Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
58 Cards in this Set
- Front
- Back
|
What dermatome?
Medial malleolus |
L4
|
|
|
What dermatome?
Lateral foot |
S1
|
|
|
What dermatome?
Lateral calf |
L5
|
|
|
What dermatome?
Nipple level |
T4
|
|
|
What dermatome?
Umbilicus level |
T10
|
|
|
What dermatome?
Hamstrings |
S2
|
|
|
What dermatome?
Pinky finger |
C8
|
|
|
What dermatome?
Medial forearm |
T1
|
|
|
What dermatome?
Deltoid |
C4
|
|
|
What dermatome?
Lateral arm |
C5
|
|
|
What dermatome?
Lateral forearm/thumb |
C6
|
|
|
What dermatome?
Occiput |
C2
|
|
|
What myotome?
Finger abduction |
T1
|
|
|
What myotome?
Wrist extension |
C6
|
|
|
What myotome?
Finger flexion |
C8
|
|
|
What myotome?
Hip flexion |
L2
|
|
|
What myotome?
Knee extension |
L3
|
|
|
What myotome?
Dorsiflexion |
L4
|
|
|
What myotome?
EHL |
L5
|
|
|
What myotome?
Plantarflexion |
S1
|
|
|
What dermatome?
Anal sensation |
S4-S5
*this determines whether an injury is complete or incomplete |
|
|
What dermatome?
Midpoint of inguinal ligament |
T12
|
|
|
What dermatome?
Anterior thigh |
L2
|
|
|
What dermatome?
Medial femoral condyle |
L3
|
|
|
What dermatome?
Dorsum of foot at 3rd MTP joint |
L5
|
|
|
In order to the an AIS level C or D a patient must have sensory or motor function in the S4-5 segments + either of what two things?
|
1. VOLUNTARY anal sphincter contraction or...
2. sparing of motor function MORE THAN 3 LEVELS below the MOTOR LEVEL |
|
|
Define AIS B
|
1. SENSORY but no motor fxn is preserved below the NEUROLOGICAL LEVEL & INCLUDES THE S4-5 segments.
|
|
|
How do you determine the MOTOR level?
|
Most CAUDAL key muscle group that is equal to or greater than 3/5 with the segment directly above it graded at 5/5.
*If there is no corresponding motor level above the level of a 3/5 or 4/5, use the lowest normal sensory level. |
|
|
What a DELAYED PLANTAR RESPONSE?
What is its significance? |
Performed like a Babinski but with DEEP pressure, response is always delayed in comparison to normal plantar response or Babinski sign -toes flex and then relax slowly.
- If persistent = high correlation with complete SCI w/ POOR prognosis for LE recovery. |
|
|
If the bulbocavernous reflex returns following spinal shock when does it typically return and what does it indicate?
|
- 24 hrs post injury.
- Indicates intact reflex innervation of bowel/bladder (upper motor neuron lesion). - If it does not return, think LMN lesion. *Squeezing penis causes REFLEXIVE anal contraction. Indicates |
|
|
On average when do reflexes return following spinal shock?
|
2-3 wks
*may take up to 3 months however Early reflexes (bulbocavernous, perianal sphincter, delayed plantar response) start to return after 24 hrs |
|
|
What is the most common INCOMPLETE SCI syndrome?
|
Central cord
|
|
|
Describe the findings in CENTRAL CORD SYNDROME
|
- Motor weakness (UPPERS>lowers)
- Variable sensory loss - Sacral sensory sparing - Variable bowel/bladder function *Remember in CORTICOSPINAL TRACT, innervation to upper limbs is more medial, lower is lateral |
|
|
Describe the recovery pattern of CENTRAL CORD SYNDROME
|
1. Legs
2. Bladder 3. Arms 4. Intrinsic hand muscles |
|
|
Main prognostic factor for CENTRAL CORD SYNDROME?
|
AGE
- if you're below 50 you have much better prognosis |
|
|
Describe the findings in BROWN SEQUARD SYNDROME
|
Loss of...
1. SAME SIDE: - Motor (CORTICOSPINAL) at level of lesion - Proprioception/vibration (DORSAL COLUMN) below lesion 2. OPPOSITE SIDE: - Pain & Temp (spinoTHALAMIC) below lesion *Rare (2-4% of SCI) |
|
|
What is the prognosis like for Brown Sequard syndrome?
|
Best prognosis for ambulation among the incomplete SCI syndromes.
|
|
|
Describe the findings in ANTERIOR CORD SYNDROME
|
Damage to anterior 2/3
- variable loss of MOTOR (corticospinal) - loss of PAIN & TEMP (spinothalamic) * DORSAL COLUMNS ARE PRESERVED (light touch, proprioception, vibration) |
|
|
What causes ANTERIOR CORD SYNDROME?
|
- ANTERIOR SPINAL ARTERY LESION
- retropulsed disc - bone fragments from flexion injury - direct injury |
|
|
What is the prognosis like for ANTERIOR CORD SYNDROME?
|
POOR
- only a 10-20% chance that muscles will recover |
|
|
What is the prognosis like for POSTERIOR CORD SYNDROME?
|
Prognosis for ambulation is POOR -mainly d/t propioceptive loss (dorsal columns)
|
|
|
Describe the findings in CONUS MEDULLARIS SYNDROME
|
- areflexic bladder
- areflexic bowel - areflexic lower limbs (if low lesion) - hyperreflexic lower limbs (if high lesion) *NORMAL MOTOR FXN usually |
|
|
How can you distinguish a HIGH CONUS lesion from a LOWER one?
|
Higher lesions may still have preservation of the bulbocavernous & micturitition reflexes
|
|
|
Injuries below what level constitute CAUDA EQUINA injury rather than CONUS MEDULLARIS injury?
|
BELOW L2
Conus medullaris = injury at T12, L1, L2 |
|
|
Describe the findings in CAUDA EQUINA SYNDROME
|
LOWER motor neuron injury:
- Weakness/atrophy (L2-S2) - Bladder/bowel dysfxn (S2-S4) - Impotence - Saddle anesthesia - Areflexia (MSRs & bulbocavernous) |
|
|
What is the relative prognosis for CAUDA EQUINA SYNDROME compared to upper motor neuron injury?
|
Prognosis is better as nerve roots are still considered peripheral, makes them more resilient, have the ability to regenerate
|
|
|
What is the prognosis like for CONUS MEDULLARIS SYNDROME?
|
POOR
- This is actual CORD injury as opposed to cauda equina which is more like multiple radiculopathies (nerve roots) |
|
|
Conus or Cauda?
Spina Bifida |
CONUS
|
|
|
Conus or Cauda?
Sacral fx |
CAUDA
|
|
|
Conus or Cauda?
Associatd with spondylosis |
CAUDA
|
|
|
Conus or Cauda?
Pelvic ring fx |
CAUDA
|
|
|
Conus or Cauda?
Tumors, glioma |
CONUS
|
|
|
Conus or Cauda?
PAIN is more prevalent |
CAUDA -nerve ROOT pain
|
|
|
Conus or Cauda?
ASYMMETRIC |
CAUDA - nerve ROOT injury
|
|
|
Conus or Cauda?
SYMMETRIC |
CONUS -cord injury
|
|
|
Conus or Cauda?
Normal EMG* |
CONUS -this is a CENTRAL injury, not a peripheral injury
*May show some external sphincter or S1/S2 involvement |
|
|
What is the highest COMPLETE SCI level that can live INDEPENDENTLY without the aid of an attendant?
|
C6 complete tetraplegic (if highly motivated)
- has elbow flexion & wrist extension C7 is the USUAL LEVEL however. |
|
|
What is the highest COMPLETE SCI level that can drive independently with or without adaptions?
|
C5
|
