Spine Disorders Flashcards

1
Q

What things can cause damage to the spinal cord?

A
  • Fracture in vertebrae
  • Tumour
  • Infection
  • Trauma
  • Herniated disc
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2
Q

How would a patient present with a high cervical injury?

A

Motor
- Spastic quadriplegia

Sensory
- anaesthesia at level corresponding with injury and below (four limbs + trunk)

Bowel + Bladder

  • Central-type impairment
  • Urinary retention
  • Severe constipation
  • Can lead to recurrent UTIs and ileus

Breathing

  • intercostal muscles impaired, diaphragm partly impaired + fatigues easily
  • breathing support needed

Very high chance of death

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3
Q

How would a patient present with lower cervical injury?

A
  • Injury at cervical enlargement (C5-T1)

Motor

  • flaccid (decreased tone) paralysis of upper limbs
  • spastic (increased tone) paralysis in lower limbs

Sensory

  • sensation lost from level of injury down
  • some sensation in arms

Breathing

  • intercostals not working, diaphragm intact
  • no breathing support

Bladder + bowels

  • Central-type impairment
  • Urinary retention + constipation
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4
Q

How would a patient present with thoracic injury?

A
  • T2-T12, below cervical enlargement, above lumbar enlargement

Motor

  • spastic paralysis of lower limbs
  • Intact upper limbs (can move themselves about in wheelchair)

Sensory
- anaesthesia below level of injury

Breathing
- intercostals not working, breathe with diaphragm

Bowel + bladder

  • central-type disturbance
  • urinary retention + constipation
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5
Q

How would a patient present with complete lumbar injury?

A
  • Lumbar enlargement injury L1-S1

Motor

  • intact upper limbs
  • lower flaccid paralysis

Sensory
- anaesthesia below level of injury (below inguinal folds L1-L2)

Breathing
- normal as intercostals not affected

Bowel + bladder
- central-type impairment

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6
Q

How would a patient present with complete conus medullaris injury?

A
  • S2
  • cauda equina syndrome

Motor

  • flaccid paralysis of lower limbs or weakness
  • upper limbs intact

Sensory
- saddle anaesthesia and lower limb anaesthesia

Breathing
- normal

Bowel + bladder

  • peripheral-type impairment (below conus)
  • urinary incontinence, leaking faeces + urine
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7
Q

What is Brown-Sequard syndrome?

A

Hemi-paraplegia on one side + hemianesthesia on other side due to injury to one side of spinal cord

E.g. L hemi-spinal cord lesion at T11

  • spastic paralysis ipsilaterally (L leg)
  • proprioception + deep sensation loss (L leg)
  • pain + temp anaesthesia contralaterally (R leg)
  • central-type impairment of LL
  • upper limbs not affected
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