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Spinal Cord

Transcript: This it the cervical spine. The spinal cord is a long, tube-like, bundle of nerve tissue and support cells. This tubular structure stretches from the medulla oblongata to the lower spine, near your pelvis. However, it doesn't extend the entire length of your spine. By Emily Stromsten What does it do? Nerves that branch off the spinal cord (spinal nerves) are divided into five sections, and each section helps control bodily functions like breathing, bowel movements and urination. Sources What is it? In more severe cases, you could suffer from full body paralysis below the site of injury. When working properly, the spinal cord, due to the messages sent to and from the brain, makes you feel hot and cold, vibration, sharp and dull sensations, and also helps your body sense where your limbs are positioned. Your spinal cord also helps your body to control blood pressure, heart rate, and body temperature. Properly Functioning The spinal cord is about 45 cm in men, and around 43 cm in women. The width of the spinal cord varies throughout its length, 13mm near the top half of your body, and 6.4 mm near the bottom half. Spinal Cord Injuries to the spinal cord can be caused by trauma to the spinal column via stretching, bruising, applying pressure, or laceration. Your vertebrae could shatter, and due to this, shards of bone could puncture the spinal cord. If this were to happen, you could lose feeling in certain parts of your body. A malfunctioning spinal cord can happen as a result of accidents, or surgical complications, or by diseases, such as polio or spina bifida. Men are at an 80% risk of injury. Young adults ages 16-21 make up more than half of spinal cord injuries. People who engage in risky behavior or with a bone or joint disorder are also more likely to injure their spinal cord. It has three main functions. It acts as a pathway for motor (movement) information. (It travels down the cord.) It acts as a pathway for sensory information in the opposite direction, traveling up the spinal cord. Finally, it acts as a center for coordinating certain reflexes. The main function of the spinal cord is the "transmission of neural signals between the brain and the rest of the body." However, the spinal cord also contains interconnected neurons that can independently control a number of basic reflexes without the use of your brain. This is the lumbar spine. There are two areas of the spinal cord that are most prone to injuries. These areas are the cervical spine and the lumbar spine, because the cervical spine is your neck, which can be snapped, bent, or kinked easily, and the lumbar spine because it bears most of our body's weight. Potential Problems Malfunctioning

Spinal Cord

Transcript: Differential Differential Diagnosis Differential Diagnosis Exam Visual fields intact to confrontation PERLA; EOMI with no nystagmus Facial sensation intact bilaterally Face is symmetric Gag reflex intact Trapezius and SCM strength 5/5 bilaterally Tongue is midline Strength is 5/5 in bilateral upper extremities 3/5 in bilateral lower extremities Reflexes are 2+ bilateral biceps, triceps, and brachioradialis 1+ bilateral patellars with mute toes bilaterally Sensation is decreased to all modalities in the bilateral lower extremities Exam Alert and oriented. Speech and Language are normal. Visual fields intact to confrontation PERLA; EOMI with no nystagmus Facial sensation intact bilaterally Face is symmetric Gag reflex intact Trapezius and SCM strength 5/5 bilaterally Tongue is midline Strength is 5/5 in bilateral upper and lower extremities Reflexes are 2+ bilateral biceps, triceps, brachioradialis, and patellar with 1+ ankle jerks; mute toes bilaterally; no ankle clonus Sensation is intact to light touch in bilateral upper extremities; Decreased to light touch in both feet. Decreased to vibration in all 4 extremities with deficit gradient from distal to proximal Exam Language intact CN II: Intact to confrontation Left pupil 3 mm and reactive; right pupil 6 mm and non-reactive Sensation is intact in face Face is symmetric Uvula is midline Tongue is midline LUE : 4/5 deltoid; 4/5 arm flex/ext; 3/5 grip strength RUE: 5/5 throughout LLE : 4/5 hip flexion; 4/5 knee ext/flex; 4/5 PF/DF RLE: 5/5 throughout Reflexes are 2+ in the RUE; 3+ LUE; 2+ RLE; 3+ LLE Sensation intact in bilateral upper extremities Decreased to vibration and proprioception in both feet Structural - Thoracic or Lumbar Stenosis Infective - Epidural Abscess; Tuberculosis (Potts disease (or tuberculous spondylitis); Poliomyelitis(viral) (no sensory involvement); Viral Myelitis (VZV; HSV; CMV; EBV); HTLV-1 associated myelopathy Inflammatory - Transverse Myelitis; Guillain-Barre; Sarcoidosis; connective tissue disorders such as SLE, Sjogren, Behcet's can give you a segmental myelitis similar to transverse myelitis; Post vaccinial (rabies, MMR, dTP); radiation myelopathy Demyelinating - MS, NMO, ADEM Traumatic - EDH; SDH; SAH Vascular - infarction; hemorrhage; aneurysm; AVM; carotid dissection; sickle cell crisis Neoplastic - Primary brain tumor; Metastatic brain tumor Inflammatory - Vasculitis; sarcoidosis Autoimmune /demyelinating - MS; ADEM Infectious- brain abscess ; viral or bacterial encephalitis Metabolic - hypoglycemia; hyper and hyponatremia Epileptic - Post-ictal / Todd's paralysis Psychiatric/ malingering - Hoover sign Exam Language intact Right gaze preference PERLA; Right Gaze Preference Decreased sensation on left side of face Left lower facial droop Uvula is midline Tongue is midline LUE : 3/5 deltoid; 4/5 arm flex/ext; 3/5 grip strength RUE: 5/5 throughout LLE : 4+/5 hip flexion; 4+/5 knee ext/flex; 4+/5 PF/DF RLE: 5/5 throughout Reflexes are 2+ in the RUE; 1+ LUE; 2+ RLE; 1+ LLE Sensation is decreased to all modalities in the LUE and LLE Intact on the RUE and RLE Differential A. Ischemic 1. Artery to Artery a. Dissection b. Aortic thrombosis 2. Cardioembolic a. Cardiac thrombus b. Endocarditis 3. Right to Left Shunts a. Air; Cholesterol 4. Thrombosis a. Small Vessel (Lacunar strokes) 5. Hypoperfusion a. MI, Shock, Hypotension with ICA stenosis B. Prothrombotic 1. Drug induced (estrogen) 2, Pregnancy related (central venous thrombosis 3. Hereditary : Sickle Cell; Antiphospholipid antibodyl protein C/S deficiency C. Inflammatory 1. Arteritis (primary) - Primary angitis of CNS Behcet's, Sjogrens syndrome 2. Arteritis (secondary) - Large arterities (Takayasu; granulomatous giant cell arteritis Medium arterities - Polyarteritis nodosa; Kawasaki disease Small to Medium - Wegener's granulomatosis; Churg-strauss syndrome Small arteries - Henoch-Schonlein purpura; lupus erythematsus Hereditary Non-metabolic - Charcot Marie Tooth axonal and demylenating Metabolic - Axonal Porphyria, Uremia. Hypothyroidism, Bariatric surgery, Hepatic failure Metabolic - Demylenating - Metachromatic leukodystrophy (adult), Late-onset Krabbe's disease Ischemic - Axonal - Diabetic focal neuropathies or plexopathy , Vasculutic Acute Autoimmune - Axonal GBS , Vasculutis ; Demylenating - GBS Chronic Autoimmune - Axonal - Lupus erythematosus, Sjögren's syndrome, Sarcoidosis, Vasculitis Cryoglobinemia, Celiac disease, Primary biliary cirrhosis Nutritional Def - Axonal - B12, Vit E, Folate, Thiamine, Copper Toxic Environmental Axonal - Acrylamide, Arsenic, Carbon disulfide, Ethylene oxide, Lead, Organophosphates, Thallium Medication Axonal- Dapsone (motor predominant), Nucleoside analogs (ddI, ddC, d4T), Disulfiram Colchicine (with myopathy), Isoniazid (INH), Metronidazole, Nitrofurantoin, Cisplatin, Thalidomide Vincristine Demylenating - Amiodarone(mixed), Taxol (mixed) Neoplastic/paraneoplasic - (extradural tumors : Mets from lung, breast, prostate) Intradural


Transcript: 1. Corticospinal Tract a. LMN Lesion*- At level of lesion b. UMN Lesion*- Below level of lesion Works Cited: "About ALS." The ALS Association, 1 Jan. 2010. Web. 27 Nov. 2013. "Anterior Cord Syndrome." Spinal Cord Injury Peer Support, 2003. Web. 27 Nov. 2013. Snell, RIchard S. Clinical NeuroAnatomy. 7th Edition. Boston: Little Brown & Co., 2009 1. Dorsal Column Medial Lemniscus (DCML) The End 1. LMN lesion 2. Corticospinal Tract (motor) 3. Anterior Spinothalamic tract (sensory) 4. Lateral Spinothalamic tract (sensory) 1. Spastic paralysis (LMN lesion) 2. Bilateral motor paralysis at level of lesion and below (CST) 3. Bilateral loss pain and temperature at the level of the lesion and below (ASTT) 4. Bilateral loss of light touch sensation at the level of the lesion and below (LSTTT) CLINICAL SIGNS LESIONS At the conclusion of this presentation, the students will be able to: 1. Identify the causes of Anterior Cord Syndrome, Posterior Cord Syndrome and ALS. 2. Understand the specific motor and sensory pathways that are affected by Anterior Cord Syndrome, Posterior Cord Syndrome and ALS. 3. Compare and contrast Anterior Cord Syndrome, Posterior Cord Syndrome and ALS lesions with respect to the clinical signs the patient presents with. 1. Ruptured posterior spinal artery (supplies posterior 1/3 of cord) 2. Associated with vertebral arch fractures 3. Rare Questions? Below level of lesion (UMN): a. Spasticity/hypertonicity b. Increased DTRs and +Babinsky sign c. Clasp-knife phenomenon At level of lesion (LMN): a. Flaccid Paralysis b. Atrophy c. Decreased DTRs d. Fasciculations 1. Unknown cause 2. 1 out of every 10 cases of ALS are due to genetic defect 3. 5 out of every 100,000 people worldwide are affected SPINAL CORD CAUSES POSTERIOR CORD SYNDROME AFFECTED PATHWAYS Nick, Parker, Brett and Alex OBJECTIVES 1.Cord contusion with vertebral fx or dislocation 2. Rupture of the anterior spinal artery and/or feeders (supplies anterior 2/3 of cord) 3. Herniated intervertebral disc 1. Bilateral loss of proprioception and vibration at the level of the lesion and below (DCML) ANTERIOR CORD SYNDROME ALS Progressive degeneration of the motor neurons in the brain and spinal cord, this inhibits neurons from sending messages to muscles, which will ultimately weaken and atrophy

Spinal Cord

Transcript: Your spinal cord stops... Injuries and disorders: What is the spinal cords job? By Gabi Porter Definition: uries(overview).html about Men- 45 cm Women-43cm The spinal cord is apart of the nervous system! Loss of sensation and ability caused by loss of blood or pressure and or bruised. Spinal cord is surrounded by fluid CSF that acts as a cushion to protect nerve tissues against damge from banging against inside of vertebrae. INcomplete: Citations: HERE! Paralysis 4:1 men suffer from spinal injuries than women. Thank you for your time! Your spinal cord is responsible for all your immediate action. Millions of neurons are in all parts of your body. They converge and join the spinal cord which leads to your brain. If an action needs to be healed quickly hence, the spinal cord resolves it. extras Working with other systems: 10-15% of spinal injuries are caused by firearms in the U.S.A. A cord of nerve tissue extending throughout your spinal canal of the nerve column. Spinal Cord Complete: visuals Fun facts! Does not result in factors above. It is connected to your brain and is about the diameter of a human finger. Everyone has a spinal cord and no one can live without it. Sends messages (neurons) to heal your "pain". IT IS YOUR BODYS TELEPHONE POLE! Quadraplegia

Spinal cord

Transcript: Work cited and all the references slide Questions What is the purpose of the spinal cord? What happens if you didn't have the spinal cord? What is the role of hormones to the spinal cord? How many segments are there on the spinal cord? What three things would happen if you broke your spinal cord? Hormones Some of the hormones that play a part in this that it helps work with the brain to tell all the hormones and other organs what to produce to help with all the other body parts. Function of spinal cord Spinal Cord Function of spinal cord The spinal cord belongs in the nervous system because it connects to the brain and transmits all the signals throughout the body. It holds your body up and also connects your brain to all the body and the neurons that are linked to it help make you move. If we did not have this body part then we would not be able to walk or stand up and we would not be able to control our body or live. Importance of spinal cord Description of spinal cord The function of the body part is to control the body and all its major functions in the body and mind. If this system was to be damaged then the ability to not be able to control our other body parts will not be there to do daily functions and lose that part of the body. the spinal cord is a very important part because it is able to control what your body does and it is so specialized that it cannot repair some cells that are very special. It also has a very strong bone structure and a fluid to protect it and it is the most protected part of the body. The only body part that literally keeps you standing up straight The spinal cord is located in the vertebral frame and is made of 31 segments 8 cervical 12 thoracic. It is located on the back of the body and is connected to the brain and all the nerves on the body.

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