walking with difficulty

walking with difficulty

1. syringomyelia

   • Causes
     • tumor
     • trauma
     • ischemia
     • Chiari malformation
       • Types:
   • Investigation
     • MRI
     • muscles grading
   • Management
     • Monitoring
       • follow-up
     • surgery
       • restoration of normal CSF flow around the spinal cord
       • direct drainage of the syrinx.
   • sign & symptoms
     • scoliosis
     • headache
     • muscles stiffness
     • numbness or tingling
     • imbalance

2. Neurological physical examination

   • assessment of
     • Motor system
     • sensory system
     • Reflexes
     • station and gait
     • power
     • tone

3. Upper Vs Lower motor neurons

4. Anatomy of the spinal cord

   • Tracts of the spinal cord
     • Ascending (sensory) tracts
       • ventral spinothalamic
         • pressure and crude touch
       • posterior column tract
         • conscious proprioception, fine touch and vibration
       • lateral spinothalamic
         • pain & temperature
     • Descending (motor) tracts
       • pyramidal tracts
         • skilled voluntary movement
       • extrapyramidal tracts
         • involuntary movement
           • reflexes
           • balance
           • tone

5. Reflexes

   • is an involuntary, unplanned sequence or action and nearly instantaneous movement in response to a stimulus
     • consist of
       • receptor
         • sensory nerve
           • integration center
             • motor nerve
               • organ

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