3.19 Spinal Region 3

Question 1

syndrome

Answer 1

collection of s/s that don’t indicate a specific cause

Question 2

anterior cord syndrome interferes with

Answer 2

• pain sensation
• temp sensation
• motor control

Question 3

central cord syndrome: small lesion

Answer 3

loss of pain and temp at lesion level

Question 4

central cord syndrome: large lesion

Answer 4

UE motor function impaired

Question 5

Brown-Séquard syndrome: ipsilateral

Answer 5

• voluntary motor
• conscious proprioception
• discriminative touch

Question 6

Brown-Séquard syndrome: contralateral

Answer 6

pain and temperature sensation

Question 7

cauda equina syndrome

Answer 7

• sensory impairment

- flaccid paresis or paralysis of LE muscles, bladder, and bowels

Question 8

tethered cord syndrome causes:

Answer 8

• low back and LE pain
• difficulty walking
• excessive lordosis
• scoliosis
• bowel/bladder control issues
• foot deformities

Question 9

spinal cord syndromes often caused by:

Answer 9

tumors

trauma

Question 10

Damage by MVA, sports injuries, and falls usually have one or more of these effects on the SC

Answer 10

• crush
• hemorrhage
• edema
• infarction

Question 11

What injury type results in severed neurons?

Answer 11

penetrating wounds

Question 12

spinal shock

Answer 12

• immediately after traumatic injury to cord

- cord functions below lesion are depressed or lost

Question 13

spinal shock due to

Answer 13

interruption of descending tracts that supply tonic facilitation to SC neurons

Question 14

What is lost/impaired during spinal shock?

Answer 14

• somatic reflexes
• autonomic reflexes
• autonomic regulation

Question 15

spinal shock: somatic reflexes lost include

Answer 15

• stretch reflexes
• withdrawal reflexes
• crossed extension reflexes

Question 16

spinal shock: autonomic reflexes lost include

Answer 16

• smooth muscle tone

- reflexive emptying of bowel/bladder

Question 17

spinal shock: result of loss in autonomic regulation of BP

Answer 17

hypotension

Question 18

What happens several weeks post SCI? (spinal shock)

Answer 18

most get some recovery of SC function

» return of reflex activity below lesion

Question 19

stretch reflex hyperreflexia

Answer 19

In some people, spina neurons become excessively excitable

Question 20

Why does hyperreflexia develop?

Answer 20

neuroplasticity produces new synapses in the reflex pathway

Question 21

chronic SCI

Answer 21

neurologic deficit is stable

Question 22

abn interneuron activities in chronic SCI

Answer 22

1. inhibitory interneuron responses to type Ia afferent activity is diminished
2. transmission from cutaneous afferents to LMN is facilitated

Question 23

What does inhibitory interneuron activity diminished in chronic SCI correlate with?

Answer 23

hyperreflexia

Question 24

Why are LMNs facilitated in chronic SCI?

Answer 24

loss of descending inhibition

Question 25

complete SCI

Answer 25

no sacral sparing

Question 26

incomplete SCI

Answer 26

preservation and/or motor function in lowest sacral segment

Question 27

Loss of descending sympathetic control with lesions above T6 results in 3 dysfunctions

Answer 27

- autonomic dysreflexia - poor thermoregulation - orthostatic hypotension

Question 28

compensation for poor regulation

Answer 28

excessive sweating above lesion level

Question 29

Why do people with complete lesions over T6 level avoid exposure to high temperatures?

Answer 29

risk of heat stroke

Question 30

signs of heat stroke

Answer 30

- high body temp - rapid pulse - dry, flushed skin

Question 31

signs of hypothermia

Answer 31

- irritability - mental confusion - hallucinations - lethargy - clumsiness - slow respiration - slow HR

Question 32

orthostatic hypotension =

Answer 32

≥ 20 mmHg fall in systolic or ≥ 10 mmHg fall in diastolic BP going from lying down to upright

Question 33

Why does orthostatic hypotension happen in SCI pts?

Answer 33

- no sympathetic vasoconstriction | - no muscle pumping action for blood return

Question 34

barriers to regeneration following SCI

Answer 34

- oligodendrocytes - glial scars - decreased growth rate of mature neurons

Question 35

functional losses not due to original trauma occur because of

Answer 35

- bleeding - edema - ischemia - pain - inflammation

Question 36

typical complications after SCI

Answer 36

- UTI - spasticity - fever/chills - pressure ulcers - autonomic dysreflexia - contractures - pneumonia - heterotopic ossification

Question 37

What can protect against UTI and pneumonia?

Answer 37

upright posture

Question 38

What can help prevent decubiti and contractures?

Answer 38

mobility