SCI
What is an injury to the sacral or lumbar nerve roots within levels T12-L2, presents with mixed and peripheral nervous system impairments
Conus Medularis syndrome
Grade 1 mTBI?
No loss of consciousness, sx last no more than days after injury
Post traumatic amnesia, headache, cog fog, mild confusion
Left anterior canalithiasis presents with what nystagmus?
Down beating left torsional
What does the medial vestibulospinal tract do?
cervical spinal cord
BL innervation of cervical muscles for head stabilization
What are the two types of paralysis post SCI?
Flaccid: decreased tone with weak or paralyzed muscles
Spastic paralysis: damage to descending motor tracts, increased tone with weak or paralyzed muscles
What is a sensory incomplete SCI, with preserves sensation below nerologic level including S4-S5, no motor function preserved more than 3 levels below the motor level of injury
ASI B
Buffalo concussion treadmill test parameters
Initiated 5-7 days after acute injury
baseline vitals
treadmill set to 3.2 or 3.6 (5'10)
walk at 0 incline for 3min then increase by 1% incline for each min up to 15 min
Injury to what (in the cerebellum) results in nystagmus?
Vestibulocerebellum (responsible for head and eye movements)
What does the Lateral vestibulospinal tract do?
Lower spinal cord
Ipsilateral innervation of axial muscles, extensor muscle activation
What is the C6 myotome?
Elbow flexion, wrist extension
What is the goal of acute pharmacologic management for SCI?
Minimize secondary damage from inflammation, reduced blood flow, and metabolic crisis
Methylprednisolone high dose within 8 hours of injury
Motor/balance assessment for mTBI
Coordination- pointing, heel to knee
Balance- mVTSIB, HiMAT
What treatment is intended to weigh the use of additional sensory information for interpretation for interpretation of head location in space
Substitution
DCML pathway transmits what information and from what side of the body?
Transmits Pressure, Vibration, Proprioception, Discriminative touch
From ipsilateral body to contralateral cortex
What is a transient condition that occurs within 30-60min after trauma to spinal cord
Temporary cessation of function in spinal cord below level of injury
typically resolves within 3-6 weeks
Spinal shock
What is no latency, sx last >60sec, nystagmus beats opposite gravity dependent of canal
Cupulothiasis
Spinothalamic tract transmits what info, and from what side of the body?
Nociception, temperature
nondiscriminative touch
From contralateral body to ipsilateral cortex
Autonomic dysreflexia signs and symptoms
High BP- pounding headache
Bradycardia
Cardiac arrhythmias
Sweating above injury
Flushing of face/neck above injury
Piloerection above injury/ or below
Pallor below injury
Blurred vision
nasal congestion
Canalithiasis treatment
Posterior canal: epley or semont
Horizontal: BBQ roll or Gufoni
Anterior: head hang
Lateral tract: precise skilled motor function
From CL cortex to ipsilateral body
Anterior tract: gross motor function of proximal muscles
From ipsilateral cortex to BL body