8. L2-L4 Paralysis of flexion & adduction of
thigh + weakening of leg extension at knee+
patellar reflex lost
L5-S1 Mvmnts of foot & ankle + flexion &
knee + extension of thigh + ankle jerk LOST
10. Low back& radicular pain
Asymmetrical leg weakness , sensory
loss,areflexia in lower extremities
Sparing of bowel & bladder function
11. 1) Distribution of root pain
ask for specific dermatomes involved
due to the involvement of posterior nerve
roots
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28. 2) Upper border of sensory loss
examine the patient from below upwards
for demonstration of upper border of
sensory loss
Due to the affection of spinothalamic tract
29. 3) Girdle like sensation / sense of
constriction at the level of lesion
due to the involvement of posterior
column
30. 4) Zone of hyperaesthesia/ hyperalgesia
localise the level of lesion one segment
below
Due to compression of posterior nerve
roots
31. 5) Analysis of abdominal reflex
[ upper abdominal reflex (T7-T9) intact -
loss of middle (T9-T11) & lower (T11-T12)
ones - site of lesion is probably at T10
spinal segment ]
32. 6) Atrophy of the muscles in a segmental
distribution
Due to involvement of anterior horn cells
33. 7) Loss of deep reflexes if the particular
segment is innvolved
brisk below the involved segment
34. 8) Analysis of BEEVOR’S SIGN
when the patient attempts to lift his head
up from the pillow, against resistance
Rectus abdominis
useful in deciding the level of thoracic
spoinal cord lesions
46. L I arch overlies sacral & coccygeal
segments
47. Inthe case of non-
compressive myelopathy
, the question of localisation
of the level of lesion does not
arise
48. Synopsis Of Bladder Dysfunction In
Neurological Diseases NEUROGENIC
BLADDER
UB receives nerve supply from
sympathetic- L 1,2,3 [ NERVE OF FILLING ]
& Parasympathetic- S 2,3,4 [NERVE OF
EVACUATION]
51. B) Complete lesion
1-Retention of urine wt overflow incontinence
commonly seen in ‘neural shock stage’
of a/c transverse myelitis
evacuation of bladder is usually
incomplete
52. 2-Automatic Bladder
evacuation complete
commonly seen when the neuronal shock
stage is over& evacuation occurs by local
reflex arc
frequency, urgency &urge incontinence
53. C) Lesion in the local reflex arc
1- sensory paralytic bladder
loss of awareness of fullness of
bladder
large volume of urine collects in the
bladder wt huge residual volume
54. 2- motor paralytic bladder
inability to initiate & continue
micturition
seen in trauma, pelvic neoplasm
55. 3- Autonomous bladder-
common in cauda equina
lesions, pelvic malignancy, spina bifida
no sensation of bladder fullness, bt
having continuous dribbling