Effect of Lesions

Question 1

C1-C5 (Mental Status, Gait, Postural Ability, Sensation, Segmental Reflexes, Others)

Answer 1

Mental status = NORMAL

Gait = SPINAL ATAXIA (crossing over limbs, abduction, long stride) & SPASTIC HEMI/TETRAPARESIS

Postural ability = INCREASED extensor tone (spastic), can be ipsilateral or bilateral

Sensation = DECREASED ipsilateral and caudal to lesion

Segmental reflexes = IPSILATERAL OR BILATERAL HYPERREFLEXIA of THORACIC AND PELVIC LIMB REFLEXES

Others…
- Cervical muscle spasms
- Horner’s syndrome
- Urinary INCONTINENCE/DECREASED ABILITY TO EXPRESS BLADDER

Question 2

C6-T2 (Mental Status, Gait, Postural Ability, Sensation, Segmental Reflexes, Others)

Answer 2

Mental status = NORMAL

Gait
- Thoracic limbs = IPSILATERAL OR BILATERAL FLACCID FORELIMB PARESIS/PARALYSIS
- Pelvic limbs = IPSILATERAL OR BILATERAL SPASTIC PARESIS AND ATAXIA

Postural ability
- Thoracic limbs = IPSILATERAL OR BILATERAL DECREASED extensor tone and postural reaction deficits
- Pelvic limbs = IPSILATERAL OR BILATERAL INCREASED extensor tone and postural reaction deficits

Sensation = DECREASED IPSILATERAL and caudal to lesion

Segmental reflexes
- Thoracic limbs = IPSILATERAL OR BILATERAL HYPOREFLEXIA
- Pelvic limbs = IPSILATERAL OR BILATERAL HYPERREFLEXIA

Other
- Horner’s syndrome
- Issues with diaphragmatic breathing
- URINARY INCONTINENCE/DECREASED ABILITY TO EXPRESS BLADDER

Question 3

T3-L3 (Mental Status, Gait, Postural Ability, Sensation, Segmental Reflexes)

Answer 3

Mental status = NORMAL

Gait
- Thoracic limbs = NORMAL
- Pelvic limbs = IPSILATERAL OR BILATERAL SPASTIC PARESIS/PARALYSIS and ATAXIA

Postural ability
- Thoracic limbs = NORMAL
- Pelvic limbs = IPSILATERAL OR BILATERAL INCREASED EXTENSOR TONE and postural reaction deficits

Sensation
DECREASED IPSILATERAL AND CAUDAL TO LESION

Segmental reflexes
- Thoracic limbs = NORMAL
- Pelvic limbs = IPSILATERAL OR BILATERAL HYPERREFLEXIA

Question 4

L4-S1(Mental Status, Gait, Postural Ability, Sensation, Segmental Reflexes, Others)

Answer 4

Mental status = NORMAL

Gait
- Thoracic limbs = NORMAL
- Pelvic limbs = IPSILATERAL or BILATERAL FLACCID PARESIS/PARALYSIS, “scuffing paws”
–> Stiff, short-strided gait or INABILITY TO SUPPORT WEIGHT

Postural ability
- Thoracic limbs = NORMAL
- Pelvic limbs = IPSILATERAL OR BILATERAL DECREASED EXTENSOR TONE and postural reaction deficits

Sensation
DECREASED IPSILATERAL AND CAUDAL TO LESION

Segmental reflexes
IPSILATERAL OR BILATERAL HYPOREFLEXIA of the PELVIC LIMBS

Other
- Urinary incontinence/decreased ability to express bladder
- Schiff-sherrington posture

Question 5

Sacral (Mental Status, Gait, Postural Ability, Sensation, Segmental Reflexes, Others)

Answer 5

Mental status = NORMAL

Gait
- Thoracic limbs = NORMAL
- Pelvic limbs = NORMAL GAIT OR IPSILATERAL/BILATERAL SCUFFING of paws

Postural ability
- Thoracic limbs = NORMAL
- Pelvic limbs = NORMAL or IPSILATERAL/BILATERAL PLANTIGRADE POSTURE

Sensation
DECREASED sensation in perineal area, tail, and skin innervated by the sciatic nerve

Segmental reflexes
- NORMAL or HYPOREFLEXIVE SCIATIC NERVE
- DECREASED anal sphincter tone
- DEPRESSED BULBOCAVERNOSUS REFLEX

Other
- URINARY/FECAL INCONTINENCE
- EASILY EXPRESSABLE BLADDER

Question 6

Peripheral nerve lesions

Answer 6

Gait
- Stiff, short-strided gait
- Flaccid paresis/paralysis
- Generalized weakness/exercise tolerance

Postural reactions
- Normal to diminished

Reflexes
- Hyporeflexia/areflexia
- Hypotonia/atonia/flaccidity
- Muscle atrophy

Other
- Fasciculations and muscle tremors
- +/- urinary and fecal incontinence
- Muscle atrophy