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SCI 2 (NEURO BASIC (determine of nerological level (neurological…

- - - - focus on what is remaining!
      - basis vertebra intact
      - 종류
        
        rostrl/cephalic/cranial
        
        head
        
        caudal
        
        tail
      - determine
        
        most caudal level of the spinal cord with normal "motor" and "sensory" function on both the "left" and "right" sides of the body;몸의 왼쪽과 오른쪽 모두에서 정상적인 운동과 감각 기능을 가진 척수의 거의 꼬리 수준.
        
        motor level
        
        most caudal segment of the spinal cord with normal motor function bilaterally;양측 정상 운동 기능을 가진 척수의 가장 꼬리 부분
        
        sensory level
        
        most caudal segment with normal sensory function. determined with dermatomes level 정상적인 감각 기능을 가진 대부분의 꼬리 부분은 dermatomes 수준으로 결정됩니다
        
        only 1 level
      - 먼저 sensory level을 체크!(pinprint) C5가 손상이라고 할때 2. MOTOR level을 확인하라 "always more than are equal to 3 or 3+"
        
        1.First check sensation(dermatomes level)
        
        motor level both left & right, MMT must 3 or more than 3
      - 예시
        
        C8이 neurological level임
        
        complete injury
        
        손상밑은 아무것도 기능 안함
        
        sensory는 둘다 C6
        
        Q.Lt. C6 3+/5 C7 2/5,Rt C6 3/5 일때 neurological level은
        
        neurological level is C6 (C7 2/5이기 때문에?)
        
        Q. Lt. C6 3+/5, C7 3/5, Rt. C6 3+/5의 neurological level은
        
        Rt. C6 motor, Lt. C7 motor임
        
        above C5는 정상
        
        sensation lt. C5, Rt. C6, motor Lt. C5, Rt. C5일때 motor is C5
        (3 or more than 3)
        
        soensory left C5, Rt.C5, motor Lt. C6(3/5) Rt. C7(3+/5) , patient has dicpts MMT 5/5, C4, C5,C6, C7에서 C5가 neurological level이다, -motor level 은 bilaterally
      - nuerulogical level of injury?
        
        3/5 or 3+/5
        
        ASIA
        
        A = Complete. No sensory or motor function is preserved in the sacral segments S4-S5.
        
        B = Sensory Incomplete. Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5, AND no motor function is preserved more than three levels below the motor level on either side of the body.
        
        C = Motor Incomplete. Motor function is preserved below the neurological level, and more than half of key muscle functions below the single neurological level of injury have a muscle grade less than 3 (Grades 0-2).
        
        D = Motor Incomplete. Motor function is preserved below the neurological level, and at least half (half or more) of key muscle functions below the NLI have a muscle grade ≥ 3.
        
        E = Normal. If sensation and motor function as tested with the ISNCSCI are graded as normal in all segments, and the patient had prior deficits, then the AIS grade is E. Someone without a SCI does not receive an AIS grade.
  - - - CN1, CN2
    - - pons
        
        medullar
        
        CN 9.10,11,12
        
        CN 5, 6,7,8
        
        midbrain
        
        CN3,4,
  - - - LMN
    - - UMN
      - affected speech, swollowing
  - - - CVA, ALS, TBI, MS, CP, tumors
    - - nerve injury, polio, GBS, ASL
- - - - 5)central cord syndrome
        
        cuase
        
        cervical hyperextension injury
        
        causes UMN in LE and LMN in UE
        
        lesion affect mostly the gray matter and tracts located cently
        
        dorsal column not affected
        
        UE pain -temp loss>LE
        
        why UE is more affcted than LE
        
        그것은 긴 이야기가 되지
        
        cortical spinal tract and ant lateral tract in UE are located centrally than LE, so "UE affected>LE"
        
        fasiculus cuneatus 와 fasciculas gracillis
        
        UE weakness>LE
      - 3)posterior cord syndrome
      - 2)anterior cord syndrome
        
        frequently related to flexion injury
        
        in cervical region with resultant damage to the 2/3 anterior portion of the cord and/or its vascular supply from the anterior spinal artery secondary to flexion injuries
        
        there is typically compression of the anterior cord from fracture, dislocation, or cervical disk protrusion
        
        this syndrome is characterized by loss of motor function(corticospinal tract damage) and loss of the sense of pain and temperature(spinothalamic tract damage) below the level of the lesion
        
        proprioception, light touch, and vibratory sense are generally preserved
      - 1)brown-sequard syndrome
      - 4)cauda equina injury
- - - - pain , temperature, crudely localized touch, tickle, itch, sexual sensation
        
        lat
        
        pain, temp, itching, ticking
        
        ant
        
        crude touch
      - corss at SC level
    - - to raticular system in vrain stem>cayse arousal on injury
    - - end at superior colliculus. the superior colliculi have the reflex function of turning the upper body, head, and eyes in the direction of a painful stimulus
    - - unconcious proprioception for movement and co-ordination
  - - - pressure, vibration, position sense, awareness of joint at rest, discriminative touch
        
        discriminative touch
        
        sterognosis
        
        입체 지각: 물체를 만지거나 들어올려 그 모양·중량을 측정하는 능력.
        
        two point discrimination
        
        두점식별
        
        barognosis
        
        무게인식
        
        grapthesthesia
        
        피부그림감각
        
        손바닥에 무슨글씨 썼는지 알아채는것
        
        tactile localization
        
        위치인식을 알기 위한 검사
        
        눈감고 몇번째 손가락 잡았는지 아는것
        
        recognition of texture
        
        double simultaneous stimulus
        
        두곳을 순서대로 만졌을때 아는것??
      - fibers don't cross at spinal level
        
        CROSS IN MEDULAR
      - fast conducting, myeilinated