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22 Cards in this Set
- Front
- Back
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ascending tracts
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sensory up- afferent
myotomes 1) pain & 2) temp together - cross to lateral horn then up |
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descending tracts
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motor down - efferent
dermatomes cross at medulla - rt. side of brain controls left side of body 3) touch, pressure, proprioception - posterior horn - up - then cross at medulla |
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UMN
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skeletal muscle
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LMN
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final path - reflex arc
message does not go to brain |
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primary injury
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axons disrupted - microscopic hemmorhages in grey matter
ischemia |
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secondary injury
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apoptosis - autodestruction of cells continues weeks/months
ischemia - hypoxia edema |
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cervical injuries
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C4 respiratory center - above fatal unless airway intervention occurs
best is C7-8 - quadraplegia with intact biceps/triceps |
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thoracic
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area protected - less common
T6-12 entire thorax muscle intact- better for respiratory reserve |
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lumbar
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below L2 is damage to bladder
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central cord syndrome
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more damage to arms and hands - motor loss in upper extremities + varying degrees of sensory loss
walking quadreplegia |
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anterior cord syndrome
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loss of motor, pain, temperature function below level of injury
touch, pressure, proprioception intact |
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brown-sequard syndrome
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cord transected - only half of cord transected
same side (ipsilateral) no motor opposite side (contralateral) loss of pain/temp |
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UMN paralysis
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LMN/reflex arc intact
spasticity, hyperactive reflexes, contracture, atrophy not prominent |
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LMN paralysis
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muscles flacid, hypoactive
no reflexes, atrophy |
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drug therapy
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methylprednisolone (solumedrol) give within 8 hours
tirilazad mesylate (freedox) lipid paradoxation inhibitor - with first 48 hours GM-1 ganglioside (sygen) prevents ischemia |
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spinal shock
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temporary
loss of autonomic, reflex, motor, sensory activity below LOI can mask permanant damage - lasts weeks - months |
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sympatheticc innervation inury effects
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bradycardia/postural hypotension
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neurogenic shock
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extreme sympathetic reaction
parasympathetic takes over - hypotension, bradycardia, warm-dry extremities, hypothermia dilation - decreased venous return, decreased CO - shock |
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vasovagal reflex
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parasympathetic response
vagus nerve stimulated - bradycardia, cardiac arrest caution when suctioning give atropine |
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poikothermia
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body adjust to room temp - sympathetic interruption
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autonomic dysreflexia
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response to noxious stimuli
below LOI - sympathetic - contstrict, HTN, piloerection above LOI - parasympathetic - bradycardia, headache, blurred vision raise HOB- vasodilator for BP - remove stimulus |
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neurogenic bowel
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spinal automism
areflexic bladder - overflow, distension, reflux reflexic -spastic |
