Brain vs. Spinal Cord:

A Directed Case Study in CNS Injury

By

Patrick Field, Department of Biological Sciences, Kean University

Tom Cappaert, Department of Physical Education and Sport, Central Michigan University

Dr. Green and Dr. Carter were nearing the end of the first year of their medical residency in the emergency department of County General Hospital. It had been a long year and a long week. They had been on duty for the last 12 hours and things were not slowing down.

“What are your plans for the weekend, Ken?” Dr. Green asked. “Sleep, what else?” Dr. Carter replied.

“I hope things slow down a bit,” Dr. Green said to himself.

Suddenly, a call came over the radio. Paramedics were bringing in a young man with injuries sustained in a diving accident. A minute later, the doors to the department burst open and the paramedics wheeled in a young man.

“What gives?” Dr. Green asked.

The senior paramedic, Jim Morrison, reported that the patient was swimming at the local quarry and did a forward flip into the water, striking some submerged rocks.

“Which part of his body struck the rocks?” asked Dr. Carter.

“He was in a hyperflexed-tucked-position when he hit the rocks, lacerating the right side of his head and neck and upper back. The patient indicated he had severe pain upon impact and loss of sensation and movement in his arm and leg. He may have lost consciousness, but he’s not sure. He also complains of a severe headache, dizziness, and nausea. When we arrived at the scene we immobilized, stabilized and transported him immediately,” Jim explained.

Looking at the patient, Jim continued. “His name is Mike Smith, and he’s 22 years of age. His vital signs include slightly lowered blood pressure (100/70), heart rate of 75 beats per minute, respiration normal and he is conscious and alert.”

As the patient was being prepped for examination, Dr. Carter and Dr. Green discussed how they should approach their evaluation. Dr. Carter started by saying, “After seeing the head wound and the amount of blood loss, and hearing his complaints, I want to confirm my suspicion that this patient has a brain injury.”

Dr. Green disagreed: “I think that the other signs and symptoms indicate a spinal cord injury, and that’s what we should investigate.”

The following table summarizes the findings of the evaluation, which included a physical exam, x-rays, magnetic resonance imaging (MRI), and neurological tests.

Based upon your previous knowledge of brain function, which results from the testing are consistent with a brain injury and why?

research on Lee Silverman's Voice Therapy or BIG Program

what is the purpose of the program? how did the program start? How has the program progressed? What exercises are now incorporated in the BIG program?

Name the muscles of the hip, knee, and ankle that act as agonist, antagonist and stabilizing muscles when ascending and descending stairs. Be sure to include the type of contraction during the different phases of the task. *Please answer all parts of the question - thank you!!!

Describe the components of the clotting cascade which are NOT directly involved in the sequence. What do they do?

se a numbered sequence to describe the intrinsic initiation of the clotting cascade through clot contraction. Then note how the extrinsic pathway feeds into to it. DO NOT just reproduce my flow chart with arrows. Do some explaining

Discuss edema. What are the basic conditions that can cause the condition and what kind of physiological events can result in those conditions?

If a tuning fork were applied to a person's forearm, they would perceive the vibration. Describe the response to the tuning fork by a "rapidly adapting" mechanoreceptor located in the forearm.

1. Patients with a specific shared brain lesion have a specific set of behavioral deficits. Does this show that this brain area is necessary for that behavior, sufficient, neither, or both?
2. What do we mean by a visual object agnosia? What are some tests you would give to a patient to try to diagnose or rule out this condition?
3. Describe an experiment that would illustrate the function of the amygdala in emotional processing.

The formula for Mean Arterial Pressure = Cardiac Output x Total Peripheral Resistance. Please explain the normal responses of Cardiac Output during graded exercise (intensity increases) and total peripheral resistance.

Match each term to the correct definition or description.