This document discusses lesions of the spinal cord caused by damage to the dorsal and ventral nerve roots or incomplete transection of the spinal cord. It describes the features that result from sectioning the dorsal or ventral nerve roots, including sensory and motor loss. It then covers the stages and features of complete transection of the spinal cord - initial spinal shock and flaccidity, followed by a reflex activity stage. The features of Brown-Sequard syndrome from transverse hemisection are also outlined, including motor and sensory losses on the side of and below the lesion.
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
Brown sequard syndrome or transverse hemisection syndrome
Causes symptoms and treatment of brown sequard syndrome
Background about the disease
Neural tracts
Ascending and descending pathways of the spinal cord (motor and sensory pathways)
Pathophysiology of brown sequard syndrome
The sciatic nerve is the longest and largest nerve in the human body. It runs from the lower back through the back of the leg, and down to the toes. Any type of pain and/or neurological symptoms that are felt along the sciatic nerve is referred to as sciatica.
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
Brown sequard syndrome or transverse hemisection syndrome
Causes symptoms and treatment of brown sequard syndrome
Background about the disease
Neural tracts
Ascending and descending pathways of the spinal cord (motor and sensory pathways)
Pathophysiology of brown sequard syndrome
The sciatic nerve is the longest and largest nerve in the human body. It runs from the lower back through the back of the leg, and down to the toes. Any type of pain and/or neurological symptoms that are felt along the sciatic nerve is referred to as sciatica.
I. Cerebrum
II. Brain Stem
III. Cerebellum.
The Cerebral Cortex
A. Frontal lobe
1) Motor area (area 4):
Frontal lobe
parietal lobe
temporal lobe
occipital lobe
an overview of the ascending tract of the spinal cord....an anatomical approach to understand the somato-sensory pathway.
Prepared as a class presentation .
lesions of the spinal cord. differences between upper and lower motor neuron lesions. brownsequard syndrome, poliomyelitis, multiple sclerosis, complete cord lesion,
spinal cord, ascending tracts of the the spinal cord, spinocortical tracts, gray matter of spinal cord, white mater of spinal cord, organization of neuron, first order second order and third order neuron, anterolateral spinal tract anteroposterior spinal tract, spinolivary tract, visceral sensory tract, dorsal column tract, spino cerebellar tract , spinorectal pathway, spino olivary pathway, cerebellar peduncles,
I. Cerebrum
II. Brain Stem
III. Cerebellum.
The Cerebral Cortex
A. Frontal lobe
1) Motor area (area 4):
Frontal lobe
parietal lobe
temporal lobe
occipital lobe
an overview of the ascending tract of the spinal cord....an anatomical approach to understand the somato-sensory pathway.
Prepared as a class presentation .
lesions of the spinal cord. differences between upper and lower motor neuron lesions. brownsequard syndrome, poliomyelitis, multiple sclerosis, complete cord lesion,
spinal cord, ascending tracts of the the spinal cord, spinocortical tracts, gray matter of spinal cord, white mater of spinal cord, organization of neuron, first order second order and third order neuron, anterolateral spinal tract anteroposterior spinal tract, spinolivary tract, visceral sensory tract, dorsal column tract, spino cerebellar tract , spinorectal pathway, spino olivary pathway, cerebellar peduncles,
The sciatic nerves branches from your lower back through your hips and buttocks and down each leg. Sciatica refers to pain that travels along the path of the sciatic nerve
Nerve roots: L4-S3.
Motor functions:
Innervates the muscles of the posterior thigh (biceps femoris, semimembranosus and semitendinosus) and the hamstring portion of the adductor magnus (remaining portion of which is supplied by the obturator nerve).
Indirectly innervates (via its terminal branches) all the muscles of the leg and foot.
Sensory functions: No direct sensory functions. Indirectly innervates (via its terminal branches) the skin of the lateral leg, heel, and both the dorsal and plantar surfaces of the foot.
The cranial cavity contains the brain and its meninges, cranial nerves, arteries, veins, and venous sinuses
The bones that take part in formation of cranial cavity are frontal, parietal, temporal, occipital and ethmoid
1-Vault of the Skull
2-Base of the Skull
1. Descending pathways
2. Types• direct pathways• indirect pathways .
3. • Most of the indirect pathways, sometimes called the extrapyramidal system, are involved in less precise control of motor functions, especially those associated with overall body coordination and cerebellar function such as posture.• Some indirect pathways, such as those from the basal nuclei and cerebellum, help in fine control of the direct pathways .
4. Direct Pathways• The direct pathways, also called the pyramidal (pi-rami-dal) system, are involved in the maintenance of muscle tone and in controlling the speed and precision of skilled movements.• Direct pathways are so named because upper motor neurons in the cerebral cortex, whose axons form these pathways, synapse directly with lower motor neurons in the brainstem or spinal cord
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
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Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
2. • Section of the Dorsal nerve root:
• Features:
• If only one dorsal nerve root is cut, there is no
appreciable sensory loss because of the
overlapping of the adjacent dermatome.
• To have sensory loss, at least three dorsal
sensory nerve roots should be damaged.
3. • The loss of all sensation in the sensory area, if lesion of the three
dorsal nerve roots are damaged.
• (fine touch, vibration, pain, temperature, proprioception).
• When there is a section of the dorsal nerve root:
• 1) There is atonia in muscles of the affected area (reflex arc is not
completed, so atonia).
• 2) Loss of superficial and deep reflexes.
• 3) Movement of the affected part is not normal because of the loss
of the proprioceptive input to the parts of the brain which control the
movements.
4. • 2) Features due to section of the Ventral nerve root:
• Ventral root of the spinal nerve contains somatic motor fibres and
autonomic nerve fibres.
• When there is section of ventral nerve root, so both somatic and
autonomic fibres are cut, so it results in:
•
• A) Flaccid paralysis in the affected part
• B) Loss of voluntary movement
• C) Muscle tone is lost
• D) Loss of superficial and deep reflexes (damage to the somatic
motor fibres).
5. • If the lesion is in the thoracic and lumber segments
of the spinal cord.
• There is also damage to the sympathetic nerve fibres, so
in the affected part, there is:
• 1) Vasodilatation (due to loss of vasomotor tone)
• 2) Fall in peripheral resistance and blood
• pressure.
• 3) Loss of sweating in the affected part.
• So skin becomes dry in the affected part.
6. Sections of Spinal cord
• Complete transection of the spinal cord:
• Causes:
• 1) Fracture dislocation of the vertebral column
• due to stab wound or bullet wound.
• 2) Extending tumor
• 3) May be due to some accident
7. • When there is complete transection of spinal cord, we can divide features
into three stages:
• 1) Stage of Flaccidity or Spinal shock:
• Immediately after the transection below the level of transection:
•
• A) There is complete flaccid paralysis.
• B) There is loss of all sensations.
• C) Loss of all superficial and deep reflexes.
• D) There is loss of skeletal muscle tone and the smooth muscle tone.
• E) Due to loss of tone in sphincters, there is urinary and fecal incontinence.
8. • If the transection is at the level of T1 or above, there
is:
• A) Loss of vasomotor tone, which results in the fall in
peripheral resistance and blood pressure.
• B) Limbs becomes cold, blue and dry.
• C) Bed sores may appear.
• This is the stage of spinal shock and flaccidity.
9. • Cause of Spinal Shock:
• Is due to loss of tonic facilitatory effect of high centres on
Spinal cord neurons through corticospinal, reticulospinal
and vestibulospinal tracts.
• Normally higher centres got tonic effects on spinal cord
through these descending tracts, so tonic effect is
disturbed, so stage of flaccidity persists.
• This stage persists for 2-3 weeks. The spinal cord
neurons are functionless without the tonic facilitatory
effect of the higher centres on spinal cord neurons.
10. Stage of reflex activity
• Tone begins to appear first in the smooth muscles and
sphincters.
• So when tone appear in urinary sphincter, there will be
retention of urine and feces.
• Vasomotor tone also appears to come back to some
extent because spinal cord sympathetic pre-ganglionic
neurons learn to function without the facilitatory effect of
higher centres.
• So V.M tone appear to some extent. When it appears,
B.P increases, blood flow to the limbs recovered.
11. • Tone begins to appear in the skeletal muscles, first appears in the
flexors, but muscle tone is not as much as the normal because
Myotatic reflex is not normally strong in the absence of the
facilitation effects from the higher centres.
• When muscle tone appears in flexors, the legs are moderately
flexed and that is called Paraplegia in Flexion.
• Muscles contraction starts during reflex action. There may be
spontaneous involuntary contractions involving mainly the flexors.
• Flexor reflex or withdrawal reflex can be elicited.
• Flexor reflex is also accompanied by crossed extensor reflex. But
response is less than the normal.
12. • Other features:
• There is Mass-reflex or response.
• When the skin over anterior abdominal wall or on the legs is stimulated
(stretched), there is a response, which includes contractions of the anterior
abdominal wall muscle.
• Contractions of flexors in the leg.
• There is evacuation of the urinary bladder even if it contains small amount
of urine.
• This is due to increased intra-vesical pressure resulting from the contraction
of the anterior abdominal wall muscles.
Loss of sweating in affected part.
13. • In males:
• Erection can occur when there is stimulation of
the genital organs.
• Muscle tones also returns in extensors.
• After months of the transection, below the level
of lesion, there is UMN type of paralysis.
• Muscles can not contract for voluntary
movement.
14. • Sensory loss is not recovered.
• There is automatic bladder and also there is
automatic defecation because reflexes can be
activated.
• By training, in some of the patients, scratch in
the skin around thigh or anal region, defecation
and urination occurs.
• So training is done, there is no recovery
regarding the reflexes.
15. • Stage of the failure of reflex activity:
• 1) When there is some severe infarction
and toxemia, condition of the patient
becomes worse.
• 2) Different reflexes become difficult to be
elicited and intensity of stimuli required to
elicit these reflexes increased.
16. • 3) Response during these reflexes are
also decreased.
• 4) Muscle tone decreases (muscles
becomes flabby.
• 5) Bed sores appear and patient becomes
worse and worse.
17. Hemisection of Spinal cord
• Brown – Sequard Syndrome:
• The clinical condition produced by transverse
section of the right or left half of the spinal cord
is called Brown Sequard syndrome.
• Causes:
• 1) Fracture dislocation of vertebral column.
• 2) Tumors
• 3) Accidents
18. • Features in three components:
• 1) Above the section of Hemisection:
• 1) There is no motor loss on the same side
and opposite side.
• 2) There may be hyper-aesthesia
ipsilaterally due to irritation of the cut
ends of the sensory nerve fibres.
• 3) No sensory loss on the opposite side.
19. • At the level of Hemisection:
• 1) Ipsilaterally there is lower motor neuron type of
• paralysis due to damage to the ventral horn of motor
• neurons.
• (Few muscles are involved,
• Flaccid paralysis, loss of voluntary movements, hypotonia, atonia,
• Loss of superficial and deep reflexes, or tendon jerks, muscle atrophy,
• Fasciculation and fibrillation, contractures formation, reaction of
degeneration).
• 2) Ipsilaterally, there is a band of a anesthesia, loss of all sensations
• on the same side.
• 3) On the opposite side, there is no motor loss, no sensory loss.
20. Below the level of Hemisection
• 1) The muscles supplied by the segments below the
lesion will show UMN type of paralysis.
• There is UMN type of paralysis on the same side.
• For example; hypertonia, Babinki’s sign, damage due to
corticospinal and extra-corticospinal tracts.
• So UMN type of paralysis.
• Motor effects are seen on the side of the section
• 2) On the opposite side, there is no motor loss.
21. • 3) Sensory loss is ipsilaterally, fine touch, two point
discrimination, vibration and proprioception (due to
damage to dorsal column medial lemniscal system).
• 4) On the opposite side, there is loss of pain and
temperature, tickle, itch and crude touch.
• This sensory loss is 2 to 3 dermatomes below the level
of hemisection (because of oblique crossing over of
spinothalamic tracts to the opposite side).
22. • 6) Sensation carried by dorsal column are lost on
the same side.
• 7) Sensation carried by spinothalamic tract, are
lost on the opposite side.
• 8) In Brown- Sequard Syndrome:
• Concentrate on motor loss on the same side:
• Ipsilaterally motor loss is important for the patient
because there is paralysis of UMN of the same side.
• On the opposite side, there is sensory loss.
• There is predominant motor loss ipsilateraally and predominant
sensory loss on the opposite side.
23. • If hemisection involves the thoracic
segments, there will be damage to the
sympathetic system.
• So there will be decrease in peripheral
resistance, fall in B.P, loss of sweating in
affected part.
24. Incomplete Transection of the
spinal cord
• The damage to spinal cord tissue is between complete transection and
hemisection.
• Causes:
• Are same as complete transection and hemisection.
• For example; fracture dislocation of vertebral column by stab wound, tumors
and accident.
• 1) Same stages, as we discuss in complete
• transection of spinal cord.
• 2) Stage of spinal shock and stage of flacidity.
• 3) Same features of Spinal shock as in case of complete
• transection.
25. • 4) After 2-3 weeks, in stage of reflex activity, there are
some differences from the features of complete
transection.
• Differences:
• 1) Skeletal muscle tone begins to appear.
• First begins to appear in the extensors.
• (There is paraplegia in extension in incomplete
• transection of spinal cord).
26. • 2) Stage of reflex activity:
• In incomplete transection, the
vestibulospinal and reticulospinal
tracts escape damage.