Spinal Cord Disorders Flashcards
4 UMN lesion signs
Babinski
Hypereflexia
rigidity
Spasticity
4 LMN lesion sings
flaccid paralysis
hyporeflexia
muscle atrophy
fasiculations/ fibrillations
Another name for acute spinal cord injury
Spinal shock
acute spinal cord injury- SSx
flaccidity
areflexia
hypotension
bradycardia
Tx for acute spinal cord injury
this is usually an emergency situation
ABCs
cervical spine immobilization
respiratory assistance
chronic spinal cord injury
signs of UMN lesion- hyper-reflexia and hypertonia
treatment for a chronic spinal injury
depends on the lesion
LMN disease/ radiculopahthy SSx
PAIN
numbness, paresthesias
weakness
hyporelfexia
UMN disease- myelopathy
NO PAIN
gait or balance problems
bowel or bladder incontinence
hypereflexia
3 spinal cord syndromes
Central spinal cord syndrome
anterior cord syndrome
Brown- Sequard syndrome
Central Cord syndrome
which tracts and what part of the spinal
Corticospinal tract and the anterior horn cells
Central Cord syndrome- UE or LE
UE are affected much more than lower extremities
Central Cord syndrome- where is sensory loss
Sensory loss is below the level of the lesion but this is variable
Central Cord lesion- etiology
bleeding into the central part of the spinal cord (edemantous injury)
cervical spondylosis
Anterior Cord lesion- which tracts are affected
Corticospinal tract is affected as well as the STT at the level of the spinal cord injury
Anterior Cord lesion- which tracts and sense are spared
the Dorsal column tract is spared so vibratory and propiocetive senses are still intact
Anterior Cord injury- What happens with STT and its senses
The STT is affected at the level of the injury b/c that is where it decussates.
Lose pain and temperature at that level
What is the etiology of Anterior cord syndrome
occlusion of the Anterior spinal artery
What is the presentation of anterior cord syndrome
Paralysis below the level of the lesion (CST)
insensitivity to pain and temperature at the level of the lesion (STT)
intact propioception and vibration (DCML)
Brown Sequard syndrome- etiology
Hemisection of the spinal cord
Brown Sequard syndrome- presentation
Ipsilateral paralysis below the level of hte lesion (CST)
Ipsilateral loss of vibration and propioception (DCML)
contralateral loss of pain and temperature (STT)
Cauda Equina Injury- Presentation
LE weakness
urinary retention BUT incontinence after voiding
Saddle anesthesia
sexual dysfunction
Cauda Equina Injury- etiology
anything that impinges on the cauda equina Tumor Trauma ankylosing spondylosis CIDP Spinal stenosis
Cauda Equina injury- location of the lesion
below L1 and L2
C5 radiculopathy=
loss of bicep reflex
C6 radiculopathy=
loss of bicep and triceps reflex
C7 radiculopathy=
triceps weakness
L4 radiculopathy=
loss of patellar reflex
L5 radiculopathy=
reduction in ankle reflex
S1 radiculopathy=
loss of ankle reflex
Treatment of radiculopathies
avoid strain
NSAIDs and analgesia
resume activites when symptoms improve
