Spinal vertebrae and levels + SB powerpoint

Question 1

C2-C7

Answer 1

Add one level to get nerve segment level

Question 2

T1-T6

Answer 2

Add 2 levels to get nerve segment level

Question 3

T7-T9

Answer 3

Add 3 levels to get nerve segment level

Question 4

T10-T12

Answer 4

Have the entire lumbar nerve segments

Question 5

L1

Answer 5

sacral and coccygeal nerve segments

Question 6

L2+

Answer 6

cauda equina

Question 7

Any lesion below L2 is going to give you what?

Answer 7

LMN sx

Question 8

Initiation of walking comes from?

Answer 8

MLR: mesencephalic locomotor region

This is supraspinal control

Question 9

MLR is what kind of control for the initiation of walking?

Answer 9

supraspinal

Question 10

Unexpected slip probably modulated by what?

Answer 10

CB

Question 11

Seeing theres an obstacle probably modulated by what

Answer 11

visual cortex via motor and premotor cortex

Question 12

what are “half centers”

Answer 12

same leg flexors vs. extensor activation

Question 13

What is critical for timing and amplitude of stepping

Answer 13

sensory input

Question 14

What is necessary for initiation and adaptive control of stepping?

Answer 14

Descending pathways/supraspinal

Question 15

CPG allowing reciprocal activation of the two limbs and modulation by afferent signals but this is not walking! Walking requires what kind of centers?

Answer 15

higher level centers

MLR which activates the spinal locomotor system

Question 16

From SCI perspective all you need is some input from _____ and spinal _____ to get you walking. It won’t look perfect but it’ll happen

Answer 16

input from the SUPRASPINAL CENTERS and

SPINAL LOCOMOTOR SYSTEM

Question 17

Arm swing comes from what kind of networks?

Answer 17

Propriospinal where different enlargements can communicate

Question 18

L1-L5 is _____ propriospinal network

Answer 18

short

Question 19

Cervical to lumbar is _____ propriospinal network

Answer 19

long

Question 20

Why is arm swing important on the treadmill?

Answer 20

increase the efficacy of propriospinal networks.

Question 21

cervical enlargement: ____ control

Lumbar enlargement _____ control

Answer 21

Cervical: forelimb

Lumbar: hindlimb

Question 22

What do you want to make sure you do after treadmill training?

Answer 22

OVERGROUND!

Question 23

High intensity stepping may provide opportunities for recovery through SC, CPG, cortex and propriospinal networks

Answer 23

This is recovery based!

Question 24

SC has the basic circuitry for ____

Answer 24

reciprocal limb action

Question 25

Can CPG's be activated w/o snesory input?

Answer 25

yes

Question 26

Can CPG's be activated w/o sensory input/? What does sensory input give us?

Answer 26

Yes Modulates timing and amplitude of stance and swing

Question 27

Where are the three places suprapspinal control is distributed? Two main jobs?

Answer 27

cortex, midbrain, proprospinal pathways Two jobs: initiate locomotion, modulate motion in case there is an error or obstacle.

Question 28

Supraspinal control is in charge of what?

Answer 28

modulation, initiate locomotion

Question 29

If children are not ambulatory by ____ years it is probably not happening

Answer 29

5 years

Question 30

Clubfeet is a common deformity for what spinal level?

Answer 30

L3 and L4 because you have some DF but no PF (antagonist muscle)

Question 31

Cavovarus feet or claw toes common in what spinal level?

Answer 31

Sacral level: they have DF and PF and are spending time on feet but no intrinsic muscles

Question 32

What vertebral level would you think someone has a better chance to ambulate? Why?

Answer 32

L3 because they have antigravity quads Above this they would need a lot more bracing

Question 33

Retention of walking into adulthood is highest in what vertebral level?

Answer 33

sacral! Lumbar is less and thoracic is less. As you have a higher injury the liklihood decreases

Question 34

Non-myelominingocele and myelomeningocele sacral level are generally _____ ______'s?

Answer 34

Community ambulators

Question 35

is it more likely to see young community ambulators or adult?

Answer 35

young, as people age it becomes less likely

Question 36

Are there benefits to early walking vs. wc use?

Answer 36

YES less fractures, fewer pressure sores, increased independence, improved transfers

Question 37

Thoracic or L1-2 what kind of bracing and AD use are you looking at?

Answer 37

THKAFO's HKAFOS WC

Question 38

L3 what kind of bracing and AD are you thinkin?

Answer 38

KAFOS or solid AFO's, anterior walker and potential to progress to forearm crutches

Question 39

L4 what kind of bracing and AD are you thinking?

Answer 39

solid AFO's Encourage lofstrands as appropriate

Question 40

L5 what kind of bracing and AD are you thinking?

Answer 40

may not need bracing

Question 41

Sacral level bracing?

Answer 41

not needed, maybe insole