spinal cord lesions Flashcards
paresis vs. paralysis
reduction in muscle strength vs. inability to perform any movement
paraplegia vs. quadriplegia
paralysis of the legs vs. paralysis of the legs and arms
-paraplegia below T1 or quadriplegia above T1
upper motor neurons lesion signs
spasticity/weakness, increased Deep tendon Reflex, clonus, half the body!
clonus
rapid contractions and relaxations
lower motor neuron lesion signs
paralysis flaccid weakness
-following dermatome patterns
most common causes of SCI
motor vehicle accident’s, falls, violence and sports injuries
-diving is a high risk sport
neurologic level
assessing for the level of damage, sensory or motor function
-most caudal segment that tests as normal or intact for both sensory and motor function
-dermatomal level by pin and touch
-myotomal level by manual muscle testing
manual muscle testing rating
5 is the best muscle function and 0 is no muscle contraction
ASIA scale
A is complete lesions and E is excellent/normal motor or sensory function
-complete lesions results in no sensory or motor function
sacral sparing
some sacral innervation remains intact
-bowel, bladder and rectal function is spared
complete SCI
interruption of ascending and descending pathways
-paraplegia or quadriplegia
-loss of sensory modalities below the lesion
acute stages
spinal shock, areflexia, flaccid paralysis
-duration is variable
chronic stages
return of reflex activity below lesion spasticity
-clonus
-hyperactive cutaneous reflexes
-flexor and extensor spasms may alternate
small central lesions
anterior white commissure
large central lesions
affecting ventral gray horns
-motor
dorsal column lesions
affecting dorsal white columns
-DCML
central cord syndrome
involves a lesion of the central gray matter and medial white matter of the cervical SC
-upper limb weakness and sacral sensory sparing
spinal cord hemisection
goes through the body and cut’s half the spinal cord and the other half is still intact
-ipsilateral loss of the corticospinal tract, dorsal column function, spinothalamic tract function and lower motor neurons
motor system disease (called amyotrophic lateral sclerosis)
progressive deterioration of the corticospinal tract as well as lower motor neurons
-muscular atrophy and fasciculations
-hypereflexia and positive babinski sign
combined systems disease
involves both motor and sensory, dorsal column and corticospinal tract
-subacute combined degeneration
-friedreich’s ataxia
subacute combined degeneration
degeneration in doral & lateral columns
due to complication of pernicious anemia
-loss of proprioception
-numbness
-spastic paresis
friedreich’s ataxia
a rare, inherited, degenerative disease,worsens over time
inherited disease with varying degrees of dorsal column, lateral corticospinal tract and spinocerebellar tract lesions
-ataxic gait and frequent loss of balance
-spastic weakness
tabes dorsalis
complication of late stage syphilis infection.
dorsal column affected and the dorsal root affected
-complication of neurosyphilis
-abnormal sensations, intermittent attacks of sharp pain
-decreased sensitivity to pain, decreased or absent DTRs
-marked impairment of kinesthesis, loss of vibratory sense, and two point discrimination
poliomyelitis
ventral gray horns which result in motor deficits
-LMN disease characterized by paresis or paralysis, atrophy, and/or complete flaccid paralysis
