A 43-year-old female presented with complete bilateral lower limb weakness and sensory loss after a road traffic accident. She reported being unable to feel or move her legs after the car she was in slid and experienced a whiplash-type trauma. Imaging showed a C7 anterior subluxation. She underwent spinal surgery and decompression. Post-operatively, her sensory function began improving but motor weakness persisted. Her symptoms were localized to a spinal cord injury at the C7 level with involvement of the lower cervical spinal cord.
Hemiparesis is a condition characterized by weakness or paralysis on one side of the body, typically resulting from damage to the brain or spinal cord. In a case presentation, it is essential to provide a comprehensive overview of the patient's history, including any relevant medical conditions or events such as stroke, traumatic brain injury, or tumor. Additionally, outlining the physical examination findings, such as decreased strength, altered reflexes, and possible sensory deficits on the affected side, aids in diagnosing and assessing the severity of hemiparesis. Diagnostic tests like brain imaging studies (CT or MRI) and electrophysiological evaluations may also be included to confirm the underlying cause and guide treatment strategies, which often involve a multidisciplinary approach focusing on rehabilitation, medication, and supportive care to improve functionality and quality of life for the patient.
I need a response to this assignmentzero plgiarismthree refe.docxflorriezhamphrey3065
I need a response to this assignment
zero plgiarism
three references
Initials: J.S Age: 42 Sex: Male Race: African American
S.
CC:
“I am experiencing lower back pain that radiates to my left leg”
HPI
: Mr. Smith is a 42-year-old African American male who reports to the clinic complaining of lower back pain that periodically radiates to his left leg. The pain started about one month ago. The character of the pain is shooting and stabbing. It appears to get worse when sitting for an extended period of time, bending over and during strenuous physical activity. The severity of the pain is 8/10 without medications but relieves to about 3/10 after taking Tylenol and getting some rest.
Location: Lower back
Onset: 1 month
Character: Shooting and Stabbing
Associated signs and symptoms: nausea, vomiting, photophobia.
Timing: Sitting for extended periods, bending over and strenuous physical activity.
Exacerbating/ relieving factors: Tylenol and rest makes the pain tolerable, but not completely better.
Severity: 8/10 pain scale
Current Medications
:
Metoprolol 100 mg tablet, PO once daily.
Acetaminophen 500 mg tabs, 1-2 PO q 6 hrs, PRN for pain. (not to exceed 3 g in 24 hr).
PMHx:
Diagnosis: Hypertension
Surgical Hx:
Laparotomy, 02/2000
Immunizations:
Childhood immunizations completed. Tetanus and Flu shots are up-to-date.
Soc Hx:
Unemployed. Lives alone and never married. Has one brother and both parents are alive. Performs physical exercise regularly at the gym, and uses seat belts all the time when driving. Denies tobacco and alcohol use.
Fam Hx
: Father has a stroke and heart disease, Mother has hypertension, Brother has diabetes. Maternal and Paternal grandparents died of a stroke 2 years ago.
ROS
: BP - 140/90 L arm, P - 86, T - 98.1 oral, RR - 18, Ht. - 5’10”, Wt. - 200 lbs. BMI 28.7
GENERAL: No weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: No visual loss, blurred vision, doubles vision or yellow sclerae.
Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.
Skin: No rash or itching. No skin lesions or moles that are new or suspicious.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema. No pleurisy pain, no hx of a heart murmur. No EKG on record. No peripheral edema or claudication. BP controlled with medication.
RESPIRATORY: No cough, sputum or SOB. No DOE, hemoptysis. Chest X-rays - 3 years ago.
GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood. No unintentional weight loss or gain. No change in bowel habits.
GENITOURINARY: No penile discharge or erectile dysfunction. No nocturia, dribbling, or incontinence.
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control. No reports of numbness or tingling to the left leg since the onset of lower back pain.
MUSCULOSK.
Foot drop doesnt mean only peripheral nerve involvement. It can be localized from cerebral cortex to muscle in the neuraxis.
An easy and practical step by step approach to foot drop
Hemiparesis is a condition characterized by weakness or paralysis on one side of the body, typically resulting from damage to the brain or spinal cord. In a case presentation, it is essential to provide a comprehensive overview of the patient's history, including any relevant medical conditions or events such as stroke, traumatic brain injury, or tumor. Additionally, outlining the physical examination findings, such as decreased strength, altered reflexes, and possible sensory deficits on the affected side, aids in diagnosing and assessing the severity of hemiparesis. Diagnostic tests like brain imaging studies (CT or MRI) and electrophysiological evaluations may also be included to confirm the underlying cause and guide treatment strategies, which often involve a multidisciplinary approach focusing on rehabilitation, medication, and supportive care to improve functionality and quality of life for the patient.
I need a response to this assignmentzero plgiarismthree refe.docxflorriezhamphrey3065
I need a response to this assignment
zero plgiarism
three references
Initials: J.S Age: 42 Sex: Male Race: African American
S.
CC:
“I am experiencing lower back pain that radiates to my left leg”
HPI
: Mr. Smith is a 42-year-old African American male who reports to the clinic complaining of lower back pain that periodically radiates to his left leg. The pain started about one month ago. The character of the pain is shooting and stabbing. It appears to get worse when sitting for an extended period of time, bending over and during strenuous physical activity. The severity of the pain is 8/10 without medications but relieves to about 3/10 after taking Tylenol and getting some rest.
Location: Lower back
Onset: 1 month
Character: Shooting and Stabbing
Associated signs and symptoms: nausea, vomiting, photophobia.
Timing: Sitting for extended periods, bending over and strenuous physical activity.
Exacerbating/ relieving factors: Tylenol and rest makes the pain tolerable, but not completely better.
Severity: 8/10 pain scale
Current Medications
:
Metoprolol 100 mg tablet, PO once daily.
Acetaminophen 500 mg tabs, 1-2 PO q 6 hrs, PRN for pain. (not to exceed 3 g in 24 hr).
PMHx:
Diagnosis: Hypertension
Surgical Hx:
Laparotomy, 02/2000
Immunizations:
Childhood immunizations completed. Tetanus and Flu shots are up-to-date.
Soc Hx:
Unemployed. Lives alone and never married. Has one brother and both parents are alive. Performs physical exercise regularly at the gym, and uses seat belts all the time when driving. Denies tobacco and alcohol use.
Fam Hx
: Father has a stroke and heart disease, Mother has hypertension, Brother has diabetes. Maternal and Paternal grandparents died of a stroke 2 years ago.
ROS
: BP - 140/90 L arm, P - 86, T - 98.1 oral, RR - 18, Ht. - 5’10”, Wt. - 200 lbs. BMI 28.7
GENERAL: No weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: No visual loss, blurred vision, doubles vision or yellow sclerae.
Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.
Skin: No rash or itching. No skin lesions or moles that are new or suspicious.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema. No pleurisy pain, no hx of a heart murmur. No EKG on record. No peripheral edema or claudication. BP controlled with medication.
RESPIRATORY: No cough, sputum or SOB. No DOE, hemoptysis. Chest X-rays - 3 years ago.
GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood. No unintentional weight loss or gain. No change in bowel habits.
GENITOURINARY: No penile discharge or erectile dysfunction. No nocturia, dribbling, or incontinence.
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control. No reports of numbness or tingling to the left leg since the onset of lower back pain.
MUSCULOSK.
Foot drop doesnt mean only peripheral nerve involvement. It can be localized from cerebral cortex to muscle in the neuraxis.
An easy and practical step by step approach to foot drop
FIBROUS-DYSPLASIA-
CASE-PRESENTATION-At-Shaheed-Suhrawardy-Medical-College-Hospital-Dhaka-Bangladesh (1).pptx is queued for conversion. Meanwhile you can add details and save.
Case Presentation of a patient presented with polyradiculoneuropathy and bilateral bulbar palsy. Detailed evaluation finally pinpoints to Guillian barre syndrome.
FIBROUS-DYSPLASIA-
CASE-PRESENTATION-At-Shaheed-Suhrawardy-Medical-College-Hospital-Dhaka-Bangladesh (1).pptx is queued for conversion. Meanwhile you can add details and save.
Case Presentation of a patient presented with polyradiculoneuropathy and bilateral bulbar palsy. Detailed evaluation finally pinpoints to Guillian barre syndrome.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
CNS_Case_9_Spinal_cord_.pptx
1. Columbia Asia Referral Hospital Yeshwantpur Bangalore
- Case presentation / Dr. Ronak Raheja
Department of Internal Medicine
2. Presenting complaints / Subjective
Age : 43/F
Presenting complaints
unable to feel lower limbs after alleged history of rta @ 6 am
No breathing difficulty and she was able to breathe adequately
3. Presenting complaints
43 year old female local of chikballapur was travelling in the backseat of a maruti omni when
the car tyre burst and caused the car to slide, with an apparent whiplash type of trauma she
was unable to feel her legs after the incident. She was taken to a nearby local hospital from
where she was referred to nimhans where she was referred to emergency room of our
hospital directly.
Check other parts improtant parts spleen liver sah
Important ask for Loc
Patient also complains of tingling in all limbs s/o cervical cord without any particular pattern
of which could be described.There was no pain associated
She reports weakness of both lower limbs (Progression_ external compression v/s sudden
direct neuronal injury poor prognosis ), with no strength to stand , sit or walk with our
without support . She mentions difficulty in turning around in bed, with decreased sensation
over trunk and body.
4. Patient presented to the emergency room where cervical spine was stabilized and
she was shifted for Mri whole spine screening and CT with focus on cervical spine.
She also complained of chest pain which was constant , non radicular and
persistent and dull
Catherized
CT reports were suggestive of c7 anterior subluxation
Ortho reference was taken and they advised 3 kg neck traction and asked to
increase traction by 3 kgs every hour , she was planned for spinal surgery and
decompression
6. Personal history
Habits none
Sleep adequate
Appetite decreased
Bowel and bladder : dependant but continent
Could mobilize before but not now
7. Summary of history
43 / f presented to the hospital post road traffic accident and she presented with
complete bilateral lower limb weakness and sensory loss of lower limbs with
occasional paresthesias on lower limbs.
8. General physical / Objective
She is bed bound and lying flat on the bed with cervical traction
Pr: 88
bp: 120/80 lying down
Temp : febrile
Spo2: 93 on room air
Piccle neg
9. HMF
HMF +---> Normal conscious cooperative to time place and person
Memory +
Orientation → good
Recall → normal
Attention → good
Language ---> normal comprehension normal repetition but dysarthria present
10. Central nervous system /Cranial nerves
CN 1 Normal Normal
CN 2 + optic field/ color /Pupil reflex direct /
indirect
Normal normal
CN 3 Normal Normal
CN 4 Normal Normal
CN 5 Sensory + motar Normal Normal
CN 6 Normal Normal
CN 7 sensory + motar Normal Normal
CN 8 Normal Normal
CN 9 Normal Normal
CN 10 Normal Normal
CN 11 Normal Normal
CN 12 Normal Normal
11. Motor system ( Bulk )
Bulk Right Left
Proximal upper limbs normal normal
Distal upper limbs normal Normal
Proximal lower limbs normal Normal
Distal lower limbs normal Normal
12. Motor system (Tone)
Tone Right Left
Shoulder elbow wrist Normal Normal
Fingers upper limbs Normal Normal
lower limbs Flaccid Flaccid
toes Flaccid Flaccid
13. Motor system (Strength)
Power Right Left
Shoulder , elbow , wrist 4/5 4/5
Fingers 4/5 4/5
Hip , knee , ankle 0/5 0/5
Toes 0/5 0/5
14. Motor system (Superfascial Reflexes)
Superfascial Right Left
Corneal normal No reflex
Abdominal Normal No reflex
Cremastric Normal No reflex
Plantar Unable to assertain Unable to assertain
15. Motor system (Deep reflexes )
Deep reflexes Right Left
Biceps Normal Normal
Triceps Normal Normal
Knee Decreased decreased
Ankle Decreased Decreased
Flaccid paraplegia of gbs v/s tml is power of pin ( sensory )
16. Motor system ( Abnormal Movements )
Abnormal movements Right Left
Face Normal Normal
Distal upper limbs Normal Normal
Proximal lower limbs Normal Normal
Distal lower limbs Normal Normal
17. Motor system ( Co-ordiation )
Coordination Right Left
Proximal upper limbs Normal Normal
Distal upper limbs Intact Intact
Proximal lower limbs Unable to determine Unable to determine
Distal lower limbs Unable to determine Unable to determine
18. Sensory system (Before surgery )
Superfascial Right Left
Fine cotton touch Normal upper limb (medial
part of arm t1 upper limb )
Decreased over ( mention
dermatomes trunk and
lower limbs
Normal upper limbs
decreased over trunk and
lower limb
Temperature (Not done ) Normal upper limb
decreased trunk and lower
limb
Normal upper limb
decreased trunk and lower
limbs lower limbs
Pain Normal face and upper
limbs
decreased trunk and lower
limbs
Normal upper limbs
decreased trunk and lower
limbs
Pressure and vibration Nomal face and upper limbs
19. Sensory system (1 day after surgery )
Superfascial Right Left
Fine touch Absent Over trunk and
lower limbs
Absent over trunk and lower
limbs
Temperature Unable to ascertain Unable to ascertain
Pain Normal face and upper
limbs
Decreased over trunk and
lower limbs
Normal upper limbs
decreased over trunk and
lower limbs
Pressure and vibration Absent Absent
20. Sensory system (2 days after surgery )
Superfascial Right Left
Fine touch Normal upper limb
Present all over
Normal upper limbs
Present all over
Temperature Normal Normal
Pain ( T2 -- L5)
Sensory recovery but motar
weakness persists takes
more time
Improved can now feel pain
in lower limbs anterior
lateral and posterior and
trunk
Improved can now feel pain(
anterior lateral in lower
limbs and trunk
Pressure and vibration Improved can now feel
pressure
Improved can now feel
pressure
21. Sensory system (Deep)
Deep Right Left
Vibration sense Cannot determine Cannot determine
Joint sense Cannot determine Cannot determine
Muscle sense Cannot determine Cannot determine
Distal lower limbs Cannot determine Cannot determine
22. Neurological deficit
1)Bilateral lower limb weakness (flaccid paraplegia) with
UMN involvement ( shock ) initial
2)loss of sensation over trunk T2 and bilateral lower limbs
3)Bladder involvemnet
24. Pathological diagnosis
Compression by what ? Hematoma / bone/ mets
diffuse axonal injury only if radiology is normal and traumatic
spinal shock improving after decompression
Intrinsic v/s extrinsic