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WALKING WITH DIFFICULTY - Coggle Diagram
WALKING WITH DIFFICULTY
SYRINGOMYELIA
cystic
degeneration of the spinal cord
C8-T1 usually
compression of nerve fibres
CAUSES
Tumor
Trauma
Chiari malformation
types
ischemia
MANAGEMENT
type of surgery depends on the cause
ACM
bony decompression +/- shunt/aspiration
trauma
aspiration
tumor
resection of tumor
hydrocephalus
shunt
INVESTIGATION
MRI
Motor Assessment
power
0 - No contraction
1 - Flicker or trace of contraction
2 - Active movement with gravity
eliminated
3 - Active movement against gravity
4 - Active movement against gravity and resistance
5 - Normal power
tone
reflexes
Gait
Anatomy of Skull
Anatomy of the spinal cord
Spinal nerve
Tracts of the spinal cord
Descending(motor) tracts
descending autonomic
Pyramidal tracts
skilled voluntary movement
extrapyramidal tracts
involuntary movement
balance
reflexes
tone
Ascending(sensory) tracts
Posterior Column
Tract
mediates fine touch and conscious proprioception
Sensory assessment
done over the dermatomes
vibration and joint position
crude touch (cotton)
pin prick
Spinothalamic tracts
anterior
mediates crude touch and pressure
lateral
mediates pain and temperature
spinocerebellar tracts
unconscious proprioception
muscle tone and body posture
Physiology of muscle tone
maintained by static stretch
reflex
sensory receptor
muscle
spindle
