Spinal cord injury/syndromes Flashcards
spinal cord injury
any pt with a severe heady injury should be presumed to have a spine injury/SCI
concussion
injury caused by a blow or violent shaking
results in temporary loss of fx
contusion
glial tissue/spinal cord surface remain intact
may be a loss of central grey and white matter
laceration
the glia is disrupted and the spinal cord tissue may be torn
pathogenesis SCI
secondary injury
syringomyelia
secondary injury SCI
ischemia
hypoxia
edema
various biochemical events
blood flow changes
demyelination
loss of grey matter
dural scarring
loss of neural function
neurapraxia
syringomyelia SCI
d/t cavitation of cervical spinal cord
destruction of ventral white commissure and interruption of decussating spinothalamic fibers
syringomyelia SCI leads to
bilateral loss of pain and temp sensation
descending autonomics @T1 (Horner’s syndrome)
scoliosis
clinical manifestations SCI
depends on level of injury
C5-T1 SCI
brachial plexus
L2-S4 SCI
lower limbs
T1-L2 SCI
sympathetic NS
S2-S4 SCI
parasympathetic
spinal cord syndromes
complete transection of spinal cord
spinal cord syndromes b/w C1-C3
exitus lethalis
usually death
spinal cord syndromes C3-C4
quadriplegia
spinal cord syndromes below T1
paraplegia
clinical manifestations spinal cord syndromes
spastic paralysis of all voluntary movements below lesion
complete anesthesia below lesion
urinary and fecal incontinence (although reflex emptying may occur)
anhidrosis and loss of vasomotor tone
if lesion is above C5 spinal cord syndromes
paralysis of volitional and automatic breathing
phrenic nuclear is found at C3-C5
anterior cord syndrome
flexion injury causes loss of blood supply to anterior spinal artery
–> bilateral loss of motor function and pain/temp sensation
central cord syndrome
hyperextension injury to C/S
–>severe neurologic involvement in UE
posterior cord syndrome
rare
loss of proprioception below lesion
–> wide based steppage gait
conus medullaris syndrome
S3-Co (d/t tumor or hemorrhage)
–> destruction of sacral parasympathetic nucleus (bladder/fecal incompetence) , peri anogenital sensory loss (saddle anesthesia)
ABSENCE motor deficits in LE
epiconus syndrome
L4-S2 –> bowel and bladder reflex intact but no voluntary control
motor disability: ER & EXT of thigh most affected
affects ventral horn and long tracts
absence of achille’s tendon reflex
