Exam 1 Flashcards
is the dorsal column medial lemniscal tract ascending or descending
what is the DCML’s function
ascending tract - carries sensory info
carries vibration, proprioception, light touch
where does the DCML cross
where is its location on a cross-section
medulla
posterior
is the spinal thalamic tract ascending or descending
what information does the spinal thalamic tract carry
ascending
sensory information
where does the spinal thalamic tract cross
where is its location in a cross-section
spinal cord
anterior-lateral
is the corticospinal tract ascending or descending
what information does it carry
descending
motor
where does the corticospinal tract cross
where is its location in a cross-section
crosses in brain stem
lateral
what is the most common age range and gender for SCI
why
males ages 15-29 d/t decreased executive function
65+ d/t increase fall risk
describe SCI diagnoses that indicate a longer life expectancy
incomplete > complete
paraplegia > tetraplegia
lower cervical tetraplegia > higher cervical tetraplegia
mortality rate higher in the first year following injury
describe spinal shock
happens immediately after SCI
period of areflexia that lasts
reflexes return over 1-3 day
hyperreflexia possible 1-4 weeks following
how is SCI named
spinal level of injury
anatomical location of injury in cord
completeness of injury
describe ASIA A
complete
no motor or sensory function is preserved in the sacral segments S4-5
describe ASIA B
incomplete
sensory but no motor function preserved below neurological level and includes sacral segments S4-5
describe ASIA C
incomplete
motor function is preserved below the neurological level and more than half of key muscles below the neurological level have a muscle grade <3
describe ASIA D
incomplete
motor function is preserved below the neurological level and at least half of key muscles below the neurological level have a muscle grade of >3
Describe ASIA E
normal
motor and sensory function is normal
how is motor level of injury evaluated and decided
determined by testing 10 key muscles on R and L side of the body
the lowest myotome that has a grade of at least 3 if the one above it is a 5
how is sensory level of injury evaluated and decided
determined by light touch and pin prick on both R and L side of the body
the most caudal level with normal light touch and pinprick sensation
define neurologic level of injury
the most caudal level of the spinal cord with normal motor and sensory function both the right and left sides of the body
define zone of partial preservation
dermatomes and myotomes caudal to the sensory or motor level that remain partially innervated
used to apply only to complete injuries (ASIA A)
sensory but not motor preserved at sacral segments describes…
ASIA B
incomplete sensory
motor below injury at 3/5 or less for more than half of muscle groups describes…
ASIA C
incomplete motor
motor below injury at 3/5 or more for more than half of muscle groups describes…
ASIA D
incomplete motor
no motor or sensory at sacral level describes..
ASIA A
complete
injury that occurs d/y hyperextension injury
B loss of DCML
posterior cord syndrome
injury that occurs d/t hyperflexion
B loss of CST and STT
anterior cord syndrome
injury d/t hyperextension in a pt that already has stenosis
UE > lE affected
varying degrees of sensory impairment
sacral sparing
central cord syndrome
rare injury d/t shot or stab that can interfere with ipsilateral blood supply to the spinal cord
ipsilateral loss of DCML and CST
contralateral loss of STT
brown sequard syndrome
what symptoms would you expect with conus medullaris syndrome
mixed LMN and UMN
what symptoms would you expect with cauda equina syndrome
LMN
flaccid paresis
saddle anesthesia
would you expect (UMN/LMN/mixed) symptoms with an injury T7-9
UMN
would you expect (UMN/LMN/mixed) symptoms with an injury T10-12
Mostly
LMN, but possibly some mixe
would you expect (UMN/LMN/mixed) symptoms with an injury L1-3
LMN
descibe the symptoms you would expect with a LMN injury
injury below T12
hyporeflexia
flaccidity
decreased tone/spasticity
negative UMN signs
flaccid bladder and bowel
psychogenic responses for sexual function
describe the symptoms you would expect with a UMN injury
injury above T12
hyperreflexia
increased tone/spacisity
positive UMN signs
spastic/hyperreflexive bladder and bowel
reflexogenic arcs for sexual function
what are symptoms of autonomic dysreflexia
HTN
bradycardia
headache
sweating
increased spasticity
vasodilation above level of injury
constricted pupils
nasal congestion
pilirecition
blurred vision
dry, pale skin
define a stage 1 pressure injury
intact skin
non-blanchable
define a stage 2 pressure injury
partial thickness looks like a blister or scrape
define a stage 3 pressure injury
full thickness into the subcutaneous fat layer
degine a stage 4 pressure injury
full thickness involving muscle or bone
at what levels should you be concerned with autonomic dysreflexia
above T6
