Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Neuropathology
Test 2
| Question | Answer |
|---|---|
| Weber's Syndrome - structures involved | Brainstem: Midbrain: 1. Descending corticospinal; 2.corticobulbar |
| Weber's Syndrome - manifestations | 1. contrlateral hemiparesis; 2. ipsilateral 3rd CN palsy(ptosis, no eye movement up, down, or medially; and if fibers of EW nucleus pupollary dilation |
| Bendikt's Syndrome - structures involved | Brainstem: Midbrain: 1. 3rd CN; 2. Red Nucleus |
| Bendikt's Syndrome - manifestations | 1. ispilateral 3rd CN palsy; 2. contralateral ataxia; (can result from a midbrain stroke involving the 3rd CN traveling near the RN. A lesion of the RN interrupts fibers from the opposite cerebellar hemisphere |
| Parinaud's Syndrome | Damage to superior colliculus; imparied upward gaze and convergence |
| Pons - Ventral and Dorsal regions | Ventral: corticospinal, pontine nuclei, transverse fibers; Dorsal region: nuclei of CN. medial lemniscus, RAS, Locus Coeruleus |
| Dorsolateral infarction of the Pons | Causes: vascular lesion or tumor; manifests: contrlateral loss of paon, temperature(face not affected), ipsilateral cerebellar ataxia, deafness, nystagmus |
| Paramedian infarction of the Pons | CN 6, 8; medial lemniscus; medial lemniscus: touch and proprioception on opposite side |
| Millard Gubler syndrome | Unilateral basilar infart; contralateral hemiplegia; CN 6,7; central pontine meylinolysis |
| Medulla - Structures | Anterior, olive, nuclei for CN 9-12, reticular formation. vasomotor center, respiratory center |
| Lateral medullary syndrome(wallenberg syndrome)- causes | Brainstem CVA-occlusion of posterior inferior cerbellar artery(branch of Vertebral artery) |
| Lateral medullary syndrome(wallenberg syndrome) - structures involved | Spinothalmic tract: contralateral loss of pain and temp below level; inferior cerebellar peduncle: ispilateral ataxia |
| Basial infarction(Locked in Syndrome) | Bilateral damage; corticospinal damage; Spinothalmic may be ok |
| Cerebellum - General Function | coordinates voluntary muscle activity; eq(Vestibular aparatus); tonicity; Modulates movements: especially rapid, helps time sequence events, monitor and makes adjustments, compares actual with intended(cortex and muscle afferent input) |
| Cerbellum - Structures | Cerebellar heispheres: anterior and posterior lobes; vermis(controls axial body); Nuclei: dentate(biggest;output), fastigial VC - eq, interposed spinocerebellum - input from spine |
| Superior Cerebellar Peduncles(input,output) | Rubiospinal Tract - Input(monitors movement): ventral spinocerebellar(contra prdominately, can ascend bilaterally from tendons) lower limbs(below L2-3); output(corrects movement): Dentate to contra RN tp cpntra cortex to contra SC(same side of input) |
| Middle Cerebellar peduncles | Pontocerbellar tract - intended movement from the cortex to pons to cerebellum |
| Inferior Cerebllar Peduncles(input,output) | input: dorsal spinocerebellar (C8-L3) (T1-L2 Clarkes nucleus) to vestibular(can influence both sides) to reticular formation(afferent(VF and ICP) and efferent(MN) to inferior olivary nuclei; Output Vestibular and RAS (fastigiobulbar tract) |
| Ataxia | Major manisfestion of cerebellar disorders, disorganized gait |
| Anterior cerebellar lobe dysnfunction | nutritional deficiencies(B12), EtOH, broader gait |
| Posterior cerebellar Vermis syndrome | brain tumors(children(80% below tentorium) with meduloblastomas or ependymomas 3,4th ventricles); profoundly disturbed gait and inability to stand without swaying(truncal dystaxia) |
| Cerbellar hemisphere syndrome | ipsilateral defecits; tumors or abcesses, uncoordination or ipsilateral limbs; Hands Tremor |
| Hands Tremor | Hypotonia(no resistnace to movement); Asynergy(decrease in coordination); Nystagmus; dysartrhria(speech/chew); Station and gait; intention tremor |
| Spinal Nerves/root types | A alpha 1a or 1b(fastest); A beta(II); A delta(III) sharp pain; A gamma; B; C (IV) small unmyelinated (dull constant) |
| Spinal cord - grey matter | Lamina 1-4 dorsal horn(substancia gelatinosa(I+II, fetanyl target); VI thoracolumbar, craniosacral (clarks T1-L2)+ANS; lamina IX: alpha + gamma MN(c3-6 phrenic Nucleus; lamina X surrnounds CNS |
| CSF - porperties | Clear wattery liquid in subarachnoid(pia and arach) contains small amount of protein sugar and electrolytes(not the same as plasma) 100-150mls, 70-180 mmH2O(10mmHg); produced by choroid plexus |
| CSF - Ciruculation | later Vent -> interventricular foramen - > third vent -> cerbral aquaduct -> fourth vent -> spinal cord and brain -> foremen of magendi and luschka -> arachnoid villi(pressure gradient leaves by bulk flow) |
| CSF - Function | preserves homeostasis - proten content(maintains oncotic pressure), buoyancy for brain, lymph system for brain |
| BBB | capillaries have tight junctions between capillary endothelial cells, glial foot processes of astrocytes encase caps; cap endo have high number of mitochon for transport out; substances that can cross: small, lipid soluble, carrier mediated transported |
| Communicating hydrocephalus | overproduction of CSF(adolescence), blood, or tissue, route is ok; montly csf taps |
| Obstructive hydrocephalus | obstruction of flow, tumors, scarring, lateral vent enlarges |
| Supratenorial Herniation | uncal - compression of 3rd CN, ipsi or if severe contra; central - pressure strain down bilat 3rd CN palsy |
| Infratentorial Herniation | trans formenal, pons - apneusis(sustained gasping inspire, short inefficient expire; top of medula - clustered, medula - gasping |
| Doll's Eyes(occulocephalic reflex) | eyes still stay straight when tuened(good vestibular, EOM; no turn brain damage midbrain and pons |
| Oculuvestibular reflex (cows) | cold water in ear, looks slowly to same side, nystagmus to the other, warm opposite; nothing brain damage, one eye damage at pons and midbrain |
| Compensation for Increased ICP | decrease blood within CV->cerebral vasoconstriction-> cerebral hypertension-> Cushing refelx(peripheral vasoconstriction) increase in MAP; cerbral perfusion pressure=MAP-ICP; Clinical signs increased BP widening pressure pulse, decrease HR |
| Increased ICP, failure to compensate from Cushings reflex | ICP still increasing->extreme hypoxic->decompensate-> vasodilate-> inc. dienceph pressure, breathing changes(cheyne stokes)-> inc. in upper brainstem pressure-> central neurogenic hyperventialtion(deep rapid breath remove CO2 from blood to cause vasocon |
| CSF Infections | Menigitis: acute(BCT), Subacute or chronic(aseptic, viral,fungal,TB); Encephalitis: acute(BCT, Viral), chronic(fungus, yeast, TB), Space occupying lesions: brain(immuno comp, iv drugs), epidural abcess(iatro), subdural empyema(iatro); encephalomyelitis |
| Menigitis | inflammation involving the archnoid, pia mater and CSF in the subarachnoid space; extends throughout the subarachnoid space around the brain, spinal cord and ventricles |
| Viral Menigitis | Benign, rarely fatal, self limiting; enterovirus(80%), mumps, EBV, Herpes(rare but serious); no preventative or tx except herpes virus; HSV and VZV needs systemic antivirals(AIDs) |
| BCT Menigitis - neonates | Group B Strept(vag), Listeria, E. coli |
| BCT Menigitis - infants and children | used to be H. flu(HIB)<5%; S. pneumo, N. Menig, S. Aureus, Listeria |
| BCT Menigitis - Normal adults | S. pneumo(30-50%), N menig(10-35%) higher morbidity |
| BCT Menigitis - post-surgical | pseudomonas, S. Aureus |
| Acute Bacterial Menigitis Risk Factors | Extremes in age, crowded conditions terminal complement deficincy(c6,7,8,9)N. men, splenectomy(S. pneumo), SCD, EtOHism/liver damage/cirrhosis, CSF leakm CSf shunt, DM, Sinusitis, OM, brain abcess, Recent Neurosurgery, immunosuppression |
| Acute Bacterial meningitis Pathophysiology - Hematological Route | Lung(S. Pneumo 31% deafness), Skin and subg tissue bone/osteomyelitis(S. Aureus), intestinal: e. coli |
| Acute Bacterial meningitis Pathophysiology - Contiguous(direct) Route | Ear/OM(infants), URI(N. Mening 11% deafness) |
| Acute Bacterial meningitis Pathophysiology - direct entry Route | trauma/Sx/LP (prophylactic AB) |
| Acute Bacterial meningitis Pathophysiology - Virulence Factors | Bct LPS activates IL-1, Il-8, and NO from endo and Astros cause leaky vessels allowing for disem. IgA proteases allow adherence to mucosa, Capsule are anti-phagocytic |
| Acute Menigitis Manisfestations of BCT | Onset: Rapid(25%)vSlow(75%); Fever>90%; headache 90%, menigismus 85%, Lethargy 80%, petechia/purp(50% if N. menin); vomit(30%), seizures(GM/inflam MC 30%); focalneurosigns(6 cn palsy)25%; hemiparesis, papolledema 1%, photophobia/blurred; no accomidation |
| Kernigs and Brudzinski signs | low sensitiveity buy high specifity to ABM; try to extend lower leg causes back pain; bring legs in to when neck flexed |
| Acute Bacterial meningitis physical findings needed for a diagnosis | Fever, menigismus, and altered mental status |
| Acute N Menigococcal Menigitis(prognosis and physical findings) | Prog: 5-10% mortality, septic 12-40%; isolate after Dx(droplet precautions); purpueric rash/DIC(40-90%) 12-36 hours may lead to pupura fulminans(systemic) increased ICF(headache, profectile vomit, papilledema/swollen disc/ av nicking(late sign) |
| Acute Bacterial meningitis physical findings for adults(early vs late) | Early: headache, vommiting, papilledema; Late lethargy, uni/bi 6 CN Palsy, transtentorial or transforaminal syndromes |
| Acute Bacterial meningitis physical findings for children(early vs late) | early: enlarged head; Late: lethargy or hyperirritiable, failure to thrive, vommit; bulging of anterior font., distention of scalp veins, seperation of cranial sutures, setting sun syndrome, papilledma. uni/bi 6 cn palsy, transtentoral and trandforam symp |
| Transtentorial Herniation - early signs | ipsilateral 3rd nerve pals; increasing stupor; contralateral hemiparesis; (ipsilateral occurs as a false localizing in 20% of cases; corticol blindness |
| Transtentorial Herniation - late signs | coma, irregular respiration(cheyne stokes, CNH; uni;/bi decorticate posutring |
| Transtentorial Herniation - Pre-terminal signs | Bilateral dilated fixed pupils; loss of VO reflex(dolls eyes); no deep tendon refexes; EEG-Flat |
| Transforamenal Herniation - early signs | head tilt, nuchal ridgity,subocipital tenderness |
| Transforamenal Herniation - late signs | respiratory arrest; stupor to coma; uni/bi decerebrate posturing |
| Transforamenal Herniation - Pre-Terminal signs | circulatory collapse |
| Lumbar puncture characteristics | pressure, clarity, presence of microorganisms, leukocytes, RBC, conc. glucose, protein, gamma globulin, lactic acid, presence of endotoxins and bct antigens |
| LP protocol | obtain before imaging if ABM suspect, repeat 8-12 hr if Dx is uncertain; pts with neuro findings or papilledma usually don't have ABM image then LP; with brain abscess, subdural empyema, subdural LP bad!; rel. contra: infect of skin, sig bleed disorder |
| Lumbar puncture pressure + tubes | normal:50-195mmH20; ABM: 90%>180mm, 20%>400mm, 5%.500mm; Tube: 1 cell count with diff, 2 glucose,protein, 3 gram stain, 4 viral cultures |
| Lumbar puncture normal levels | WBC: 0-5; %PMNs: 0-15%; Glucose: 45-65; CSF Blood glucose .6; Protein: 20-45 |
| Lumbar puncture ABM | WBC: >1,000; %PMNs: 90%; Glucose: <40; CSF Blood glucose <.4; Protein: >150 |
| Lumbar puncture Viral | WBC: not as high as BCT; %PMNs: <50%; Glucose: 45-65%; CSF Blood glucose .6; Protein: 50-100 |
| Acute Bacterial Meningitis empiric Treatment | early rec, id and rapid intiation, isolation, empiric AB(IDSA): <1 month amp+cefotaxime or aminoglycoside; 1-23 months + 2-50yers: vanco + 3rd ceph; >50yrs vanco+3rd ceph+amp |
| Acute Bacterial Meningitis tailored Treatment | S. Pneumo, N. Mening, Listeria pen G or amp; H. flu amp; Dexamenthasone stops deafenss: .15mg/kg every 6 hr for 2-4 days; sequelae, icp pressure bolt and management - mannitol |
| Acute Bacterial Meningitis Prevention | HIB; N. Mening multival poly cap vacc ACY and W-135 not B(U.S) - effect in 3mo up; pneumovax: 23 poly caps(the majority of ABM) - adults>65; chronic disease; DM; EtOHism; CSF leak; immunocomp;asplenia, lymphoma, HIV neph synd or multi myeloma 6mo boost |
| Acute Bacterial Meningitis phrophylaxis | menigoccal disease: rifampin, monocycline, cipro; Hflu rifampin |
| Stretch Reflex(myoactic, deep tendon) | Stimulus: stretch of the muscle SAR: Muscle spindle to the chord; MER: AMN(Extrafusal fibers) contracts muscle, GMN contracts the muscle spindle(intrafusal) |
| Muscle Spindle | afferent to the cerebellum, Nuclear bag, annulospiral endings detect length and rate of change, Nuclear chain has flowerspray endings and detects change in length |
| upper arm(lateral surface) chord segment | C5 |
| Thumb and lateral forearm cord segment | C6 |
| middle finger cord segment | c7 |
| little finger cord segment | C8 |
| nipple cord segment | T4 |
| Umbilicus cord segment | T10 |
| Big toe cord segment | L5 |
| Heel cord segment | S1 |
| Elbow flexion cord segment | C6 |
| Elbow extension cord segment | C7 |
| Wrist flexion cord segment | C7 |
| Wrist extension cord segment | C6, C7 |
| Knee Flexion cord segment | L5, S1 |
| Knee extension cord segment | L3, L4 |
| Ankle Dorsiflecion cord segment | L4 |
| Plantar flexion cord segment | S1 |
| Withdrawl reflex | Stim: pain. Sensory afferent, motor efferent flexors excited, extensors inhibited |
| Reflex scale | 0-areflexia. 1-hypo, 2-normal, 3 hyper, 4-clonus(spinal cord severed) |
| Crossed Extensor Reflex | Stimulus: pain on opposite side, sensory afferent, motor afferent flexors inhibited extensors excited; usually linked with withdrawl |
| Noiciception | recognition and signaling of a deleterious stimuli |
| Pain | conscious awareness of the nociceptive event |
| Suffering | emotional and behavioral sequelae |
| Deafferention pain | pain due to loss of sensation of an afferent fiber |
| Hyperalgesia | increased sensitivity to stimuli |
| Pain afferent nerve ending activators | thermal, mechanical, chemical(H+, bradykinin, histmaine, prostaglandins, hypoxia) |
| A-delta Fibers | location: body surface/skin, Stimuli: mech, therm, and chem. type of pain: sharp prickly pain, large diamerter myelinated 5-30m/sec |
| C fibers | Location: deep skin and all tissues; Stim: therm, mech, and chem, type of pain: aching, burning pain, small diameter unmyelinated .5-2m sec |
| Lissares tract | afferent pain neurons synapse with spinal chord and decusate at two spots, one at the level and one 2 segments above(lissares) using substance P and glutamate |
| Cord damage to one side | no pain contralateral side 2 segments down because of lissares |
| Neospinothalmic tract | Ascending pathways of pain Lateral spinothalamic tract: 1. RAS 2. Thalamus(VPL) 3. Somatosensory cortex; does paon localization and intesity; a delta uses this the most |
| Paleospinothalmic Tract | Ascending pathways of pain Lateral spinothalamic tract:1. RAS 2. thalmus(VPL), 3. intralaminar nuclei 4a. Somatosensory cortex(secondary/how er interpret pain) 4b. limbic(prefrontrontal cortex); emotinal response to pain |
| Modulation of pain | 1. periaqueductal gray releases enkephalin on internneruon that releases neurotensin on the 2. Raphe nucleus(medulla)which releases 5HT on a interneuron which releasts enkephalin on the 2. opiod recptors of the dorsal horn which stops ca++ channels |
| Epidural | phentyl(100x morphine/antidote naicam) binds opoid receptor in dorsal horn stops Ca++ channels |
| Tricyclic Antidepressants and pain modulation | Block reuptake of 5HT, NE, and DA; more 5Ht in the CNS more ENK less pain; SSRI don't cross BBB |
| Exogenous modulation of pain - opiates | oral/iv/im(euphoria); Epistays local no euphoria; intrathecal(subarachnoid space spreads with CSF movement) |
| Exogenous modulation of pain - local anesthetic agents | Lidocaine(short)MSD:5-7 mg/kg, tox: cns before cardiac, CNS: twitch tinnitis, GM seiz, card: heart block; Marcaine(long) MSD: 2-3mg/kg, toc cardiac(DIC) before CNS(V. Fib); Nsaids(block prosta; tricyclics |
| Surgical Modulation of Pain | Cordotomy: lateral spinothalmic tractotomy, loss of pain on contra side 1-2 seg below, temp.(reroute) SE:no cerebellar input/loss of balance; Lesions-dermato pain(shingles), rhixotomy, intralamin nuclei obliterate(no suffering just acute pain); VPL or VPM |
| Radicular Pain | Follows dermatome |
| Thalamic syndrome | vascular lesion, hypoxia to thalmus often VPL |
| Complex regional pain syndrome(reflex sympathetic dystrophy) - component 1 | 1.pain: out of prop to injury, burn, numb ting, itch, derma(vasc. dist) or diffuse(less), distal, super nonocious stim(air hurts, behavioral changes(reclusive or withdrawn) |
| Complex regional pain syndrome(reflex sympathetic dystrophy) - component 2 | unspecified abnormalities of sensation, motor function and blood flow: bad cap refill, soft puffy edema, color changes, cold or warm, joint limitations |
| Complex regional pain syndrome(reflex sympathetic dystrophy) - component 3 | Sweating and trophic changes in the skin and soft tissue: excess moisture or dryness, increased haro or nail growthm osteoprosis(affected area), muscle atrophy |
| Complex regional pain syndrome(reflex sympathetic dystrophy) - 3 types | algodystrophy: pain and all features of dystrophy; dystrophy without pain; sympathetically maintained pain, not exhibiting dystrophic changes |
| Complex regional pain syndrome(reflex sympathetic dystrophy) - treatment | meds: phoxybenzamine hydrochloride(alpha blocker), clonidine(alpha 2 agonist(blocks symp at synaptic cleft) all meds have postural hypotension; Nerve blocks(first and fast) inject into dorsal root ganglion; cut the nerve |
| Crude touch | same side; anteriolateral system |
| Discriminatory touch(conscious proprioceptive) | ascends same side in fasiculus gracilus decusates in nucleos gracilla(medulla) goes to SS cortex |
| Myopathy | proximal: going up stares; CPK; EMG; |
| Neuropathy | Distal:button shirt, gradual, painless |
| Lesion in the anterior horn | volunt motor control: pralysis(flaccid, hypotonia; Reflex motor: decreased/absent, atrophy: profound, Fascic: motor unit(see), Fibril:fiber(emg) |
| Posterior Root Lesion | causes: tumor, infection, injury(IVD hern); Manifests: dermatomal/radiculopathy; motor volunt motor: ok/uncoordinated(no cerebellar sense); atrohy/fascic:absent; hypotonia; sensory: pain, paraesthesa(sciatica); reflexes decreased or absent. |
| Upper motor Neuron Lesions: internal capsule(posterior limb) - intial | manifests:(7-21d, shock like, paralysis: contra, flaccid, hypotnia, Refelxes: DTR-absent, Babinksi-no response |
| Upper motor Neuron Lesions: internal capsule(posterior limb) - long term | Manifests: paralysis: contr, spastic, hypertonia: flexors of arm, extensors of legs(fetal posit), reflex: DTR:4+, Babinski + on contra, hoffman normal: hyperreflexive |
| Upper motor Neuron Lesions: Corticospinal lesion | Above decusast: contra, spastic paralysis, babinski: +; Below: ipsi, spastic paralysis, babinski:+ |
| Lesions of peripheral Nerves: Mononeuropathy | 1 nerve, cause:trauma, entrampment(IVD), infection, vascular, pain common |
| Lesions of Peripheral Nerves: Mononeuropathy multiplex | asym, 2 or more, more proximal, prevelent in autoimmune or DM before they go poly |
| Lesions of Peripheral Nerves: polyneuropathy | generalized, Motor: sym, distal the proximal, weak, atrophy; Sensory: stocking and gloves appearance(feet before hands, upper calf before fingers); Reflex:absent or dec; ANS: dec. sweating, bladder/bowl, blood pressure, sexy dysfx |
| Lesions of Peripheral Nerves:plexopathy | Nerve plexus incolved, trauma, tumor, infection, compression, Erb's palsy: usually upper trunk of brachial(c5-t1) to much force during delivery, shorter arem from disuse |
| Lesions of Peripheral Nerves:Amyotrophy | muscle atrophy secondary to damaged nerve |
| Lesions of Peripheral Nerves:myopathy | weakness due to a problem with the muscle |
| Lesions of Peripheral Nerves:myositis | muscle destruction, inflam, immune |
| Lesions of Peripheral Nerves: sensory deficits | Large fibers: pins and needles, small fibers: decrease in pain and touch, Hypesthia-dec/alt sensitivity, paraesthesia-pins and needles, dysesthesia-bad pain, hyperesthesia-inc repsonse to pain |
| Lesions of Peripheral Nerves: polyneuropathy causes | DANG THE RAPIDST:DM, EtOH, Nut(B12, Thiamine), GBS, Trauma, Hereditary, Enviro(acrylamide, lead, arsenic, remote effects of cancer, amyloid, porphyria, inflan/infect(vascular), syph/systemic(hypothryoid), tumor |
| Diabetic Neuropathy | most com cause of polyneur, based on duration and severity, slow insidious with minimal motor, normal polyneuro pres, proprio: dec joint posit leads to destruc(diabetic pseudo tabes), DM amyotrophy-weak,atrophy in prox mm, lumbosac polyrad(L2-4) |
| Peripheral nerve testing | Nerve conduction velocity, EMG, F wave: conduction velocity in proximal nerve and nerve root, H wave: reflex arc. |
| GBS(acute Demyelinating Inflammatory Polyneuropathy) | Causes: post infection viral(CMV, EBV), progressive weakness in >1limb with areflex or hypo; Pathology: demyel over 1-3 weeks; Sensory may be 1st follow by ascending m weak, motor:distal b4 prox, Leg b4 arm; CNs, ANS:arryth, bladderm tenp, fluctuating bp |
| GBS(acute Demyelinating Inflammatory Polyneuropathy) - Diagnosis + treatment | Dx: CSF: inc protein, emg prolonged F wave and no H wave; Tx:steroids:contro, vent, plasmapharesis, ig |
| C5-C6 IVD herniation | C6 root compression; Sensory Dec over thumb lateral radius, Motor weak elbow/flexion/bicep; Reflex: dec bicep/bracioradialis |
| C6-C7 IVD herniation | C7 root compression; Sensory Dec over index and missle digit, Motor weak elbow/extension/tri; Reflex: dec tri |
| L4-L5 IVD herniation | L5 root compression; Sensory: dec. over anterolateral big toe; Motor: weak dorsiflexion(heel walking); Reflex: dec hamstring |
| L5-S1 IVD herniation | S1 root compression; Sensory: dec. over lateral leg and heel; Motor: weak plantarflexion(toe walking); Reflex: dec ankle |
| IVD herniation diagnosis and treatment | MRI, Myelogram(young and healthy; conservative: PT, corito inject; Surgery if motor def.:laminectomy with repair or fusion |
| Spinal cord Injury Statiitics | 10k/year, 50% quads 50% para; 81% males 34y, common locations c1-2, c4-7 T-L2; causes: 48% MVA, 21% falls, 14.6% trauma, 14% sports(water) |
| Types of Spinal Cord Injuries | compression, extension, flexion, rotational, lateral |
| Spinal cord injury classification ASIA | Based on neuro levels, touch and prick each derma, and strength of: shoulder shrug(c4), elbow flex(c5), wrist flex(C6), Elbow ext(C7), hip Flex(L2); A:complete loss, B: incomp, some sensory, C:incomp some motor pres<.5, D incomp, .5 muscle pres, E:normal |
| Spinal cord injury - immediate | submicroscopic hemorrhage->edem+/- 2 segments, neurogenic shock(hypotension, bradycardia, hypothermia, tx fluids, vasopressor), spinal shock |
| Spinal Shock - Spinal cord injury | 7-21day, absent reflexes, flaccid paralysis, no sensory or ANS(over distended bladderimpacted rectum) babinksi absent |
| Spinal cord injury - long term | return of spinal cord reflexes, dependent on level of injury, autonomic hyper-relfexia |
| Autonomic Hyper-reflexia | Massive rerouting through the sympathetic trunk, bladder distention can activate it. below T6 you don't have enough space to hold the blood displaced by the vascon, TX alpha blockers(postural hypotension, pooping schedules and dialy straight caths |
Created by:
bmg4