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    Spinal Cord Injury and Sensory Information Processing

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    This question has three small parts - I have answered (a) okay I think, but am really stuck on (b) and (c). Please help:

    "Patient A has a tumour located on the thoracic spinal cord at the level of T3 and shows differences in the way sensory information in his legs and lower trunk is processed. This mainly involves alterations in the sensation of pain and temperature on the right side and in the sensation of touch on the left side".

    (a) Is the lesion provoked by the tumour in the thoracic spinal cord partial or complete?

    I have said that Patient A's symptoms suggest thoracic paraplegia & partial transection of the spinal cord, as the legs and lower trunk are primarily affected and as sensations below the tumor area are not completely lost.

    (b) Would patient A's knee-jerk reflex be affected?

    (c) Would patient A be able to reach for a cup of coffee?

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    Solution Preview

    I will answer your questions in the order you presented them. I have included additional information supporting the correct answer, including two attachments that provide excellent information and act as quick references. Your answer for (a) is correct by your definition of "complete" and "incomplete". However, please refer to attachment for the The ASIA Spinal Cord Injury Classification scheme and the information below on "complete" versus "incomplete."

    Here complete (A) means "no sensory or motor function is preserved in the sacral segments S4-S5" and incomplete (B) means sensory but not motor function is perserved below the neurological level, including the sacral segment S4-S5." It should be noted that ASIA A and B classification depend entirely on a single observation, i.e. the preservation of motor and sensory function of S4-5. Based on this classification scheme, (a) is correct when Patient A's "sensation of pain and temperature on the right side and in the sensation of touch on the left side" includes the sacral segment S4-S5. Then, the lesions would be classified as "incomplete."

    (a) Complete versus Incomplete Injury (Source: http://carecure.rutgers.edu/Spinewire/Articles/SpinalLevels/SpinalLevels.html which is attached)

    Much confusion surrounds the terminology associated with spinal cord injury levels, severity, and classification. The American Spinal Injury Association tried to sort some of these issues and standardize the language that is used to describe spinal cord injury. The ASIA Spinal Cord Injury Classification approach has now been adopted by almost every major organization associated with spinal cord injury. This has resulted in more consistent terminology being used to describe the findings in spinal cord injury around the world.

    "Most clinicians commonly describe injuries as "complete" or "incomplete". Traditionally, "complete" spinal ...

    Solution Summary

    Though examples, diagrams and discussion, this solution assists with problems related to the topic of spinal cord injury and sensory information processing.