HTHSCI 1H06 Lecture 14: Tutorial #3: The Spinal Cord
13 Nov 2016
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Tutorial Problem #3 The Spinal Cord Clinical Problem: Spinal Cord Injury (Spinal Shock)
Objective: To think about and understand how sensory information travels up the spinal cord to
the brain, how voluntary motor output travels from the cortex to the spinal cord, and where
crossover of information occurs in both pathways. This is best understood by examining the
pattern of sensory and motor loss following injury to the spinal cord.
Preparation: Students may find it helpful to complete the readings for the CNS – Spinal Cord
Pathways lecture and PNS & Paralysis lectures.
The Case: It was a dark and stormy night. Despite the heavy rain, the driver of the car kept his
foot heavy on the accelerator. Everyone else in the car was sleeping, and he felt satisfied with
the time he was making up. Entering a gradual curve on the freeway, he suddenly lost control
as the vehicle’s tires aquaplaned. Seconds later, in a state somewhere between panic and
shock, the driver pulled himself through the broken windshield. Seemingly, the car had flipped
several times after it had left the road. Moans were coming from the car. The driver cleared his
head and started helping people from the car. Jack, who was still strapped in the back seat,
warned the driver to stay away. He anxiously stated that he could neither feel nor move
anything from his neck down. Jack kept trying to convince himself that it was a dream and that
he would wake up in a comfortable bed—not a paraplegic. The ambulance arrived within 20
minutes and Jack was carefully removed from the car. During this time, Jack was passing in and
out of consciousness. At the hospital, X-rays were taken and standard clinical tests were
performed to assess the extent of spinal injury.
Questions:
1. What is spinal shock and why does it occur?
- Spinal Shock is an immediate response to spinal cord injury characterized by temporary
areflexia, loss of reflex function.
- Results from a trauma to the spinal cord therefore causing loss of motor movement and
sensation.
- Due to compression which prevents normal conduction of action potentials, nutrients and
blood supply
- Compression leads to Edema (inflammation) and hemorrhage
- It can last several days to several weeks following the transection of the spinal cord
- Areflexia occurs in parts of the body served by spinal nerves below the level of injury
2. What precautions must be taken when moving a potential victim of spinal injury?
Why? On what type of surface would such a patient be transported to hospital?
Precautions
- Limbs are flaccid; be sure they don’t fall off of trolley or get caught
- Manual support of head and neck
- Using a flatbed transfer
find more resources at oneclass.com
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Document Summary
Tutorial problem #3 the spinal cord clinical problem: spinal cord injury (spinal shock) Objective: to think about and understand how sensory information travels up the spinal cord to the brain, how voluntary motor output travels from the cortex to the spinal cord, and where crossover of information occurs in both pathways. This is best understood by examining the pattern of sensory and motor loss following injury to the spinal cord. Preparation: students may find it helpful to complete the readings for the cns spinal cord. The case: it was a dark and stormy night. Despite the heavy rain, the driver of the car kept his foot heavy on the accelerator. Everyone else in the car was sleeping, and he felt satisfied with the time he was making up. Entering a gradual curve on the freeway, he suddenly lost control as the vehicle"s tires aquaplaned.
