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Def. of "Normal" ASIA
- American Spinal Injury Assoc.
- the motor level is defined by the lowest key ms. that has a grade of at least 3, provididng the key ms. represented by segments abouve the level are judged to be normal.
How many levels of classifiacation could there be?
what are the two types of SCI?
designation of neurological levels
- neurological level
where the greatest vertebral damage has occured.
the most caudal segment of SC with normal SENSORY functions as determined by testing the 28 dermatomes on each side of the body.
the most caudal segment of SC with normal MOTOR function as determined by testing 10 myotomes on each side of the body.
the most caudal segement of the SC with Normal sensory and motor function
def. of "Normal"
- ASIA American Spinal Injury Assoc.
- "The motor level is defined by the lowest key ms. that has a grade of at least 3, providing the key ms. represented by segments above the level are judged to be normal(grade5)
Prediction of self-care & ambulation is usually based on?
the Motor Level
is having No Sensory of Motor function in the lowest sacral segment (S4 & S5)
How are Sensory and Motor function at S4 & S5 determined?
By anal sensation and voluntary external anal sphincter.
is classified as having motor &/or sensory fuction below the neurological level including sensory &/or motor function at S4 & S5.
Zone of Partial Preservation
an individual has motor &/or sensory function below the neurological level, but does not have function at S4 & S5.
hemisection of the SC & is typically caused by penetration wounds, i.e. gunshot or stab.
- loss of sensation in the dermatone segment
- lateral column damage
- decrease reflexes
- lack of superficial reflexes
- positive Babinski sign
- loss of proprioception
- kinesthesia & vibration
What happens on the contralateral side of the lesion?
- Spinothalamic tracts results in loss of sense of
- loss begins several dermatome segments below the level of injury. This discrepancy in levels occurs bc the lateral spinothalamic tracts ascend two to four segments on the same side before crossing.
Anterior Cord Syndrome
frequently related to flexion injuries of the cervical region with resultant damage to the anterior portion.
What are some characteristics of the Anterior cord syndrome?
- loss of motor function (cortical spinal tract damage)
- loss of the sense of pn and temp.(spinothalamic tract damage)
- below the level of the lesion
Why are Proprioception, kinesthesia, and vibratory senses preserved in an Anterior Cord Syndrome?
bc they are mediated by the posterior columns with a separate vascular supply from the posterior spinal arteries.
Central Cord Syndrome occurs from?
- hyperextension injuries to the cervical region.
- also associated with congenital or degenerative narrowing of the spinal canal
There is characteristically more severe neurological involvement of the ___ than of the ____ in Central Cord Syndrome.
- UEs (cervical tracts are more centrally located)
- than of the LEs (lumbar and sactal tracts are more centrally located more peripherally)
Varying degrees of sensory impairment occur but tend to be less severe that motor deficits. With complete preservation of sacral tracts, normal sexual, bowel, and bladder function will be retained. What syndrome is this?
Central Cord syndrome
Pts with this syndrome typically recover the ability to ambulate with some remaing distal UE weakness. What syndrome is this?
Central cord syndrome
this syndrome is extremely rare?
Posterior cord syndrome
the clinical manifestations for this syndrome includes preservation of motor function, sense of pn, and light touch. What syndrome is this?
Posterior Cord syndrome
With Posterior Cord syndrome there is loss of what?
- Epicritic sensation below the level of the lesion
- e.g., two point discrimination,
A wide-base steppage gait pattern is typical with this syndrome?
Posterior Cord Syndrome
This syndrome is due to injury in the lumbosacral nerve roots in the Spinal canal, leading to areflexic bladder, bowel and lower limbs
Cauda Equina Injuries