Spinal Cord Lesions

Question 1

What happens with a complete SCL at and below lesion level?

What happens to autonomics?

Answer 1

At level- flaccid paralysis at that myotome, dermatomal anaesthesia

Below- spastic paralysis, no sensation/very little

Quadrapalegia- hypotensive shock bc above level of heart
Low bp- hypothalamus cut off from body
Notepinephrine cannot vasoconstrict and bp sensors cant send info to hypothalamus

Question 2

What happens with incomplete lesions Brown sequard syndrome above and below lesion level?

Answer 2

At lesion level- ipsilat anaesthesia, contralat full sensation, ispilat flaccid myotome

Below lesion level- ipsilat loss of fine touxh, proprioception and 2 pt discrimination (contralat fine)
Contralat loss of temp, pain and deep touch (ipsi is fine)
Ipsilat spastic paralysis

Question 3

Name some complications of scl

Answer 3

Bladder and bowel dysfn, cv disease, deep vein thrombosis
Heterotopic ossification (abnormal bone development jn soft tissue)
Neuropathic spinal cord pain
Osteoporosis and fractures
Pnemonia, acteletasis and aspiration
Postural/ orthostatcic hypotension
Syringomelia- enlargement of central canal with a syrinx (fluid cyst)
VasculF dysfn (spinal shock)
Biochemical cascade- glutamate causes incomplete lesion to become complete
Spasticty
Autonomic dysreflexia (hyperreflexia) so very high bp

Question 4

What are some symptoms of autonomic dysreflexia (ad)?

Answer 4

Punding headache
Goose pimples
Sweating above injury
Nasal congestion
Slow pulse
Nausea

Question 5

What is the treatment for ad?

Answer 5

Medical emergency

Client sit up so heart is above head

Question 6

What should you do if a spasm occurs during treatment?

Answer 6

Do not attempt to restrain it
Gently pull in opp direction to break pattern
Let client deal with it

Question 7

Define ALS

Answer 7

Degeneration occurs in corticospinal tract and spreads down to ant horn cells and nn roots (starts as upp and ends as lower)

Question 8

Name some signs and symptoms of als

Answer 8

Spastic paralysis in fingers and hands 
Slow mm atrophy
Reflexes increase but then lost
Spasticity replaced by flaccid paralysis
Respiratory and cardiac symptoms

Question 9

What Are some causes of SCL?

Answer 9

Trauma
Inflamm
Degenarative
Congenital
Tumours