SC 2 Flashcards

(35 cards)

1
Q

Conus medullaris syndrome

1(S2 – S5):

A
  1. Late pain in thighs & buttocks
  2. Pelvic floor muscle weakness
  3. Symmetric saddle anesthesia numb
  4. Early bladder dysfunction
  5. Early loss of bowel and sexual functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cauda equina syndrome

(L1 – S5):

A
  1. Early root pain radiating to legs
  2. Leg weakness and DTRs (LMNs)
  3. Patchy, asymmetric “saddle”
  4. Late bladder dysfunction
  5. Late loss of bowel & sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

mictrition neural pathways

A

is coordinated activity of the bladder detrusor and the sphincter muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

voiding bladder

A

under the control of higher cortical centers that develops as continence and is achieved early in childhood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

incontinence

A
  1. occurs when neuroanatomic pathways that innervate the bladder are interrupted or when there are physical problems with the pelvic floor and sphincter muscles.
  2. Important symptom occurs in association with other neurological deficits that localize to the spinal cord.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

bladder control is controlled by

A

areas of the brain and brainstem that send axons down the spinal cord, traveling just medial to the LCST.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bilateral projections of bladder control terminate on

A

preganglionic parasympathetic neurons at S2, S3 and S4

  1. The preganglionic parasympathetic neurons send their axons out the ventral roots of the S2, S3, and S4 to synapse on postganglionic parasympathetic cells in ganglia near the bladder
  2. These postganglionic parasympathetic cells in turn innervate the detrusor (smooth) muscle of the bladder for voiding.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

There are muscle spindles, nociceptors, and other sensory receptors in the detrusor muscle & bladder wall whose cell bodies lie in the

A

dorsal root ganglia at S2, S3 and S4.

These fibers participate in local reflex arcs and ascend the nervous system via the AL pathway and dorsal columns.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

bladder filling steps

A
  1. bladder fills and muscle spindles of detrusor and bladder wall are stretched
  2. firing is increased.
  3. initially enhances (through reflex pathway) neuronal firing of sympathetic preganglionic neurons in the intermediolateral cell column from T11-L1
  4. this causes increased constriction of the internal urethral sphincter
  5. this info also travels in a reflex pathway that results in decreased neuronal firing or pregang symp at s2-s4 and inhibits contraction of detrusor
  6. filling increases and afferent info activates higher center in BS and cortex
  7. descending pathway along medial LCST, coordinated inhibition of sympathetic done and activation of parasymp contraction of detrusor
  8. results in contraction of voluntary sphincter prevents voiding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

PNS LMN lesion controlling micturition

A

weakness atrophy, hyporeflexia

—>bladder does not contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

PNS LMN lesion controlling micturition

sensory afferents affected

A

no sensation of full bladder will be recieved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PNS LMN lesion controlling micturition

Intact sensory afferents with affected motor efferents

A

urge to void but good detrusor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PNS LMN lesion controlling micturition

lesion location

A
  1. anywhere from pregang parasymp neurons at S2, S3, S4
  2. sacral roots of cauda equina
  3. pelvis plexus
  4. 2 postganglionic parasymp neuron that innervates the detrusor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

UMN lesion controlling micturition

A

To affect bladder function, lesions must be bilateral.

Detrusor becomes flaccid –>
urinary retention –>
flaccid bladder

With time, spasticity develops and the bladder contracts with small degrees of stretch
1. Urinary frequency and urgency
2. Whenever the bladder fills a little: increased stretch carried by afferents activate
the parasympathetic motor neurons that control the detrusor and thus intermittent voiding –> Spastic bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

C5 sensory territory

A
  1. shoulders

2. upper lateral arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

c5 motor territory

A
  1. deltoid
  2. infrapinatus
  3. biceps
17
Q

c5 reflex component

18
Q

c6 sensory territory

A

1st and 2nd digits of hand

19
Q

c6 motor territory

A
  1. wrist extension

2. biceps

20
Q

c6 reflex components

A
  1. biceps

2. brachioradialis

21
Q

C7 sensory territory

22
Q

C7 motor territory

23
Q

C7 reflex component

24
Q

L4 sensory territory

A
  1. knee

2. medial leg

25
L4 motor territory
1. psoas | 2. quadriceps
26
L4 reflex
patellar
27
L5 sensory territory
1. dorsum of foot | 2. great toe
28
L5 motor territory
1. foot dorsiflexion 2. big toe extension 3. foot eversion 4. foot inversion
29
L5 reflex
none
30
S1 sensory territory
1. lateral foot 2. small toe 3. sole of foot
31
S1 motor territory
foot plantar flexion
32
S1 reflex
achilles
33
nipple dermatome
T4
34
xyphoid dermatome
T7
35
umbilicus dermatome
T10