Ch. 13: Spinal Region Flashcards
Overall Function of Anterior Columns
Motor
Overall Function of Anterolateral Columns
Pain
Overall Function of Lateral Column
Autonomic
Overall Function of Dorsal Columns
Sensory
Spinal cord regional differences
Sacral: decreased white matter
Lumbar: increased grey matter
Thoracic: decreased grey matter
Cervical: increased grey and white matter
Dorsal Root
- Sensory
- dorsal root ganglion
- 2 divisions: medial and lateral
Medial division fibers of dorsal root
- sensory fibers into dorsal column
- discriminative touch, proprioception
Lateral division fibers of dorsal root
-sensory fibers that cross midline to go up anterolateral column
White Matter
- propriospinal axons
- Tract axons (vertical columns of white matter)
- columns (bundles of white matter)
Bladder Void Reflex
- autonomic/visceral reflex (reflex loop of aff/eff autonomic)
- stim: stretch of full bladder
- Response: parasymp control bladder
- descending sympathetics inhibit void
Cauda Equina damage on bladder
-flaccid bladder
Spinal cord damage above lumbar affect on bladder
-spastic bladder
Segmental dysfunction (horizontal)
- S/Sx level of lesion only
- decreased dermtomal sensation
- decreased myotomal motor function
Tract Pattern
-sensory, motor, and autonomic loss at all segments below lesion
Neurologic Level
-lowest level of spinal cord that still has normal sensory function and motor function is 3/5 with the next level up 5/5
Propriospinal Axons
- interneurons that travel between spinal segments to help coordinate multi-segmental reflexes
- create wiring for multisegment reflexes (w/d) and stepping pattern generator
Grey Matter
- Horns
- dorsal: sensory somas
- lateral: efferent autonomic somas
- ventral: LMN somas
Spinal Shock
- initial loss of spinal level reflexes and autonomic reflexes
- then hyperreflexia below lesion
Vertical Tract Dysfunction
- Tract pattern
- dorsal column signs contralateral
- anterolateral column signs contralateral
- corticospinal signs ipsilateral
Spinal Region Syndromes
- Anterior cord syndrome
- central cord syndrome
- brown-sequard syndrome
- cauda equina syndrome
Tetraplegia
paralysis of all 4 limbs and trunk
paraplegia
paralysis of 2 LE and some trunk
Atrophy of Denervation
-LMN injury
Atrophy of Disuse
-UMN injury
Abnormal reflex activity in chronic cord injury
- below level of injury: hyperreflexia, enhanced w/d reflex
- the more the reflex loop is cut off from the UMN, the worse the hyperreflexia will be
Autonomic Dysfunction in chronic Spinal cord injury
- Autonomic hyperreflexia
- impaired temp regulation (decreased sweating and shunting of blood)
- orthostatic hypotension
- (above T1)
Autonomic Hyperreflexia
- cause: damage of autonomic (above T1)
- stimulus: noxious irritant (full bladder)
- response: systemic increase in sympathetic functions (HR, BP)
Mechanical changes in Mm below lesion
- Atrophy
- Fibrosis
- Contracture
