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Neuro > 3.2- Spinal Cord Syndromes > Flashcards

3.2- Spinal Cord Syndromes Flashcards

1
Q

What is injury to exactly ½ of the SC (right or left)?

A

Brown-Sequard Syndrome

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2
Q

What is very rare- due to violence (gun or knife)?

A

Brown-Sequard Syndrome

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3
Q

Brown-Sequard Syndrome affects ____________on side of lesion.

A

both white and gray matter

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4
Q

Brown-Sequard Syndrome causes what symptoms in the Dorsal Column (white matter)?

A

loss of light discriminating touch, kinesthetic sense, and vibration on the same side of the lesion (does not cross until the brain)

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5
Q

Brown-Sequard Syndrome causes what symptoms in the Lateral Column- contains Lateral Spinothalamic tract?

A

loss of pain and temp on the opposite side (crosses at same level)

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6
Q

Brown-Sequard Syndrome causes what symptoms in Lateral Corticospinal tract?

A

loss of upper motor neuron on same side (crosses in brain)

results in spastic paralysis on same side- hypertonic and hyperreflexic

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7
Q

Brown-Sequard Syndrome-
cell bodies contained in the ____ are damaged at just that level of trauma, so the affects of cell body loss will be seen at just that level

A

gray matter

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8
Q

Brown-Sequard Syndrome causes what symptoms in the dorsal horn? ventral horn?

A

dorsal horn- complete anesthesia same side in just that dermatome

ventral horn- flaccid in that myotome due to destroyed alpha motor neurons (hypotonic, areflexia just at that level)

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9
Q

What syndrome is anterior 2/3 of spinal cord affected bilaterally?

A

Anterior Cord Syndrome

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10
Q

Anterior Cord Syndrome is very common. It is often seen with ____ injury to the neck damaging the ____ directly or _____ artery.

A

flexion injury

damaging the anterior cord directly or anterior spinal artery

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11
Q

Anterior Cord Syndrome causes what symptoms in the lateral column?

A

damaged bilaterally

lose pain, temp, crude touch bilaterally below lesion

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12
Q

Anterior Cord Syndrome causes what symptoms in the Lateral Corticospinal Tract?

A

damaged bilaterally

spastic paralysis bilateral

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13
Q

Anterior Cord Syndrome causes what symptoms in the cell bodies of gray matter?

A

damaged bilaterally

flaccid paralysis in myotome of lesion level bilaterally

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14
Q

Anterior Cord Syndrome does not affect what spinal structure? What symptoms are left intact?

A

dorsal column

light touch, vibration, kinesthesia intact

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15
Q

What is the most common spinal cord syndrome?

A

Central Cord Syndrome

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16
Q

Central Cord Syndrome affects what area?

Symptoms are not as clear cut.

A

“middle” of cord affected- starts centrally and spreads out

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17
Q

What is usually result of progressive stenosis or compression from a hyperextension injury (bleeding into the gray matter produces the damage)?

A

Central Cord Syndrome

18
Q

Central Cord Syndrome typically affects ___ more than ___. Why?

A

Typically affects UE’s more than LE’s b/c the cervical tracts/UE tracts are deeper than LE and sacral tracts

19
Q

Central Cord Syndrome causes what symptoms in the dorsal column?

A

(light touch and kinesthetic)

variable results with UE’s (deeper) affected before LE’s

can cause “Cape Analgesia”

20
Q

What is “Cape Analgesia”? What syndrome is this associated with? What spinal structure?

A

bilateral decreased sensation in a “cape” pattern

associated with Central Cord Syndrome

Dorsal Column

21
Q

Central Cord Syndrome causes what symptoms in the lateral column?

A

(pain and temp)

generally not affected b/c where it is located except at the level of the lesion bilaterally (remember this is where these fibers cross to the other side- do so through the middle of the cord)

22
Q

Central Cord Syndrome causes what symptoms in the Lateral Corticospinal Tract?

A

(motor)

will have bilateral spastic paralysis in UE’s (deeper) but not necessarily LE’s (b/c of layering)

23
Q

Central Cord Syndrome causes what symptoms in the cell bodies of gray matter?

A

flaccid paralysis bilaterally at level of lesion

24
Q

What syndrome is posterior 1/3 of SC injured due to compression of the Posterior Spinal Artery? (This syndrome has 2 names)

A

Dorsal Column Syndrome

Posterior Cord Syndrome

25
Q

What syndrome is very rare- due to tumor or vascular problem?

A

Dorsal Column Syndrome

sometimes both of these arteries are blocked, but usually its just 1

26
Q

What symptoms result from the dorsal column in Dorsal Column Syndrome?

A

(light touch, kinesthesia)

lost below level of lesion- bilateral if both arteries are affected and same side if only 1 affected

27
Q

What symptoms result from the lateral column in Dorsal Column Syndrome?

A

(pain and temp)

not affected

28
Q

What symptoms result from the Lateral Corticospinal Tract in Dorsal Column Syndrome?

Cell bodies of gray matter?

A

motor is generally not affected

generally not affected

29
Q

More than 50% of SC injuries are ______ injuries because victims are being immobilized better before transport to the hospital.

A

incomplete injuries

30
Q

What is Sacral Sparing?

A

the sacral fibers run the most medially so they are often spared in incomplete injuries

good for client b/c they retain bowel and bladder control

31
Q 
Function depends on level of injury.  UE- level dictates remaining function
C3, C4, C5:
C5:
C6:
C7:
C8:
A 
C3, C4, C5:   diaphragm and upper trap
C5:   deltoid and biceps
C6:   wrist extensors
C7:   triceps, lats
C8:  finger flexors
32
Q 
Function depends on level of injury.  LE- ambulation is always client’s concern.
L2:
L3:
L4:
L5:
S3, S4, S5:
A 
L2:   hip flexors (psoas)
L3:  knee ext
L4:   ankle dorsiflexors
L5:   great toe ext (extensor halluces)
S3, S4, S5:  bladder, bowel, sex organs
33
Q

A ______ injury requires vent, full time help, sip and puff wheelchair.

A

C1-C3

34
Q

A _____ injury allows independent living b/c triceps help with transfers, pressure relief, and self-stretching.

A

C7

35
Q

A ____ injury requires power wheelchair with mouth stick or chin control, mechanical ventilation (maybe only part of the time), full time help.

A

C4

36
Q

A ____ injury requires power chair with hand controls, manual chair with rim projections, Max Assist transfers, independent pressure relief, help setting up self-care activities.

A

C5

37
Q

A ____ injury requires independent sliding board transfers, independent manual wheelchair with rim projections, drive with hand controls, independent feeding with adaptive equipment, independent rolling.

A

C6

38
Q

A ____ injury requires independent pulling into standing in parallel bars and use of long leg braces (community ambulation).

A

L1-L2

39
Q

A ____ injury requires swing through gait with crunches and long leg braces. Able to do curbs and may still use wheelchair b/c of energy and speed considerations.

A

L3-L5

40
Q

A ____ injury-

bracing not as extensive (hinged AFO)

A

sacral

Neuro (30 decks)

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