor function and pain and temperature sensation below the lesion, but fine touch and proprioception and 2 point discrimination and vibration is spared Autonomic dysfunction (bladder, bowel and sexual dysfunction too)
What usually causes central cord syndrome?
Most often from acute hyperextension injury in elderly
Cervical spinal stenosis
Syringomyelia
What is syringomyelia?
Formation of a syrinx (cyst) within the central canal
Obliterates spinothalamic fibres so presents with loss of sensitivity to pain and temperature, usually in a cape like distribution (as these fibres tend to be more medial)
Can lead to motor weakness
DCML tracts spared (like central cord syndrome)
Can expand and lead to varying symptoms depending on affected tissue (primary lesion may have been present since birth but slow growing hence symptom progression)
In what distribution does syringomyelia usually present?
Cape like distribution
How does central cord syndrome present?
Great motor impairment in upper limbs compared to lower
Distal affected more than proximal
Bladder dysfunction and urinary retention
What tracts are effected in posterior cord syndrome?
DCML
What are some causes of posterior cord syndrome?
Very rare, and more likely to be due to chronic pathological process rather than trauma E.g. Spondylosis Infection Spinal stenosis Vitamin B12 deficiency Infarction of posterior spinal artery
How would posterior cord syndrome present?
Loss of fine touch, proprioception, vibration and 2 point discrimination
Retained motor function and pain and temperature sensation
When should intubation be considered for a spinal cord injury?
If C5 or above
Lose innervation to diaphragm via phrenic nerves and intercostal muscles will tire out quickly
