Spine Disorders Flashcards
What things can cause damage to the spinal cord?
- Fracture in vertebrae
- Tumour
- Infection
- Trauma
- Herniated disc
How would a patient present with a high cervical injury?
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
How would a patient present with lower cervical injury?
- 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
How would a patient present with thoracic injury?
- 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
How would a patient present with complete lumbar injury?
- 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
How would a patient present with complete conus medullaris injury?
- 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
What is Brown-Sequard syndrome?
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