Lec 09: Rehabilitation of Neurogenic Bowel, Bladder, and Spinal Cord Flashcards
What are the three main functions of the spinal cord?
motor, sensory, ANS
How many pairs of spinal nerves and dermatomes are there?
31 pairs of SNs and 28 pairs of dermatomes (no C1, S4 and S5 correspond to 1 dermatome)
What is the topography of fibers in the anterolateral system of the spinal cord?
cervical, thoracic, lumbar, sacral (medial to lateral)
How is the spinal cord supplied with blood?
anterior 2/3: anterior spinal artery
posterior 1/3: posterior spinal artery
Which nerve fiber tract is responsible for proprioception?
medial lemniscal
Why should a dermatomal assessment not be done above the level of T3?
there is overlapping of sensory fibers
What should be the direction of the dermatomal assessment in a patient with spinal cord injury?
caudocephalic - to avoid conditioning
Sympathetic and Parasympathetic fibers are mostly located at which level of the spinal cord?
sympathetic - thoracolumbar
parasympathetic - craniosacral
Which drug is used to reverse the inflammatory process in spinal injury patients?
methylprednisolone (within 6-8 hours)
In an incomplete injury, which area is usually spared?
outermost (sacral)
How is the bulbocavernosus reflex elicited?
feel for anal sphincter contraction while gently pulling on the catheter (a positive sign means that there is sacral sparing)
How long does it usually take for spinal shock to resolve?
within 72 hours
Which terms are used to refer to paralysis in brain and spinal cord pathology?
brain pathology - quadriplegia and diplegia
spinal cord pathology - tetraplegia and paraplegia
What are the characteristics of anterior cord syndrome?
- anterior 2/3 affected
- loss of pain and temp. sensation (spinothalamic tract)
- loss of motor function
- deficit is contralateral to lesion
What are the characteristics of posterior cord syndrome?
- posterior 1/3 affected
- loss of proprioception
- deficit is ipsilateral to the lesion
What are the characteristics of Brown-Sequard syndrome?
- contralateral loss of pain and temp. sensation and ipsilateral motor deficits
- hemisection (lateral damage)
Which nerve innervates the respiratory muscles?
phrenic nerve (C3, C4, C5)
What are the manifestations of cervical injury in the heart and GIT?
heart - vagus nerve is spared: bradycardia
GIT - vagus nerve is spared: parasympathetic manifestations (ex. hypermotility)
(T/F) If the LE motor function is graded 0/5 the sphincter muscles of the bladder will be unable to contract
F - sphincter is controlled by the sympathetic NS (alpha innervation is intact)
What are the requirements for bladder training?
intact cognitive function, hand function, sitting balance
What 3 parameters are used in the ASIA classification?
motor, sensory, sacral sparing
When can the ASIA classification be used?
after 72 hours (no longer in spinal shock)
