spinal cord injury 9
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ant cord syndrome
loss of motor unction + pain & temp due to involvement of ant nerual structures -- cotical spinal and spinothalamic
the anterior neural structures damaged in ant cord syndrom
- corticospinal tract (this is more medial than spino)
- spinothalamic tract
In antherior cord syndrom proprioception & kinesthesia are spared. Why?
they're controled by the dorsal column structures, which are preserved bc they're posterior and have their own vascular supply
this leaves the pt w more skills, bc he knows where his body is in space
which part of the cord controls proprioception, vibratory sense, deep touch, discriminative touch (2 point discrim)? and does it do it ipsi or contralat?
lateral corticospinal tract controls what? ipsi or contralat?
voluntary motor control for the ipsilateral side
lateral spinothalamic tract is located where in compareison to the lateral corticospinal tract
the lateral spinothalamic tract is ant to the corticospinal
lateral spinothalamic tract controls what? ipsi or contralat?
in Brown Sequard syndrome there's ipsilat loss of __ and __ due to damage to lateral corticospinal tracts & dorsal columns
- motor function
- position sense
in Brown Sequard syndrome there's contral loss of __ and __ due to damage to spinothalamic tract
- pain and temp
- but this loss appears a few levels below the lesion
dorsal column controls what?
- vibratory sense
- deep touch
- discriminatory touch
4 factors influencing restoration of independance for SCI
- degree of motor function
- physical proportions of pt (wt...)
- amount of spasticity
- additional medical complications
6 common limiting factors for SCI pts
- pressure sores
- insufficient motivation
- joint deformity
- urinary infection
things to consider in goal-setting w SCI
- utilize info gained in eval
- determine appropriate progressions
- determine appropriate time frames
- determine level of independance
- determine use of assistive devices
- long term plans (living where, with whom...)
when to perform the first motor exam to establish a diagnosis?
- asap - within 6 hours - usually done right after injury by a neurologist
- monitor until pt hits a plateua, but even then keep checking
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