Week 2- The Spinal Cord Flashcards
Spasticity is more pronounced in what type of muscles?
anti-grativty…flexors
What does baclofen do?
Activates GABA b (presynaptic) receptor which prevents glutamate release (glutamate is excitatory)
What is gliosis? What cells are involved?
astrocyte hyperplasia and hypertrophy
What happens to microglia when there is CNS injury with cell death and without cell death?
With cell death: become macrophages
Without cell death: become “activated”, secrete cytokines
Where do MS lesions normally happen? What starts off things?
MS lesions are usually periventricular and is started by CD4 cells –> upregulate macrophages that remove myelin
What is a “narcotic”?
A drug that produces sleep…avoid using this term :)
What is the pre and postsynaptic action of opiods (e.g. ions….)
Presynaptic: closes Ca, reduces excitatory NT release
Postsynaptic: hyperpolarizes by opening K channels
What are the two general classes of opiods used? Are most pure agonists, agonist-antagonists or partial agonists?
Phenanthrenes
Phenylpiperidines
…most are pure agonists! Buprenorphine is a partial agonist
Can you use morphine in someone with renal failure? Someone who is pregnant? Someone who has pre-existing respiratory disease?
No-it is metabolized by the liver, but the metabolite is still active until it is excreted by the kidney
No
No
What are potential opioid side effects?
Peripheral:
- constipation
- urinary retention
- constriction of sphincter of Oddi
- histamine release
- bradycardia
- hypotension
Central:
- analgesia
- hyperalgesia at high dose
- cough suppresion
- euphoria
- sedation
- resp depression
- N/V
- pruritus
- miosis
- truncal rigidity
- convulsion
What reverses opioid OD?
naltrexone, naloxone
What spinal levels are responsible for psychogenic erection? Which levels are responsible for genital erection?
Psychogenic: T10-T12 (+L1,2,3??)
Genital: S2,3,4
For an erection to be reliable these spinal levels must communicate with one another
What must be intact for voluntary anal tone? What must be intact for involuntary anal tone? What must be intact for a working bulbocavernosus reflex?
Voluntary: the lateral corticospinal tracts
Involuntary: it is a triangle between S2,3,4 and T10-T12…so if you have a lesion between the two you won’t get the anal tone reflex
BCR: S2,3,4 reflex
Pain felt on testicular squeeze in a SCI pt means?… pinprick testicular pain means?
Lesions is below T9 for squeeze
Pinprick felt means that lateral spinothalamic still intact..lesion is incomplete
What part of the NS does seminal emission? Propulsatile ejaculation?
Seminal emission is SNS
ejaculation is PNS
What is the uncinate process? Why is it clinically relevant?
A hook like part of the cervical vertebrae…can cause radiculopathy. Connect by Joint of Lushcka
