3.2- Spinal Cord Syndromes Flashcards
What is injury to exactly ½ of the SC (right or left)?
Brown-Sequard Syndrome
What is very rare- due to violence (gun or knife)?
Brown-Sequard Syndrome
Brown-Sequard Syndrome affects ____________on side of lesion.
both white and gray matter
Brown-Sequard Syndrome causes what symptoms in the Dorsal Column (white matter)?
loss of light discriminating touch, kinesthetic sense, and vibration on the same side of the lesion (does not cross until the brain)
Brown-Sequard Syndrome causes what symptoms in the Lateral Column- contains Lateral Spinothalamic tract?
loss of pain and temp on the opposite side (crosses at same level)
Brown-Sequard Syndrome causes what symptoms in Lateral Corticospinal tract?
loss of upper motor neuron on same side (crosses in brain)
results in spastic paralysis on same side- hypertonic and hyperreflexic
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
gray matter
Brown-Sequard Syndrome causes what symptoms in the dorsal horn? ventral horn?
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)
What syndrome is anterior 2/3 of spinal cord affected bilaterally?
Anterior Cord Syndrome
Anterior Cord Syndrome is very common. It is often seen with ____ injury to the neck damaging the ____ directly or _____ artery.
flexion injury
damaging the anterior cord directly or anterior spinal artery
Anterior Cord Syndrome causes what symptoms in the lateral column?
damaged bilaterally
lose pain, temp, crude touch bilaterally below lesion
Anterior Cord Syndrome causes what symptoms in the Lateral Corticospinal Tract?
damaged bilaterally
spastic paralysis bilateral
Anterior Cord Syndrome causes what symptoms in the cell bodies of gray matter?
damaged bilaterally
flaccid paralysis in myotome of lesion level bilaterally
Anterior Cord Syndrome does not affect what spinal structure? What symptoms are left intact?
dorsal column
light touch, vibration, kinesthesia intact
What is the most common spinal cord syndrome?
Central Cord Syndrome
Central Cord Syndrome affects what area?
Symptoms are not as clear cut.
“middle” of cord affected- starts centrally and spreads out
What is usually result of progressive stenosis or compression from a hyperextension injury (bleeding into the gray matter produces the damage)?
Central Cord Syndrome
Central Cord Syndrome typically affects ___ more than ___. Why?
Typically affects UE’s more than LE’s b/c the cervical tracts/UE tracts are deeper than LE and sacral tracts
Central Cord Syndrome causes what symptoms in the dorsal column?
(light touch and kinesthetic)
variable results with UE’s (deeper) affected before LE’s
can cause “Cape Analgesia”
What is “Cape Analgesia”? What syndrome is this associated with? What spinal structure?
bilateral decreased sensation in a “cape” pattern
associated with Central Cord Syndrome
Dorsal Column
Central Cord Syndrome causes what symptoms in the lateral column?
(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)
Central Cord Syndrome causes what symptoms in the Lateral Corticospinal Tract?
(motor)
will have bilateral spastic paralysis in UE’s (deeper) but not necessarily LE’s (b/c of layering)
Central Cord Syndrome causes what symptoms in the cell bodies of gray matter?
flaccid paralysis bilaterally at level of lesion
What syndrome is posterior 1/3 of SC injured due to compression of the Posterior Spinal Artery? (This syndrome has 2 names)
Dorsal Column Syndrome
Posterior Cord Syndrome
What syndrome is very rare- due to tumor or vascular problem?
Dorsal Column Syndrome
sometimes both of these arteries are blocked, but usually its just 1
What symptoms result from the dorsal column in Dorsal Column Syndrome?
(light touch, kinesthesia)
lost below level of lesion- bilateral if both arteries are affected and same side if only 1 affected
What symptoms result from the lateral column in Dorsal Column Syndrome?
(pain and temp)
not affected
What symptoms result from the Lateral Corticospinal Tract in Dorsal Column Syndrome?
Cell bodies of gray matter?
motor is generally not affected
generally not affected
More than 50% of SC injuries are ______ injuries because victims are being immobilized better before transport to the hospital.
incomplete injuries
What is Sacral Sparing?
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
Function depends on level of injury. UE- level dictates remaining function C3, C4, C5: C5: C6: C7: C8:
C3, C4, C5: diaphragm and upper trap C5: deltoid and biceps C6: wrist extensors C7: triceps, lats C8: finger flexors
Function depends on level of injury. LE- ambulation is always client’s concern. L2: L3: L4: L5: S3, S4, S5:
L2: hip flexors (psoas) L3: knee ext L4: ankle dorsiflexors L5: great toe ext (extensor halluces) S3, S4, S5: bladder, bowel, sex organs
A ______ injury requires vent, full time help, sip and puff wheelchair.
C1-C3
A _____ injury allows independent living b/c triceps help with transfers, pressure relief, and self-stretching.
C7
A ____ injury requires power wheelchair with mouth stick or chin control, mechanical ventilation (maybe only part of the time), full time help.
C4
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.
C5
A ____ injury requires independent sliding board transfers, independent manual wheelchair with rim projections, drive with hand controls, independent feeding with adaptive equipment, independent rolling.
C6
A ____ injury requires independent pulling into standing in parallel bars and use of long leg braces (community ambulation).
L1-L2
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.
L3-L5
A ____ injury-
bracing not as extensive (hinged AFO)
sacral
