Spinal Cord Syndromes & Tracts Flashcards
What does the Dorsal Column Medial Lemniscus Tract supply?
Vibration, proprioception, stereognosis, 2 POINT DISCRIMINATION, barognosis, FINE TOUCH, graphesthesia
What does the Anterior Spino Thalamic Tract supply?
Crude touch
What does the Lateral Spino thalamic Tract supply?
Pain and temperature
What does the Corticospinal tract supply?
Movement
What are the ascending tracts?
Named for their pathway
DCML and ASTT and LSTT, spinocerebellar, spinoreticular
Descending Tract?
Corticospinal tract, vestibulospinal, rubro spinal, retículo spinal, tectospinal
If an individual has Posterior Cord syndrome what is effected?
DCML
-Bilateral loss of proprioception, vibration, pressure, and epicritic sensations (stereognosis, two point discrimination)
-Preservation of motor function, pain and light touch
If an individual has anterior Cord syndrome what is effected?
STT and Corticospinal tracts are affected
-HYPERFLEXION INJURY
-Bilateral loss of pain and temperature
-Bilateral loss of motor function, spastic paralysis below level of lesion
-Proprioception, light touch and vibratory sense are generally preserved
If an individual has a Brown Sequard Syndrome what is affected?
BROWN POTS
Ipsilateral: DCML sensory (tactile discrimination, pressure, vibration and proprioception), and motor function loss below injury
Contralateral: loss of p! And temp below level of injury
What is Cauda Equina Syndrome?
Location: Unilateral and asymmetrical in perineum, thighs, leg, and back- loss of nerve roots at or below L1
Flaccid paralysis of bladder and bowel, no spinal reflexes
Sensory: saddle distribution UNILATERAL AND ASYMMETRIC
LMN
What is Conus Medullaris?
Location: bilateral and symmetrical in perineum and thighs
Sensory: saddle distribution, bilateral and symmetric
LMN & UMN
What is central cord syndrome?
HYPEREXT INJURY
-Bilateral UE affected because the cervical tracts are located more centrally located
-Loss of bilateral pain and temperature
What is autonomic dysreflexia?
-At or above T6
-Noxious (painful) stimuli below level of lesion
-Rise in systolic BP of 20-30 mmHg
What is the PT response for Autonomic dysreflexia?
SIT UP AND LOWER LEGS
-remove painful stimuli
What is the treatment for spastic bladder?
UMN/Reflexive bladder
-Seen in patients with injury above S2 sacral segments
Trx
-Require intermittent catheterization every 3-6 hours
-Suprapubic tapping
What is the treatment for Flaccid bladder?
LMN/Areflexic bladder
-Seen in patients with injury at or below S2 sacral segments
Trx:
-Require intermittent catheterization every 3-6 hours
-Valsalva or Crede’s maneuver
What does a patient do with pushers syndrome?
PUSH TO THE WEAK SIDE
Spinocerebellar tracts
Convey proprioception info from muscle spindles, Golgi tendon organs, and touch and pressure receptors to cerebellum for control of voluntary movements; dorsal spinocerebellar tract ascends to ipsilateral inferior cerebellar peduncle, and ventrospinocerebellar tract ascends to contralateral and ipsilateral superior cerebellar peduncle
Spinoreticular tracts?
Convey deep and chronic pain to the reticular formation of brain stem via diffuse, polysynaptic pathways
Corticospinal tracts?
Arise from primary motor cortex, descend in brain stem, cross in medulla (pyramidal decussation), via lateral corticospinal tract to ventral gray matter (anterior horn cells); 10% of fibers do not cross and travel in anterior corticospinal tract to cervical and upper thoracic segments; important for VOLUNTARY MOTOR CONTROL
Vestibulospinal tracts?
Arise from vestibular nucleus and descend to spinal cord in lateral (uncrossed) and medial vestibulospinal tracts; important for control of muscle tone, antigravity muscles and postural reflexes
Rubrospinal tract?
Arise in contralateral red nucleus and descend in lateral columns to spinal gray matter; assist in motor function
Reticulospinal system?
Arises in the reticular formation of the brain stem and descends in ventral and lateral columns, terminates both on dorsal gray and ventral grey. *Modifies transmission of sensation, especially pain, influences gamma motor neurons and spinal reflexes
Tectospinal tract?
Arises from superior colliculus and descends to ventral gray; assists in head turning responses to visual stimuli
