Cortex- Spinal Injuries Flashcards
if you suspect a cervical spine injury what should you do
immobilised
how can the spinal chord or nerve roots be damaged
contusion (bruise), compression, stretch or laceration
what might vascular disruption and oedema cause in a spinal chord injury
further ischaemic damage and hypotension
what is spinal shock
physiological response to injury with complete loss of sensation and motor function and reflexes below the level of injury. resolves in 24 hrs
what is the bulbocavernous reflex
contraction of the anal sphincter with either: -squeeze of the glans penis -tapping of the mons pubis -pulling of the urethral catheter (absent in spinal shock)
what is neurogenic shock
occurs secondary to temporary shutdown of sympathetic outflow from T1-L2
usually due to injury in cervical or upper throacic cord
causes hypotension and bradycardia
resolvese within 24-48 hrs
what is priapism
painful erection, caused by unopposed parasympathetic stimulation, may be present is neurogenic shock
how is neurogenic shock treated
IV fluid therapy
what are complete spinal chord injuries
when there is no sensory or voluntary motor function below the level of the injury (reflexes should return)
what determines the level of injury
the most distal level with partial function- dermatomal sensation and myotomal skeletal muscle voluntary contraction (after spinal shock has resolved)
what is the prognosis for recovery in complete spinal cord injuries
poor
what are incomplete spinal cord injuries
where there is some neurologic function (sensory and/or motor) present distal to the level of injury
what is the prognosis for incomplete spinal injuries
the greater the function present, the faster the recovery and better the prognosis
in spinal injuries what does sacral sparing with preservation of perianal sensation, voluntary anal sphincter contraction and big toe flexion (FHL muscle, S1/2) show
continuity of the cortiospinal (motor) and spinothalamic (course touch, pain and temperature) tracts
sacral sparing indicates an incomplete injury with better prognosis than a complete injury
what nerve abducts the arm
C5
what nerve flexes the fingers
C8
what nerve adducts and abducts the digits
T1
what nerves flex the elbow
C5,6
what nerve extends the elbow
C6,7,8
what nerve adducts the toes
S2,3
what nerve does great toe dorsiflexion
L5
what nerves flex the leg
L1,2
what nerve flexes the knee
L5,S2
what nerve extends the knee
L3,4
