loss of motor unction + pain & temp due to involvement of ant nerual structures -- cotical spinal and spinothalamic
the anterior neural structures damaged in ant cord syndrom
corticospinal tract (this is more medial than spino)
spinothalamic tract
In antherior cord syndrom proprioception & kinesthesia are spared. Why?
they're controled by the dorsal column structures, which are preserved bc they're posterior and have their own vascular supply
this leaves the pt w more skills, bc he knows where his body is in space
which part of the cord controls proprioception, vibratory sense, deep touch, discriminative touch (2 point discrim)? and does it do it ipsi or contralat?
the dorsal column
ipsilat
lateral corticospinal tract controls what? ipsi or contralat?
voluntary motor control for the ipsilateral side
lateral spinothalamic tract is located where in compareison to the lateral corticospinal tract
the lateral spinothalamic tract is ant to the corticospinal
lateral spinothalamic tract controls what? ipsi or contralat?
pain & temp
contralat
in Brown Sequard syndrome there's ipsilat loss of __ and __ due to damage to lateral corticospinal tracts & dorsal columns
motor function
position sense
in Brown Sequard syndrome there's contral loss of __ and __ due to damage to spinothalamic tract
pain and temp
but this loss appears a few levels below the lesion
dorsal column controls what?
proprioception
vibratory sense
deep touch
discriminatory touch
ipsilaterally
4 factors influencing restoration of independance for SCI
degree of motor function
physical proportions of pt (wt...)
amount of spasticity
additional medical complications
6 common limiting factors for SCI pts
spasms
pressure sores
insufficient motivation
joint deformity
urinary infection
incontinence
things to consider in goal-setting w SCI
utilize info gained in eval
determine appropriate progressions
determine appropriate time frames
determine level of independance
determine use of assistive devices
long term plans (living where, with whom...)
employment
when to perform the first motor exam to establish a diagnosis?
asap - within 6 hours - usually done right after injury by a neurologist
monitor until pt hits a plateua, but even then keep checking