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Innervation of Spinothalamic Tract
DRG to cross central part of gray and white matter to opposite side of Spinal Cord white matter up tract to Thalamus and to the Primary Sensory Cortex
Posterior Dorsal Column (contralateral or ipsilateral??)
ipsilateral; contralateral in cerebral hemispheres.
Test pain and temperature
Sharp and Dull with cotton tip for pain; hold tube with hot water for temperature.
If entire cord damaged, what happens below lesion?
No sensation below lesion; full sensation above the lesion
If only half the cord damaged, what happens below lesion?
Contralateral loss of pain and temperature below the lesion; Ipsilateral depends on which side...
Sensory Reflex Pathway
DRG- synapse in SP with motor neurons in anterior root- synapse in SP and back to the same muscle.
Normal Reflex Results
Skeletal muscle contracts when they are stretched by the pull of gravity or external manipulation or when their tendons are stretched.
Pt responds only to strong generally painful stimulus; returns to unconscious state when it stops.
Glasgow Coma Scale
Used for head trauma- Score 3-15, based on Eye opening, Verbal response and Motor response.
Can comprehend language, but cannot use motor/speech to get the words out; may have paralysis of upper limb on the right
Functions of Skin
Protection, Sensory, Temperature, Wound repair, Absorption and Excretion, Production of Vitamin D
Preparation for Skin Assessment
Warm room, good lighting, modesty, use proper equipment, Inspect and Palpate
Test for Melanoma- Asymmetry, Border Irregularity, Color Variation, Diameter greater than 6 mm, Elevation/Enlargement
Skin Cancer Risk Factors
History, Change in pigmentation or mole, excessive dry or moist, pruritus, bruising, rash or lesion, medications, hair loss
Anterior Horn cell lesion on right side
Flaccid paralysis on the right side-ipsilaterally- AT THE LEVEL OF THE LESION ONLY
Spinal cord transected also damages Anterior Horn
Spastic paralysis below level of Spinal cord lesion and flaccid paralyis at the level of the anterior horn damaged.
Ask the pt. to perform an isometric exercise in a muscle group away from the one being tested.
progressive deterioration of intellect, behavior and personality due to loss of cortical neurons.
Kinesthesia- Position Sense
Hold finger and move up, down, left and right; have patient tell which way you are moving it
Two point discrimination
the ability to discriminate whether one or two areas of skin are being stimulated
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