3.19 Spinal Region 4 Flashcards
disorders in addition to traumatic SCI that interfere with spinal region function
- meningomyelocele
- spastic CP
- dorsal and ventral nerve root lesions
- MS
- lesions that cause compression on SC
meningomyelocele
- developmental defect arising from failure of inferior neuropore to close
- outcomes equivalent to SCI later in life
When does spastic CP develop?
- in utero
- during infancy
characteristics of spastic CP
- excessive muscle contraction
- phasic stretch hyperreflexia
radiculopathy
- lesion of nerve root
- damage to spinal nerve
How are radiculopathies formed?
- mechanical irritation
- infection
produces pain in innervated dermatome and muscles innervated by the segment
Erb’s palsy
- paralysis that results from separation of the head and shoulder
- common causes include birth trauma and motorcycle accidents
Klumpke’s palsy
- avulsion of motor roots of C8 and T1
- caused by traction on abducted arm
result of Klumpke’s palsy (complete severance)
- muscles in myotome deprived of motor innervation
- get atrophy and fibrillation
MS characterized by
random, multifocal demyelination of CNS
variable s/s
sensory complaints with MS
- numbness
- paresthesia
- Lhermitte’s sign
LE effects from MS
- asymmetrical weakness
- ataxia
TM
- immune disorder that damages part of the SC
- inflammation produces spinal segment losses and blocks ascending/descending signals
looks like a SCI
pressure in spinal region causes
- pain (usu constant)
- sensory changes
- weakness
- paralysis
- hypertonia
- ataxia
- impaired bowel/bladder function
onset of s/s from spinal region compression
- gradual
- progressive
- no hx of trauma
- segmental/vertical tract signs
- cervical spondylosis
- syringomyelia
spinal region tumors: outside the dura may cause compression on
- SC
- nerve roots
- spinal nerve
- blood supply
spinal region tumors: most common initial symptom
pain, aggravated by coughing or sneezing
Where can spinal region tumors occur?
inside and outside the SC
myelopathy
disorder of SC
cervical spondylosis
- degeneration of cervical vertebrae and discs
- produces narrowing of vertebral canal and intervertebral foramina
narrowing causes
- increased stretch and shear forces on cord and nerve roots
- damages glia and neurons
(Gray/White) matter is particularly susceptible to stretch injury
gray
vertebral canal stenosis
- narrowing of the vertebral canal
- compresses neural and vascular structures
- usually degenerative disorder
vertebral canal stenosis: degenerative disorder brought on by
- bone growth
- facet hypertrophy
- bulging discs
- hypertrophy of ligamentum flavum
syringomyelia
rare, progressive disorder
- segmental signs in UE
- sensory loss often distributed similarly to a cape draped over the shoulders
segmental signs with syringomyelia
- loss of pain and temperature sensitivity due to interruption of axons crossing midline in anterior white commissure
- paresis
- atrophy
s/s that are indicative of a SC lesion (red flags)
- bilateral alteration or loss of somatosensation
- incoordination
- UMN signs
What are the UMN signs?
- decreased muscle power
- spasticity
- muscle hypertonia
- Babinski’s sign
- clonus
s/s that indicate a possible cauda equina lesion (red flags)
- difficulty with urination and/or defacation
- saddle paresthesia
- LBP
- unilateral or bilateral sciatica
- LE paresis and sensory deficits
- decreased or lost LE reflexes
s/s that indicate intermittent claudication (red flags)
- cramping in calf or foot while walking or exercising that disappears after a brief rest
- decreased pulse in LE
- cyanosis
