Flashcards in lecture 4c-spinal cord lesions Deck (10)
what is a myotome
the skeletal musculature innervated by motor axons in a given spinal root
what is a dermatone
the sensory component of each spinal nerve is distributed to a dermatome, a well defined segmental portion of the skin. conditions that affect the dorsal roots or dorsal root ganglia produce sensory alterations in the distribution of skin segments supplied by that
what happens when you have total destruction to the cord at a certain level?
pts eventually lose all somatic sensations below the level of the lesion, and they also lose all voluntary motor control below the level of the lesion
-don't lose involuntary
what accounts for the paralysis everywerhe below the level of the lesion
-spastic paralysis: lose voluntary motor activity below the lesion, you don't lose involuntary activity
what spinal shock
happens right after the injury, early on
-the spinal cord shuts down for a few days-weeks
-during this time, you lose all motor-voluntary AND involuntary, so no reflexes, no muscle tone, no voluntary strength.
-AFTER THIS acute phase of spinal shock do the segmental reflexes and muscle tone return
what happens above the level of the lesion?
at the level of the lesion?
below the level?
-motor: segmental LMN signs (ventral horns/verntral roots)-flaccid paralysis, fasciculations, atrophy, areflexia
-sensory: segmental loss of pain and temp (ventral white commissure) 1-2 lvls below
-motor: UMN signs (spastic paralysis, babinski, etc); paraplegia or tetraplegia
-sensory: no sensations
what happens if you have a C1-C4 injury
injuries above C7?
injuries sparing of C7?
-rarely survive w/o immediate ventilatory support
-dependent on others for care
-retain elbow and wrist extension allowing independent ability to transfer to wheelchair
-have arm strength but require wheelchair
what is brown-sequared syndrome aka hemicord syndrome or cord hemisection
lesion one half of the spinal cord at a certain level
what happens to the white matter sections in cord hemisectoin
dorsal column: loss of proprioception, 2 point tactile, pressure, and vibratory sense. ipsilateral loss and below the level of the lesion
lateral corticospinal tract: UMN signs, ip loss, below level of lesion
spinothalamic tract: loss of pain and temp. contralateral loss. starting 1-2 segments below lvl of lesion