43 INJURIES OF THE SPINAL CORD

Question 1

Define Brown Sequard syndrome

Answer 1

Hemisection of the spinal cord

Question 2

Describe the consequences of a left side hemisection at T8

Answer 2

Left side monoplegia of leg. Left side loss of discriminative sensation (below T8). Right side loss of non-discriminative sensation (below T8). Spastic reflexes of left leg (stretch and babinski’s). Hypertonia of left leg

Question 3

What is the role of the reticulospinal tract

Answer 3

Extrapyramidal; In locomotion and postural control

Question 4

What is the role of the vestibulospinal tract

Answer 4

To alter muscle tone, extend, and change the position of the limbs and head with the goal of supporting posture and maintaining balance of the body and head

Question 5

What occurs in the acute phase following complete transection of the spinal cord at T8

Answer 5

Spinal shock- areflexia
Flaccid paralysis in both legs (paraplegia)
Anaesthesia of sensation in both legs
Disturbed autonomic action- vasodilation (BP drop), absent sweating, bladder and bowel atonia, dysfunction of sexual organs.

Question 6

What occurs with recovery phase

Answer 6

Recovery of muscle tone, increased reflexes, reflex emptying of bladder/bowel, BP increases but remains unstable due to autonomic dysreflexia
May get paresthesia’s (burning pain in abdomen) due to lack of sensory stimulation

Question 7

What are the mechanisms for recovery

Answer 7

Sprouting of axon terminals and formation of new synapses, synaptic plasticity, surviving neurons produce more receptors so more sensitive