Spinal Cord Lesions

Front 1

what does it mean if the cord is "functionally" transected?

Back 1

even if only bruised, the cord may undergo swelling, drop in BP in damaged area, myelin unravels, neurons die, axons degenerate, astrocytic scar tissue forms and the cord is thus functionally transected.

Front 2

a hemisection of S2 would cause what? a complete transection?

Back 2

some bowel and bladder problems, complete incontinence

Front 3

a hemisection of L2 would cause what? a complete transection?

Back 3

ipsilateral monoplegia, paraplegia

Front 4

a hemisection of the cord at T1-L3 would cause what? a complete transection?

Back 4

ipsilateral loss of body temp regulation and vasoregulation, complete bilateral loss

Front 5

a hemisection of the cord at C5 would result in what? a complete transection?

Back 5

hemiplegia, quadriplegia

Front 6

what brain center controls temperature and vasoregulation via the sympathetic nervous system? What tract does it take to reach the preganglionic sympathetic fibers coming out of the cord at T1-L3?

Back 6

the hypothalamus, it follows the hypothalamospinal tract

Front 7

a lesion of the hypothalamospinal tract will do what?

Back 7

ipsilateral loss of temp regulation, anhydrosis (dry skin), temporary flushing (hyperemia) of skin

Front 8

the pregagnglionic sympathetic fibers are located where (not spinal cord level, but name of cells...)

Back 8

sympathetic intermediolateral cell column

Front 9

what is autonomic dysreflexia and who is at risk for it??

Back 9

excessive sympathetic signs and symptoms (high BP, headache, anxiety...) due to unabated discharge of sympathetic neurons below a lesion that are no longer under control of the higher centers. Usually occurs after a sympathetic event: sex, pain, fear. Those with complete cord transections are at risk.

Front 10

a complete transection at T1 results in what and why?

Back 10

loss of all temp regulation and horners syndrome (ptosis, enopthalamus, miosis, anhydrosis, facial flushing). All sympathetic neurons have lost there connection to the brain

Front 11

a tumor of the neck or tumor in the apex of the lung that presses on the superior cerical ganglion will produce what?

Back 11

Horner's syndrome

Front 12

what are the sensory deficits with a brown sequard syndrome? a complete transection?

Back 12

ipsilateral loss of epicritic sensation below hemisection and contralateral loss of protopathic sensation beginning two segments below hemisection. complete loss of all sensation below transaction

Front 13

what types of paralysis would be seen with a brown sequard lesion? a complete transection?

Back 13

ipsilateral spastic paresis (pyramid syndrome) and ipsilateral LMN damage at lesion site. Complete bilatereal paralysis below transection that may be spastic.

Front 14

what patients are polikothermic (they cannot regulate their own body temp)?

Back 14

those with lesions at or above T1

Front 15

an occlusion of a posterior spinal artery would result in what? sulcal branch of anterior spinal? anterior spinal?

Back 15

ipsilateral loss of epicritic sensation below level of lesion and dorsal root loss at lesion site. Ipsilateral Anterior horn loss at level of lesion, ipsilateral loss of protopathic sensation. Bilateral anterior horn and protopathic sensation

Front 16

spinal shock syndrome is characterized by what? And what is the protocol to treat?

Back 16

usually lasts several weeks and is characterized by loss of reflexes below the transection. The bladder becomes atonic with overflow incontinance and dribbling and must be catheterized to prevent infection.

Front 17

What happens when reflexes return after spinal shock?

Back 17

flaccid bladder becomes spastic, disynergic (automatic and not symmetric)and muslt be catheterized bc it still does not empty completely. Flexor and muscle receptor reflexes return. Antigravity muscles may become hypertonic as the spinal cord is rewired and excitation is favored. Mass reflexes may occur which are elicited by any mild stimuli and makes everything go off that can go off below the level of the transection. (spasms, urination, ejaculation... you name it)

Front 18

in the bladder reflex:
1. what provides GVE sympathetic input to the internal spincter?
2. what provides GVE parasympathetic input to the detrusor muscle?
3. What provides the LMN to the externla sphincter?
4. what is the order of muscle stimulation in order to micturate?

Back 18

1. the lumbar and sacral splanchnics
2. pelvic splanchnics of S 2,3,4
3. the pudendal nerve
4. first sensory stimulation, then relaxation of external sphincter, relaxation of internal sphincter, and contraction of detrusor muscle.

Front 19

lesion of the frontal lobe may produce a neurogenic bladder. What are the signs and symptoms of this frontal lobe lesion? what diseases usually produce these lesions?

Back 19

spastic overactive bladder (no UMN), detrusor hyperreflexia, urgency, frequent urination and incontinence. Especially seen in right frontal lobe lesion. stoke, brain tumor, hydrocephalus, parkinsonism, and cerebral palsy

Front 20

what is the specefic symptom seen with loss of pontine bladder center input? what diseases may cause this?

Back 20

detrusor-sphincter disynergia: external and\or internal sphincter tightens as bladder wall contracts resulting in urine retention. spinal transection, multiple sclerosis and tumor

Front 21

what is commonly seen with peripheral nerve lesions to the bladder? what diseases can cause this to happen?

Back 21

flaccid and atonic bladder with retention and overflow incontinence: expanded bladder does not contract due to loss of parasympathetic motor and/or sensory fibers of reflex. Diabetes, guillain barre, tabes dorsalis, and AIDS

Front 22

where is the center for defecation located?

Back 22

the pons.