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56 Cards in this Set

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Describe the symptoms associated with a Hemisection at C5 level.
Hemiplegia
Describe the symptoms associated with Complete Transection at C5 level.
Quadraplegia
Describe the symptoms associated with Hemisection at T1-L3.
Ipsilateral loss

Body temperature
Vasoregulation
Describe the symptoms associated with Complete Transection at T1-L3.
Bilateral loss

Body temperature
Vasoregulation
Describe the symptoms associated with Hemisection at L2.
Monoplegia - ipsilateral side
Describe the symptoms associated with Complete Transection at L2.
Paraplegia
Describe the symptoms associated with Hemisection at S2.
Bowel & Bladder
(some problems)
Describe the symptoms associated with Complete Transections at S2.
Bowel & Bladder
(Incontinent)
Define Spinal Man Syndrome.
Where a lesion severs, crushes, or bruises the spinal cord resulting in a loss (if not all) of sensory and motor pathways below the injury.
The hypothalamospinal tract runs with what other tract?
Lateral Reticulospinal tract
Along what column & tract are the sympathetic preganglionic neurons located?
Intermediolateral cell column

from T1 - L3
What region of the brain controls sweat glands and the peripheral vasculature?
Hypothalamus
Describe the positional pathway of the hypothalamospinal tract towards the sympathetic intermediolateral cell column.
Uncrossed throughout in the anterior lateral funiculus
A lesion of the hypothalamospinal tract results in what symptoms?
1. Ipsilaeral loss of temperature regulation

2. Anhydrosis

3. Hyperemia (temporary)
Describe the effects on body temperature regulation for both hemisection and complete transection at L4.
NONE

b/c outside range sympathetic intermediolateral cell column
Describe the Brown Sequard Sydrome and Spinal Man Syndrome for a lesion on T6.
BS - Ipsilateral hyperemia, Anhydrosis , and loss of temperature regulation seen on T7 and below.

SM - bilateral Hyperemia, Anhydrosis , and loss of temperature regulation seen on T7 and below.
Describe the symptoms of autonomic dysreflexia.
Condition due to vasoconstriction below lesion level

characterized by excessive increase in blood pressure (hypertension), Headache, anxiety, and other sympathetic related phenomena.
Transections above T5-T6 may also result in what condition?
Autonomic Dyreflexia.
The autonomic dysreflexia response can be initiated by what type of stimuli?
Nociceptive, sex, etc.
Describe the Brown Sequard Sydrome and Spinal Man Syndrome for a lesion on T1.
BS - Ipsilateral loss of temperature regulation in ALL dermatomes + face. Also, hyperemia and anhydrosis.

SM - bilateral loss of temperature regulation in ALL dermatomes + face. Also, hyperemia and anhydrosis.
What are the symptoms of Horner's syndrome? x5
1. Hyperemia of face
2. Anhydrosis of face
3. Miosis
4. Enophthalamus
5. Ptosis of eye
What can cause Horner's syndrome? x3
1. Lesion at T1
2. Neck tumor
3. Tumor at the apex of lung
In Brown Sequard's, describe the sensory deficits.
Ipsilateral loss of epicritic sensation below lesion.

Contralateral loss of protopathic sensation two levels below lesion.
In Spinal Man syndrome, describe the sensory deficits.
Complete loss of all sensation below transection.
In Brown-Sequard syndrome, describe the effects of paralysis.
Ipsilateral spastic paresis- pyramidal syndrome
(Lower cord - monoplegia;
Upper cord - hemiplegia)

Ipsilateral LMN damage at legion site
In Spinal Man syndrome, describe the effects of paralysis.
Complete bilateral paralyssis below transection.
May be spastic.

(Lower cord - paraplegia;
Upper cord - quadriplegia)
In Brown-Sequard syndrome, describe the effects on the Babinski sign.
Ipsilateral only
In Spinal Man syndrome, describe the effects on the Babinski sign.
bilateral
In Brown-Sequard syndrome, describe the effects on body temperature regulation.
At L3 and above, ipsilateral loss below hemisection

At T1 and above, ipsilateral loss of temperature control and ipsilateral Horner's syndrome
In Spinal Man syndrome, describe the effects on body temperature regulation.
At L3 and above, bilateral loss below transection.

At T1 and above, poikilothermia and bilateral Horner's syndrome.

At T5-6 and above, Autonomic Dysreflexia
In Brown-Sequard syndrome, describe the effect on Bladder and Bowel.
Possible spastic-disynergic bladder with incomplete control.
In Spinal Man syndrome, describe the effects on Bladder and Bowel.
Complete incontinence with spastic-disynergic bladder
In Brown Sequard syndrome, describe the existence of mass reflex.
Absent
In Spinal Man syndrome, describe the existence of mass reflex.
Present
Describe the symptoms associated with an occlusion of the posterior spinal artery.
Loss of ipsilateral epicritic at below level of lesion.
Describe the symptoms associated with an occlusion of the sulcal branch of the anterior spinal artery.
Same as Brown-Sequard's syndrome, but no loss of epicritic.
Describe the sensation associated with an occlusion of the anterior spinal artery.
Same as Spinal Man's syndrome, but no loss of epicritic.
Following spinal cord transection (Spinal Man Syndrome), a period of what ensues? What are the symptoms?
Spinal shock.

Loss or shutdown of all reflex activity below transection.

Bladder becomes atonic ("flaccid") with overflow incontinence.
As spinal shock subsides, what happens?
Reflex returns

Atonic bladder becomes spastic, disynergic (automatic) bladder.
During Spinal shock, what do many para- and quardriplegics experience?
Mass reflex
What are the centers responsible for bladder reflex?
Frontal lobe
Pontine Bladder Center
Spinal centers (S2, S3, and S4)
What are the muscles involved in the bladder reflex? Type of muscle for each. What controls them?
Detrusor muscle
- smooth
- ANS

Internal sphincter
- smooth
- ANS

External sphincter
- skeletal
- Upper motor neurons
What type of innervation is involved in bladder reflex?
Bilateral
What is the activity of the frontal lobe on to the activity of the bladder?
Suppresses both sensory and motor activity of bladder.
In the bladder reflex, Sympathetic regions are found where on the spinal cord?
L1 and L2
In the bladder reflex, Parasympathetic regions are found where on the spinal cord.
S2, S3, and S4
In the bladder reflex, LMN regions are found where on the spinal cord.
S2, S3, and S4
What nerve and nerve component excites and inhibits the external spincter?
LMN (Pudental nerve)

GSE
What maintains contraction of the external sphincter?
UMN in the frontal lobe
What nerve and nerve component controls the internal sphincter muscle?
Lumbar and Sacral splanchnics

GVE - Sympathetics
What nerve and nerve component controls the detrusor muscle?
INHIBITION
Lumbar and Sacral splanchnics
GVE - Sympathetics of Lumbar cord

EXCITATION
Pelvic Splanchnic
GVE - Parasympathetics of sacral cord
What are the steps in micturation?
1. Sensory stimulation (stretch receptors stimulate the GSA nerve fibers, going to the sacral cord, then to the lumbar cord, then to pontine bladder center, and ultimately into the frontal lobe)

2. Motor Neuron relaxation of External sphincter
(Frontal lobe suppresses the GSE LMN fibers of the Pudental nerve, thus relaxing external sphincter)

3. Sympathetic relaxation of Internal sphincter
(GVE sympathetics of the lumbar and sacral splanchnics will relax the internal sphincter)

4. Parasympathetic contraction of Detrusor muscle.
(The GVE Parasympathetics from the pelvic splanchnic will contract the detrusor muscle for micturation)
In terms of bladder activity, what does a lesion of the frontal lobe (especially the right frontal lobe) do?
Cause a spastic (overactive) bladder.

Leads to
increased frequency
increased urgency
incontinence
detrusor hyperreflexia
In terms of bladder activity, what does a lesion of the spinal cord do?
1. Spastic (overactive) bladder

Leads to
increased frequency
increased urgency
incontinence

2. Detrusor-sphincter disynergia

External and/or internal sphincter tightens as bladder wall contracts leading to urinary retention.
In terms of the bladder activity, what does a lesion of the peripheral nerve do?
Flaccid Bladder

Leads to retention and overflow incontinence.
Why does the expanded bladder NOT contract in peripheral nerve lesions?
Due to loss of parasympathetic motor and sensory fibers of reflex.