Complete Transection of spinal cord

Question 1

بسم الله الرحمن الرحيم
Mention cause of complete transection of spinal cord

Answer 1

الحمدلله رب العالمين
Gunshot
Vascular
Spin dislocation in accidents

Question 2

Mention effects of Complete Transection of spinal cord

Answer 2

Sensory: loss of all sensations below the level of lesion
and the tracts has no neurliemma so cannot regenrate
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Motor loss of all vouluntery movments below the level of lesion and the treacts has no neurlemma cannot regenrate
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Motor reflexs the patients enter spinal shock stage then with cure spinal recovery can occur

Question 3

Motor paralysis in complete transection of spinal cord describe

Answer 3

If above C5 = Diapharamtic paralysis as Respiratoy center cannor reach c345 of phrenic which supply the diapharagam
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If below C5 = Quadriplegia with diapharagmatic respiration
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if Lesion in Mid thoracic casues paraplegia = Paralysis of lower limbs with Normal Respiration

Question 4

Paraplegia occurs in casue of ?

Answer 4

Med thoracic segments complete spinal cord transection

Question 5

Spinal shock Stage what is it ?

Answer 5

Stage of loss of all reflexes after complete transection of spinal cord semgntes and this occure below the lesion
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Explain : due to Cut of Faciliatory Suprspinal impulses if Cortico Reticulo Vestibulospinal Tracts causing loss of its Excitation to alpha motor neruons and loss of reflexes and responses to afferents
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2-6 weeks human 2-6 days monkeys 2-6 h dogs
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-Loss of Relfexes;
Deep reflexes - areflexia atonia
Superfical reflexes lost
Flexor withdrawal refelx lost
-Loss of Autonomic control of Micturation and defectaion
by lateral horn cells casuing reterntion with dribbling
-Loss of Vasmotor tone from VMC of sympathatic
casuing Vasodilation and Hypotension .
less blood flow and venous return from the paralysed limbs and casuign cold dry limbs may develops into Bed sores or Ulcers
Muscle atrophy due to loss of viluntary movments and reflexes
Bone Demineralization occurs hypercalacemia

Question 6

Care proceudres for spinal shock patient mention

Answer 6

Catherization
Rectal enema
Antibiotics
Bed movments
Physiotherapy
Good Nutrition

Question 7

Bad care in stage of Spinal shock leads to ?

Answer 7

CNS deprssion of Vital centers and death due to ?
Toxemia + septicemia from Urinary Tract infections
and bed sores infections

Question 8

What is the result of good care of spinal shock patient ?

Answer 8

Enter stage of recovery of reflexes :-
due to Denervation hypersenstivity of alpha motor.
Collateral arsising from a neurons exciting each other
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-Reflexes : SR: Muscle tone Reappear.
Flexor tone appear first=Paraplegia in flexion
Deep refelxes ankle then Knee jerks
Flexor with drawal reflex with flexion and inhibtion ofEX
-ABP increased due to increased tone increasing venoconstriciton and venour return and cop and ABP
But the regulation of ABP is not good due to Cut of VMC impulses
Autonmic Micturation and Defecation as infants when filled with 150 ml the bladder is evacuated
Reflexes are EXAGGERATED
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Sexual function : In spite of loss of sexual desire with manipulation of Gentalia impulses reaches the lumbosacral semgents lateral horn giving orders to Erection and Ejaculation
-Mass Reflex
-After some time Paraplegia in Extension
Some infant relfexes: Grasp + and Babinski +
flexor withdrawal reflex accompanied with Corssed Extensor Reflex

Question 9

Explain mass Reflex

Answer 9

Reflex appeara in recovery from spinal shock in Complete spinal cord Transection
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Due to Scratching of skin of L.L OR abdomen
causes:
LL Flexion - Contraction of Abdominal Mucles
Defecation -Micturation - Erection
Sweating of Below lesion -Increased BLOOD PRESSURE
Due to :
1-Denervation Hypersensitvity
2-Collaterals from the alpha motor neurons
3- y motor neurons excitability

Question 10

Explain Thalamic Syndrome

Answer 10

Due to Thalamgeniculate artery thrombosis
ACUTE AND CHRONC
ACUTE
LOSS OF ALL SENSATIONS of opposite side
2ndy hyperalgia due to release from gate inhibitory fibs
Sensory ataxia
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Chronic :
Recovered crude touch - poorly localized - need high threshold stimulation
2ndry Hyperalgesia
Attacks of pain
Thalamic hyperpathia
emotional disturbances
Motor ataxia
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Question 11

والحمد للـــــــــــــ رب العالمين ـــــــــــــــــــه