Anterior, Central and Posterior Cord Syndrome (Nursing)

00:01 Okay. So anterior cord syndrome is an acute spinal cord injury to the front of the spinal cord.

00:08 So take a look at the spinal cord, what type of neurons are at the front or the anterior area of the spinal cord? Right. You're gonna have problems with motion.

00:19 So it's kinda characterized by lack of motion and feeling in some areas that are serviced by that damaged cord.

00:25 So the area supplied by the undamaged parts of the cord may still have function and feeling.

00:32 So if it's an anterior cord syndrome, what would you expect with your patient? Well, you're gonna have a lack of motion and feeling in the areas that's used to servicing those areas. Right? That's where the information would be delivered to the body and received up to the brain.

00:48 If we've had damaged there, depending on how severe the damage is, that's where we're gonna run into problems with the patient.

00:55 so, whatever areas that part of the spinal cord was servicing that's where the patient's gonna have functional problems.

01:01 So the undamaged parts might still be doing okay, might have some function and some feeling.

01:07 So anterior cord syndrome is just a big umbrella category for any patient that has had damage to the anterior portion of their spinal cord.

01:19 Now, central cord syndrome, remember this is all about location.

01:25 So central cord syndrome is an acute spinal cord injury to the center of the spinal cord.

01:30 Now, this could result in loss of movement to the arms and legs.

01:34 But with this type of injury, it's usually the arms that are affected more than the legs.

01:39 So you might hear people call this walking paraplegia.

01:43 We talked earlier in the video that when - usually when we say paraplegia, we mean that it's a lower injury, right? The lower legs are not able to move.

01:53 But this type with central cord syndrome, it's usually the arms that are affected more than the legs and why we give it the term "walking paraplegia." Okay. So we've talked about anterior; that was a problem in the front or the anterior portion of the spinal cord.

02:08 This is central cord syndrome, so - and thankfully, these are named in a way that's helpful, right? So right in the middle of the spinal cord, and these are the ones that have walking paraplegia because their arms are gonna be affected more. Lastly, of course we have posterior cord syndrome.

02:26 This is an injury based on location. It's the back of the spinal cord or the posterior cord syndrome.

02:32 It's - might not result in a lack of feeling or emotion, but instead this goes after coordination.

02:38 So if I were you, I would take the time in my notes to write in the anterior portion of the spinal cord, what can you remember is the damage.

02:47 For the central portion of the spinal cord damage, what would be the experience of the patient? Good. That's a good opportunity to review.

02:58 So if you need a little bit more time, just pause the video and make sure you go back and review that concept, it'll help you lay it down.

03:06 Okay. If you need a little bit of time, welcome back.

03:09 Now let's talk about posterior cord syndrome, location, location, location.

03:15 So this is to the back.

03:17 And we're not talking so much about feeling or motion, but coordination.

03:22 So this can be particularly frustrating because with the posterior cord, you do have - you could have some sensory loss.

03:29 The posterior spinal cord carries mainly sensory information from the periphery to the brain.

03:35 So this is really important information to the brain.

03:38 It includes sensations about the position of the body and the limbs so that's like that proprioceptions.

03:44 So, if I have a posterior cord injury, I'm not gonna be able to tell exactly where my body parts are.

03:51 Also, the vibration sense, the ability to finally discriminate touch sensations.

03:56 So if you destroy the neurons in the posterior spinal cord, you have loss of these sensations below the level of involvement.

04:04 So this one is more complex, right? It's a little more detailed than what we talked about the others.

04:09 Anterior and central, we talked about loss of movement and some sensation, but this one, it’s gonna have to do with my ability to walk well, to know where my body parts are and to stay upright.

04:20 So I'm on increased risk when I'm trying to move by myself for falling.

04:26 Now, this weird - we can also have these other symptoms.

04:29 If the neurons are destroyed in the posterior cord, got these weird sensations on the skin.

04:34 They might have some shooting or burning pain or prickling or feeling that feels like insects crawling on their skin that would be horrible.

04:43 And pain and temperature sensation are preserved below the involved area.

04:48 Okay. So, let's look at this one cuz this one should likely stick in your mind.

04:53 If it's a posterior cord, I'm gonna have problems with sensing where my body is or feelings with touch.

05:01 And then I might have some really bizarre things, like a shooting pain or feeling like insects are crawling on my skin.

05:09 Let's look at motor function.

05:11 Now we talked about motor function and the posterior cord injury, there's - injury to the posterior spinal cord usually doesn't produce motor deficits like they do with the other areas of the spinal cord.

05:23 So they're not as severe. That would be important for you to know that's because the posterior spinal cord carries primarily sensory information to the brain that's why we get those super weird things with shooting pain and balance and the ants and bugs crawling up your arm.

05:40 But the motor function usually is preserved below the area of involvement even in the presence of a really significant sensory deficit.

05:47 Okay. So the biggest thing with that is gonna be more sensory problems and not so much touch as in the strange sensations the patient might feel and not really being able to tell where their extremities are.