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exam 4
neuro teri
| Term | Definition |
|---|---|
| vertebral colum | 8 cervical, 12 thorasic,5 lumbar, 5 sacral, 3-5 coccygeal (30 spinal cord segments) |
| spinal menings | pia mater (innermost layer), arachnoid layer (subarachniod space contains csf), dura mater ( outermost layer, sensory nerve endings) |
| cuada equina | "horse tail" ends at L1 (are periphreal nerves in spinal cord) |
| what happens with a sci Above L1 | upper motor neuron signs, spasticity and hyper-reflexia |
| what happends with sci below L1 | damage the periphjreal nerves of cauda equina, lower motor neuron signs, flaccidity and hyporeflexia |
| what are the componets to grey matter | composed of neuron cell bodies and dentrites. has three regions dorsal horn( sensory nerve fibers), lateral horn (cells of autonomic neurons), ventral horn ( cells of motor neurons) |
| what are the componets of white matter | contains columns of axons ascending tracts (afferent) carry sensory info to the brain. descending tracts (efferent) carry motor signals from the brain to body. |
| what are the four major ascending tracts | doral columns, lateral spinothalamic, anterior spinothalamic, spinocerebellar. |
| dorsal columns | two piont discrimination, vibration, conscious proprioception |
| lateral spinothalamic | pain, temperature |
| anterior spinothalamic tracts | light touch, pressure |
| spinocerebellar | unconscious propioception, conveys info to cerebellum, tension and position of tendons and muscles |
| what are the descending tracts | lateral corticospinal tracts, anterior corticospinal tracts,reticulospinal tracts, vestibulospinal tracts. |
| lateral corticospinal tracts | responsible for voluntry movement, connect motor portions of brain to muscles, injury causes ipsilateral paralysis or paresis. |
| anterior corticospinal tracts | primarily innervates upper exremity muscles, does not cross medulla |
| reticulospinal tracts | fibers originate from brainstem, controls rythmic gait patterns, communicates with ans, helps inhibit muscle tone. |
| vestibulospinal tracts | helps control balance, damage results in ataxia and balance problems. |
| quadriplegia | (tetraplegia) all four limbs affected |
| paraplegia | lower extremities affected |
| hemiplegia | one side of body affected |
| monoplegia | one extremity affected |
| complete sci | no motor or sensory function below level of injury, no anal sensation. |
| incomplete sci | any motor or sensory function below level of injury, anal sensation. |
| C1-C4 | effects neck stability and mobility |
| C3-C5 | effects diaphragm, ventilator dependent |
| C5-T1 | effects upper extremities, tetraplegia |
| T1-L5 | effects trunk muscles, intercostals, accessory respiratory muscles. |
| L2-S4 | lower extremities, paraplegia |
| S2-S4 | effects sphincter control, sexual function, |
| Brown-Sequard Syndrome | Lesion to ½ the spinal cord, Ipsilateral side: motor paralysis and loss of proprioception, Contralateral side: loss of pain, temperature, and touch sensation |
| Central Cord Syndrome | “Reverse paralysis,Motor and sensory loss is greater in the upper extremities |
| Anterior Cord Syndrome | Complete motor paralysis, Paralysis and loss of pain, temperature, and touch sensation; proprioception is preserved |
| Cauda Equina Syndrome | Flaccid paralysis, Bowel and bladder problems, Usually with fractures below L2, Better prognosis for recovery |
| dermatome | sensory region of the skin innervated by a nerve root |
| Age: | : 58% SCI’s occur in persons 16-30 years of age |
| Gender | : 82% male |
| C5 | Elbow flexors (biceps, brachialis) |
| C6 | Wrist extensors (extensor carpi radialis ,longus ,and brevis) |
| C7 | Elbow extensors (triceps) |
| C8 | Finger flexors (flexor digitorum profundus) to the middle finger |
| T1 | Small finger abductors (abductor digiti minimi) |
| L2 | Hip flexors (iliopsoas) |
| L3 | Knee extensors (quadriceps) |
| L4 | Ankle dorsiflexors (tibialis anterior) |
| L5 | Long toe extensors (extensor hallucis longus) |
| S1 | Ankle plantarflexors (gastrocnemius, soleus) |
| mmt | 0-total paraliysis, 1-palpable or visible contraction, 2-active movement gravity eliminated, 3-movement against gravity, 4-movement against resistance, 5-movement against full resistance. |
| Treatment Involving C1 to C4 | Self-directed care, PROM including abduction protocol, mouthsticks, communication/ recreation, w/c selection (team), environmental control units (ECU), work, school, etc. |
| Treatment Involving C5 | Self-directed care, PROM, AAROM including abduction protocol, ADL, communication/ recreation, w/c selection (team), Splinting, dorsal wrist supports, long opponens, resting hand, ECU, |
| abduction protocol | supine, pillow behind scapula, shoulder abducted 90 degrees, elbows extended, forearms supinated, wrist neutral. |
| Treatment Involving C6, C7, & C8 | treatment for higher level injurie, Tenodesis training, Electrical stimulation to wrist extensors for muscle re-education, Simple Homemaking, Driving |
| how long can bowel management take | two weeks to a month |
| reasons for bowel management | Prevent constipation and impaction, Prevent autonomic dysreflexia, Prevent bowel accidents |
| Reflexive bowel | empty upon reflex if the colon is full associated with T12 and above easier to train |
| A-Reflexive bowel | sphincter remains open can be trained with consistency |
| bladder management | UMN (spastic bladder) Injuries above T12 Muscle spasms cause spontaneous voiding, LMN (flaccid or neurogenic bladder) Injuries T12 and below muscles of the bladder will not contract or spasm |
| Foley catheter | always drains the bladder, so the bladder does not fill greatest risk of UTI |
| ICP - Intermittent Catherization Program | catheterized every 4-6 hours using the sterile or clean technique urine output should not exceed 400-500 cc as preferred method due to decreased risk of UTI’s |
| condom catheter) | also allows the bladder to always drain less risk of UTI than Foley catheter |
| Suprapubic catheter | placed through the abdomen into the bladder easy to self-manage, especially for women. |
| FIM scale | 1-7 , dependant, max, mod, min, supervised, mod ind, independent. |
| Autonomic dysreflexia | LIFE THREATENING!!! (may be seen in persons with injuries above T4-T6*), dysreflexia may occur with injuries above T5 |
| symptoms of autonomic dysreflexia | •Pounding headache •Anxiety •Perspiration •Flushing •Chills •Nasal congestion •Sudden, severe elevation in blood pressure •Bradycardia |
| Treatment of Autonomic Dysreflexia | •Sit individual up if they are supine; do not leave individual alone!Check and remove anything restrictive •Check catheter tubing for kinks - •Check catheter bag •Monitor blood pressure •Check for abdomen distention, provide bowel program •Check f |
| PNS | Somatic nervous system - voluntary, Autonomic nervous system - involuntary |
| Somatic nervous system - voluntary | Input from sensory organs in muscles, tendons, and joints Output from skeletal muscles |
| Autonomic nervous system - involuntary | Sympathetic Parasympathetic Input from internal receptors Output to smooth muscles/glands |
| motor axons | pass into the ventral roots before uniting with the sensory axons to form the mixed nerves., Motor neurons ("Efferent") - moving toward muscle, organ |
| sensory axons | pass into the dorsal root ganglion where their cell bodies are located and then on into the spinal cord itself, Sensory neurons ("Afferent") - moving away from muscle, organ |
| spinal nerves | 31 pairs "mixed" |
| decreased vital capacity | limited chest expansion due to weakness or paralysis of secondary respiratory muscles |
| What are the spinal nerve roots that comprise the brachial plexus? | C5,C6,C7,C8, T1 |
| In your spinal cord, what kind of tract is located aneteriorly? | Motor |
| In your spinal cord, what kind of tract is located dorasally? | Sensory |
| Sensory axons go to what after leaving the spinal cord? | Doral root ganglion |
| motor axons go to what after leaving the spinal cord? | ventral roots |
| What is the exception to the rule that each signal travels to the brain and back down for output | spinal reflex |
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