Tom was recently diagnosed with a tumor in the posterior aspect of his spinal co
ID: 3510038 • Letter: T
Question
Tom was recently diagnosed with a tumor in the posterior aspect of his spinal cord at the level of C6 that has resulted in a C5 incomplete spinal cord injury with changes in sensation. Based on the location of the tumor: 1. What ascending spinal tract(s) have been affected? 2. What types of sensation have been affected and what types remained intact? (i.e. temperature, pain, proprioception, etc.) 3. Where on Tom’s body will the sensory deficits be present? Use specific dermatomes. After Tom undergoes surgery to remove the tumor, he presents to inpatient rehabilitation to begin therapy. 1. Given the sensory changes you discussed above, what activities would be difficult for Tom to perform? (i.e. ADLs, functional mobility…) 2. If you were Tom’s occupational therapist, what interventions would you recommend to help with his recovery?
Explanation / Answer
1) tract of goll (fasciculus gracilis) and tract of burdach(fasciculus cuneatus)
2) fine touch, proprioception, vibration, pressure will be lost whereas, pain, temperature,crude touch, kinesthetic sensation will be intact
3) C5 covers the lateral arm at and above the elbow.
whereas, C6 covers the forearm and the radial side of the hand (thumb).
1)the biceps (C5) may be initially weak the wrist extensors (C6), however, remain weak and sensation at and below C6 will be severely compromised.since it is an incomplete injury motor functions will not be compromised.
it will be difficult for him to eat, comb his hair, shave his beard etc most of the hand functions will be compromised that too will recover with proper physical therapy.
2) I'd make him do all overhead activity, fine works like kneading, grasping, writing, knitting, putting up his shirt buttons, putting up his t-shirt, opening up the bottle etc