Chapter 13 Park 2

Question 1

What can a lesion in the spinal region interfere with?

Answer 1

segmental function
vertical tract function
both segmental and vertical tract function

Question 2

What does segmental function affect?

Answer 2

function of a spinal cord segment
interfere with neural function only at level of lesion

Question 3

What does vertical tract function affect?

Answer 3

Conveys ascending and descending information

result in a loss of function below the level of the lesion

Question 4

What are signs of segmental dysfunction?

Answer 4

abnormal or lost sensation in a dermatomal distribution and/or lower motor neuron signs in a myotomal distribution

Question 5

What do lesions interrupting vertical tracts result in?

Answer 5

in loss of communication to and/or from the spinal levels below the lesion

Question 6

What are autonomic signs?

Answer 6

problems with the regulation of blood pressure (BP), sweating, and bladder and bowel control

Question 7

Descending tract (UMN) signs include:

Answer 7

include paralysis, spasticity, and muscle hypertonia

Question 8

When is Babinski’s sign present?

Answer 8

if the lateral corticospinal tract is interrupted

Question 9

Ascending tract signs are ipsilateral of:

Answer 9

dorsal column in interrupted

Question 10

Ascending tract signs are contralateral if:

Answer 10

STTs are involved

Question 11

Peripheral region lesions produce deficits in:

Answer 11

distribution of a peripheral nerve.

Question 12

What does peripheral nerve lesions cause:

Answer 12

Altered or lost sensation in a peripheral nerve distribution
Decrease or loss of muscle power in a peripheral nerve distribution
No vertical tract signs

Question 13

When does spinal region segmental signs occur?

Answer 13

nerve roots and/or spinal nerves are compromised

Question 14

What is included in segmental signs?

Answer 14

Altered or lost sensation in a dermatome
Decreased or lost muscle power in a myotome
Decreased or lost phasic stretch reflex

Question 15

What is included in spinal region vertical tract signs?

Answer 15

Altered or lost sensation below the level of the lesion

Altered or lost descending control of BP, pelvic viscera, and thermoregulation

Question 16

What is included in UMN signs?

Answer 16

Decrease or loss of muscle power
Spasticity
Muscle hypertonia
If the lateral corticospinal tract is involved, positive Babinski’s sign and clonus

Question 17

What are spinal region syndromes?

Answer 17

Syndromes are collections of signs and symptoms that occur together. Spinal cord syndrome do not indicate a specific cause,

Question 18

What do syndromes result from?

Answer 18

tumors or trauma

Question 19

What is anterior cord syndrome?

Answer 19

Interferes with pain and temperature sensation and motor control while preserving proprioception & discriminative touch

Question 20

What is central cord syndrome?

Answer 20

In a small lesion, loss of pain and temperature occurs at the level of the lesion. In a large lesion, the upper limb motor function is impaired

Question 21

What is Brown-Sequard syndrome?

Answer 21

Below the level of lesion, voluntary motor control, conscious proprioception, and discriminative touch is lost ipsilaterally; pain and temperature sensation are lost contralaterally.

Question 22

What is cauda equina syndrome?

Answer 22

Causes sensory impairment and flaccid paresis or paralysis of lower limb muscles, bladder, and bowels

Question 23

What is tethered cord syndrome?

Answer 23

Causes low back and lower limb pain, difficulty walking, excessive lordosis, scoliosis, problems with bowel and/or bladder control, and foot deformities

Question 24

What happens immediately after a traumatic injury to the spinal cord?

Answer 24

cord functions below the lesion are depressed or lost (“spinal shock”)

Question 25

What is spinal shock due to?

Answer 25

the interruption of descending tracts that supply tonic facilitation to the spinal cord neurons

Question 26

What is lost or impaired during spinal shock?

Answer 26

somatic reflexes autonomic reflexes autonomic regulation of BP control of sweating and piloerection is lost

Question 27

What is included in somatic signs?

Answer 27

including stretch reflexes, withdrawal reflexes, and crossed extension reflexes

Question 28

What is included in autonomic reflexes?

Answer 28

including smooth muscle tone and reflexive emptying of the bladder and bowels

Question 29

What is a chronic spinal cord injury?

Answer 29

Is the period after recovery from spinal shock when the neurologic deficit is stable can last for decades

Question 30

What are the two abnormalities that occur in interneuron activity below the level of the lesion?

Answer 30

Inhibitory interneuron response to type Ia afferent activity is diminished. (Correlates with hyperreflexia.) Transmission from cutaneous afferents to lower motor neurons is facilitated.

Question 31

How is a spinal cord injury classified?

Answer 31

whether injury is complete or incomplete

Question 32

Complete injury:

Answer 32

lack of sensory and motor function in the lowest sacral segment

Question 33

Incomplete injury

Answer 33

preservation of sensory and/or motor function in the lowest sacral segment

Question 34

What happens to pelvic organs during spinal shock ?

Answer 34

organs are depressed

Question 35

What does a lesion of T6 result in?

Answer 35

loss of descending sympathetic control

Question 36

What three dysfunctions are a result of a lesion above T6?

Answer 36

``` Autonomic dysreflexia Poor thermoregulation (body temperature regulation) Orthostatic hypotension ```

Question 37

What are signs and symptoms that indicate a spinal cord lesion?

Answer 37

Bilateral alteration or loss of somatosensation Incoordination (sensory ataxia), caused by inadequate somatosensory information to the cerebellum Upper motor neuron signs