no difficult word

28 y/o male

• good immune system

• pt is active invidual

• young anad healthy

motorcyclist

• doesnt have any neurological disorder

• high risk getting into accident

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involve in vehocle accident

• possible life threathening need immediate treatment

• cause high impact trauma - vertebral injury/dislocation/spinal cord injuries

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complained of severe mid-

back pain and inability to move both legs.

• had paralysis both lower limbs

• could be sign of spina cord damage

• possible affect thoracic vertebra

• damage spinal - distrupt motor pathway

traumatic spinal cord injuries

vertebra fracture

spinal shock

leg fracture

neurogenic shock

hematoma in spinal cord (compresss)

dislocation

numbness- loss of sensation or tinggling feeling

high speed collision- possible to get back fracture and damage the spinal cord

landed on his back on the road surface.- direct spinal effect

sudden weakness of bilateral lower limb and numbness below

the chest. - shows primary spunal cors injury..indicate both motor and sensory tract damage ...below the chest t4-t6 dermatome consistent with thoracic spinla cord lesion

He wore a helmet and remained conscious after the accident.- still has possibility of head injuries ...isolated spinal injury

He also experienced urinary retention (inability to pass urine)- autonomic dysfunction due to spinal cord injury

He had no history of alcohol or drug use prior to the accident. - not drunk during riding

He had no past medical history- means his condition is due to accident not past illness

no family history- rule out any genetically neuronal diseases

vital signs

palpation

inspection

x-ray

neurological examination

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bulbocavernosus reflex- test to check if ower part spinal chord (s2-s4) is woring properly, to asset SCI

flaccid paralysis - loss of muscle tone an movement due to interuption of motor nerve signals from brain or spinal chord to muscle.

BP low; hypotension- neruogenic shock

HR low; bradycardia; neurogenic shock

RR slightly inc-

O2 normal

abdomen was soft and non-tender- no sign of internal bleed or inj

the bladder was distended- loss urinary retention, ditrusor muscle coulnt contract, so bladder overfillled

flaccid paralysis of both lower

limbs with absent deep tendon reflexes- spinal shock; medhcanism due to loss descending MN

Sensory testing demonstrated complete loss of sensation below T5 dermatome- indicate level of SCI (t5 and below)

upper limbs were intact, with normal power and sensation- sesnsation can move arms n hands nomally

Anal sphincter tone was absent- lesion at t5 (LMN loss function)

he bulbocavernosus reflex could not be elicited- ongoing spinal shock

Burst fracture- type of spinal injury where vertebrae breaks due to high axial loading fall from high or car accident