By Thomas N. Byrne
Illnesses of the backbone and Spinal wire reports the total spectrum of problems affecting this zone together with fundamental spinal tumors and metastases, an infection, degenerative illnesses, and trauma. providing an inter-disciplinary viewpoint, the e-book contains updated info on treatment [including neurosurgical], new details on developmental problems of the backbone, and a definitive bankruptcy on trauma, together with details on biomechanics. A separate bankruptcy on discomfort syndromes is also integrated.
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Extra resources for Diseases of the Spine and Spinal Cord (Contemporary Neurology Series)
72 A network of veins termed the internal vertebral venous plexus or Batson's plexus courses in the epidural space. Batson's plexus forms a collateral valveless route for venous return from intraabdominal and intrathoracic organs to the heart. Venous effluent from these organs enters the valveless system when intrathoracic and intra-abdominal pressure is increased, such as occurs during straining, coughing, and sneezing. Neoplasms and infections in the viscera of these locations may thus metastasize to the spine through this collateral circulation.
43 Muscle Stretch Reflex The muscle stretch, or myotatic, reflex is tested as a part of all neurological examinations. In its simplest form, the stretch reflex is a monosynaptic reflex in which a sensory afferent neuron synapses directly onto a motor efferent neuron in the anterior horn of the gray matter. The sensory afferent (group la) is stimulated when the muscle spindle that it innervates is stretched, as occurs with percussion of a deep tendon. This la afferent makes direct excitatory monosynaptic connections with the alpha motor neurons of the same muscle and synergistic muscles, which are activated and cause muscle contraction (see Chapter 2).
In testing corticospinal function in patients with spinal cord disease, therefore, there is usually a loss of individual toe or finger movement long before there is loss of proximal muscle strength and control. Corticospinal tract dysfunction results in release phenomena, such as the Babinski response (a withdrawal response). The Babinski sign is observed more often with the loss of skilled movements of the foot than with hyperreflexia. Gijn65 has described the Babinski sign as due to a disturbance of direct pyramidal tract projections to distal motor neuron.