Chapter 13 Park 2 Flashcards Preview

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Flashcards in Chapter 13 Park 2 Deck (37)
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1
Q

What can a lesion in the spinal region interfere with?

A

segmental function
vertical tract function
both segmental and vertical tract function

2
Q

What does segmental function affect?

A
function of a spinal cord segment
interfere with neural function only at level of lesion
3
Q

What does vertical tract function affect?

A

Conveys ascending and descending information

result in a loss of function below the level of the lesion

4
Q

What are signs of segmental dysfunction?

A

abnormal or lost sensation in a dermatomal distribution and/or lower motor neuron signs in a myotomal distribution

5
Q

What do lesions interrupting vertical tracts result in?

A

in loss of communication to and/or from the spinal levels below the lesion

6
Q

What are autonomic signs?

A

problems with the regulation of blood pressure (BP), sweating, and bladder and bowel control

7
Q

Descending tract (UMN) signs include:

A

include paralysis, spasticity, and muscle hypertonia

8
Q

When is Babinski’s sign present?

A

if the lateral corticospinal tract is interrupted

9
Q

Ascending tract signs are ipsilateral of:

A

dorsal column in interrupted

10
Q

Ascending tract signs are contralateral if:

A

STTs are involved

11
Q

Peripheral region lesions produce deficits in:

A

distribution of a peripheral nerve.

12
Q

What does peripheral nerve lesions cause:

A

Altered or lost sensation in a peripheral nerve distribution
Decrease or loss of muscle power in a peripheral nerve distribution
No vertical tract signs

13
Q

When does spinal region segmental signs occur?

A

nerve roots and/or spinal nerves are compromised

14
Q

What is included in segmental signs?

A

Altered or lost sensation in a dermatome
Decreased or lost muscle power in a myotome
Decreased or lost phasic stretch reflex

15
Q

What is included in spinal region vertical tract signs?

A

Altered or lost sensation below the level of the lesion

Altered or lost descending control of BP, pelvic viscera, and thermoregulation

16
Q

What is included in UMN signs?

A

Decrease or loss of muscle power
Spasticity
Muscle hypertonia
If the lateral corticospinal tract is involved, positive Babinski’s sign and clonus

17
Q

What are spinal region syndromes?

A

Syndromes are collections of signs and symptoms that occur together. Spinal cord syndrome do not indicate a specific cause,

18
Q

What do syndromes result from?

A

tumors or trauma

19
Q

What is anterior cord syndrome?

A

Interferes with pain and temperature sensation and motor control while preserving proprioception & discriminative touch

20
Q

What is central cord syndrome?

A

In a small lesion, loss of pain and temperature occurs at the level of the lesion. In a large lesion, the upper limb motor function is impaired

21
Q

What is Brown-Sequard syndrome?

A

Below the level of lesion, voluntary motor control, conscious proprioception, and discriminative touch is lost ipsilaterally; pain and temperature sensation are lost contralaterally.

22
Q

What is cauda equina syndrome?

A

Causes sensory impairment and flaccid paresis or paralysis of lower limb muscles, bladder, and bowels

23
Q

What is tethered cord syndrome?

A

Causes low back and lower limb pain, difficulty walking, excessive lordosis, scoliosis, problems with bowel and/or bladder control, and foot deformities

24
Q

What happens immediately after a traumatic injury to the spinal cord?

A

cord functions below the lesion are depressed or lost (“spinal shock”)

25
Q

What is spinal shock due to?

A

the interruption of descending tracts that supply tonic facilitation to the spinal cord neurons

26
Q

What is lost or impaired during spinal shock?

A

somatic reflexes
autonomic reflexes
autonomic regulation of BP
control of sweating and piloerection is lost

27
Q

What is included in somatic signs?

A

including stretch reflexes, withdrawal reflexes, and crossed extension reflexes

28
Q

What is included in autonomic reflexes?

A

including smooth muscle tone and reflexive emptying of the bladder and bowels

29
Q

What is a chronic spinal cord injury?

A

Is the period after recovery from spinal shock when the neurologic deficit is stable
can last for decades

30
Q

What are the two abnormalities that occur in interneuron activity below the level of the lesion?

A

Inhibitory interneuron response to type Ia afferent activity is diminished. (Correlates with hyperreflexia.)
Transmission from cutaneous afferents to lower motor neurons is facilitated.

31
Q

How is a spinal cord injury classified?

A

whether injury is complete or incomplete

32
Q

Complete injury:

A

lack of sensory and motor function in the lowest sacral segment

33
Q

Incomplete injury

A

preservation of sensory and/or motor function in the lowest sacral segment

34
Q

What happens to pelvic organs during spinal shock ?

A

organs are depressed

35
Q

What does a lesion of T6 result in?

A

loss of descending sympathetic control

36
Q

What three dysfunctions are a result of a lesion above T6?

A
Autonomic dysreflexia
Poor thermoregulation (body temperature regulation)
Orthostatic hypotension
37
Q

What are signs and symptoms that indicate a spinal cord lesion?

A

Bilateral alteration or loss of somatosensation
Incoordination (sensory ataxia), caused by inadequate somatosensory information to the cerebellum
Upper motor neuron signs