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SCI 3 (T6문제- AD (AD ,autonomic dysreflexia, 자율신경반사부전증 (intervention…
SCI 3
T6문제- AD
AD ,autonomic dysreflexia, 자율신경반사부전증
symptom
hypertension triggered by AD can lead to ->seizures, cardiac arrest, subarachnoid hemorrhage, stroke, or even death
C/F-increase sweating, flushing(redeness of face due to the vasodilation) , head ache, blurred vision
common in the chronic stage of recovery(more than 3 to 6 months after injury), but may also occur in the early stages after SCI. it is more common with complete injury, but it may also occur with an incomplete SCI also
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intervention
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look for trigger point->check any bladder distension, bowel impaction, ask pt about last bowel movement, pressure sores etc.
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sympathetic/parasympathetic system
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parasympathetic system(P-P) peace, just come down
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on a day-to day basis, these two pathways work in parallel to maintain homeostatic balance within the body
bradycardia나타나는 이유
bainstem
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vagus nerve
- Dec HR through the cranial nerve
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문제
Q.in relation to autonomic dysreflexia which statement is correct? a) it occure as a result of uncontrolled over activity of sympathetic system b)occure as a result of uncontrolled over activity of parasympathetic system c)in episodes of AD, therapist must consider situation as medical emergency and should immediately stop any rehab and make pt lay down in order to relax the pt d) both blood pressure and heart rate increase in case of AD
Q. in case of autonomic dysreflexia, pt will present with
a)vasodilation above and below the lesion b)vasoconstriction above and below the level c)vasoconstriction above the lesion and vasodiation below the lesion
d)none of the above
Q. in relation to AD which statement is correct? a)uncontrolled over activity of sympathetic system b) uncontrolled over activity of parasympathetic system c) in episode of AD, therapist must consider situation as medial emergency and should immediately stop any rehab and make pt lay down in order to relax the pt
d) both blood pressure and HR increase in case of AD
답은 b, c가 틀린이유는 lay down 이 아니라 sit해야 하고, d가 틀린이유는 HR는 증가하고 BP는 떨어지기 떄문이다
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뇌에서 T6에 닿지 못해서 vasculation이 안된다고? try to controlled sympathetic system? 그러면 심장밑의 소화기관?이 작동이 안해...? direct inhibit 어떻게 한다고? limit of heart rate / not enough contorlled blood pressure so heart still high /sympathetic nerve
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above the injury area는 vasolation(parasympathetic), below the injury level은 vasocontraction(sympathetic)
따라서 T6위에는 parasympathetic만 남아있고, T6아래에는 sympathetic만 남아있음
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Cauda Equina injury
symptom
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CEL is LMN injury and present with areflexive bladder(involve micturition reflex center S2-4 and saddle ansthesia)
very rare, motor, pain and temp are preserved
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CAUDA EQUINA
upper L2에서 척수가 끝나는거 같기도 하네 -nerve immersing L3-4 , anteror horn cell은 L3-4에서는 없니? peripheral spinal nerve 가 시작한다고? 먼
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ㅣ1-L3cauda equina(tail)
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Lower motor neuron임
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spinal shock
spinal shock!
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Q. 12 hours after an C7 spinal cord injury the pt willl present with
1)UMN type DTR in LE and LMN type DTR in UE
2)UMN type DTR in UE and LMN type DTR in LE
3)UMN type DTR below the level of lesion and LMN type DTR at the level of lesion
4)none of the above
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homework-check
all the superficial &deep reflexes TED /stimulation /response /nerve associated
1.Dermatomes myotomes, keymuscle 2. reflexes
3. lets find you big red book, clean the dust & start reading stop using it as pillow, dumbell or support under ur table, stop scaring ur familty that u have to read