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lesions of spinal cord - Coggle Diagram

- - - - refers to the cessation of all the
        functions & activity below
        the level of the section
        immediately after injury
      - features of this stage are similar to thoes in stage of spinal shock of complete transection
    - - tone appears in extensor muscle first
        
        extensor reflexes( stretch reflex) return first
        
        cross extensdor reflex
        
        mass reflex is not elicited
    - - the failure of reflex activity may occur when general condition of patient starts deteriorationg due to malnutrition, infection, toxeamia
- - - - refers to the cessation of all the
        functions & activity below
        the level of the section
        immediately after injury
      - effects
        
        depend on the
        site of injury
        
        in cervical region
        (above C5)
        
        is fatal
        
        cos of cutting of connection
        betw respiratory center n resp.muscles
        leading to paralysis of these and eventually death
      - in quick transection of SC
        
        patient feels as he has been cut into 2 portions
        
        above the level of inj- is uneffected
        
        below level of inj- all sensory n motor activity lost
      - causes of this stage
        
        also called stage of flaccidity
        
        cause is exactly unknown
        
        but is related to cessation of tonic neuronal
        discharge frm upper brain stem or ---- pathway
      - duration & severity
        
        depends on
        
        the evolution of the animal
        
        higher the animal more profound n longer lasting is the spinal shock
        
        in frogs-a few mins
        
        in cats n dogs- a few hrs
        
        in monkey- a few days
        
        in humans- abt 3 weeks
        
        in higher animals, damage to any part if the NS disturbs its smoothness of working n the functional failure is more severe.
        this is called diaschisis
      - motor effects during S shock
        
        Paralysis of muscles
        
        below the level of section
        
        transection betw
        
        cervical
        
        & lumbosacral
        enlrgements
        
        paraplegia
        
        transection
        below C5
        
        quadriplegia
        
        loss of tone
        of paralysed muscle -flaccid paralysis
        
        Areflexia- all superficial n deep reflexes
        are markedly decreased or lost
        
        sensory effects
        
        all the sensations are lost below the level of transections
        
        vasomotor effects
        
        visceral effects
    - - if the patient survives the stage of spinal shock,
        gradually he regains a few functions
        
        its also called stage of recovery
        
        smooth muscle regain functional activity
        
        sympathetic tone of blood vessels is regained
        
        skeletal muscle tone recovers slowly
        
        reflex activity begins to return after a few weeks of recovery of muscle tone
    - - the failure of reflex activity may occur when
        general condition of patient starts deteriorating due
        malnutrition,infection,toxeamia
- - - - changes on same side
        
        sensory changes
        
        ALL sensations are lost
        complete damage to
        posterior nerve root,
        posterior horn cells,
        n spinothalamic fibers
        
        motor changes
        
        complete LMN type paralysis is seen
        due to damage to ant horn cells
        
        flaccid paralysis of muscles
        
        All the reflexes are lost
        
        Muscle power is lost
        
        muscle degenerate n undergo wasting
      - changes on the opp side
        
        sensory changes
        
        some loss of
        pain
        temp
        n crude touch
        due to inj to the fibers of spinothalamic tract
        
        but tract of Gall n Burdach( cuneates n gracilis) are not effected
        
        motor changes
        
        No motor changes
      - changes below the level
        
        changes on same side
        
        sensory changes
        
        inj to fibers of tracts of gall n burdach causes
        loss of:
        fine touch
        tactile localization
        tactile discriminatino
        sensation of vibration
        concious kinaesthetic sensation
        n stereognosis
        
        motor changes
        
        UMN type of paralysis
        due yo inj to pyramidal tracts
        
        vasomotor changes
        
        changes on the opp side
        
        sensory changes
        
        injury to crossed spinothalamic tracts
        
        no inj to uncrosses tracts of Gall n Burdach
        
        motor changes
        
        no motor changes
        
        UMN lesion type paralysis of few muscles
        
        changes above the level of lesion
        
        changes on the opp side
        
        sensory changes
        
        either no sensory change
        or referred hyperesthesia may b seen one or two segemnts
        
        motor changes
        
        no motor changes
        
        changes on same side
        
        sensory changes
        
        incr cutaneous sensations present in 1 or 2 segments
        
        occurs due to irritation of the neighbouring posterior roots
        
        motor changes
        
        twitching of muscle in upper one or two segments may occur
        
        due to irritation of neighbouring anterior nerve roots