Download MBBS Paraplegia Lecture PPT

Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Paraplegia PowerPoint PPT presentation

LEVEL OF LESION
Localisation of the lesion is carried out at three levels
?Sensory level
?Motor level
?Reflex level

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SENSORY LEVEL
COMPLETE TRANSECTION OF CORD
All sensory tracts involved ----------total anaesthesia below the level
ANTERIOR SPINAL ARTERY SYNDROME
Spinothlamic tract.................loss of sensations below the level
SYRINGOMYELIA
Dissociated anesthesia

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DERMATOMES

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MOTOR LEVEL
AT THE LEVEL OF LESION.................LMN type
BELOW THE LEVEL OF LESION ................UMN type
Hip flexion L1,L2,L3 ankle dorsiflexion L4,L5
Hip extension L5,S1,S2 ankle inversionL5,S1
Hip adduction L2,L3,L4 ankle eversionL5,S1
Hip abduction L4,L5,S1 plantar flexion L5,S1,S2
Knee extension L2,L3,L4 Big toe extensionL5,S1
Knee flexion L4,L5,S1,S2 extension of other toes and flexionL5,S1

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REFLEX LEVEL
AT THE LEVEL OF LESION...........reflexes are absent or diminished
BELOW THE LEVEL..................exaggerated

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BLADDER

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VERTEBRAL LEVELS AND
SPINAL SEGMENTS
Vertebral level
Spinal segment
Upper cervical
same
Lower cervical
+1
Upper thoracic
+2
Lower thoracic
+3
T 10
L1 ? l2
T11
L3-l4
T12
L5-S1
L1
S2-C0

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INVESTIGATIONS
BLOOD ROUTINE...........TC,DC,ESR,
MANTOUX TEST
CHEST XRAY
XRAY OF SPINE
LYMPH NODE BIOPSY
MRI/CT SCAN OF spine
LUMBAR PUNCTURE

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MANAGEMENT
?Adequate nutrition
?Care of bowel ,bladder and trophic ulcers
?Muscle spasm................. Diazepam
?Underlying cause
?Physiotherapy
?surgery

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