Spinal Flashcards
What is complete spinal cord injury
No motor or sensory function below injury level
Bulbocavernosus reflex still present
What is incomplete spinal cord injury
Some motor or sensory function below injury level
- voluntary anal contraction
- palpable / visible muscle contraction
- perianal sensation
What is neurogenic shock
Loss of autonomic tone causing haemodynamic changes
Due to spinal cord injury
Symptoms of neurogenic shock
Occurs if injury above T5
- hypotension
- bradycardia
Management of neurogenic shock
Lasts 3d-3w
Vasoactive drugs and close monitoring
Pathogenesis of spinal shock
Caused by spinal cord injury
- loss of spinal reflexes causing flaccid areflexia and paralysis
Symptoms of spinal shock
Hypotension and bradycardia
Absent reflexes
Management of spinal shock
Lasts weeks - months
Bladder and bowel management
Monitor for respiratory difficulty
Monitor for fever (cannot perspire where paralysed)
Describe the descending tracts of the spinal cord
Tracts to upper limbs = medial
Tracts to lower limbs = lateral
Corticospinal = voluntary movement of ipsilateral limbs, mainly in posterior half of spinal cord
- most decussate in brainstem
Describe the ascending tracts of the spinal cord
Tracts to upper limbs = lateral
Tracts to lower limbs = medial
Function of lateral spinothalamic
Pain and temperature
Function of dorsal column medial lemniscus
Fine touch and proprioception
Where does dorsal column medial lemniscus decussate
Brainstem
Where does lateral spinothalamic decussate
2-3 levels above where they enter the cord
What does damage to DCML cause
Ipsilateral loss of fine touch, vibration and proprioception
What does injury to spinothalamic cause
Contralateral pain and temperature loss
What is brown sequard syndrome
Hemisection of the spinal cord
Symptoms of brown sequard syndrome
Loss of ipsilateral motor and fine touch / proprioception below level injured
Loss of contralateral temperature / pain 2-3 levels below injured
Cause of brown sequard syndrome
Penetrating trauma eg gunshot wound
What is central cord syndrome
Injury to central grey matter of cord
Symptoms of central cord syndrome
Loss of motor function in upper limbs > lower limbs
Variable sensory loss
Cause of central cord syndrome
Pre existing cervical spondylosis + hyper extension injury
What is anterior cord syndrome
Injury to anterior part of the cord
Symptoms of anterior cord syndrome
Pain and temp bilaterally affected
Loss of motor function in lower limbs > upper limbs (lateral motor tracts affected)
Sparing of fine touch and proprioception
