PREDISPOSING FACTORS PRECIPITATING FACTORS

- AGE: 65 YR. OLD - Px (PAT KUMAR) FELL BACK

- GENDER: MALE ON HIS HEAD
- Hx OF ILLNES: DM,
IHD, HPN, HERPES
ZOSTER

INSULIN DEPRIVATION AGING ETIOLOGY:

TRAUMA

INCREASE ENTRY OF SPINAL DEGENERATION

GLUCOSE INTO
INSULIN DEPENDENT MECHANISM OF
CELLS INTERVERTEBRAL INJURY: FLEXION-
DISC LOSE HYDRATION AND ELASTICITY EXTENSION
358
mg/dL HYPERGLYCEMIA
RBS
DISK SUBSEQUENTLY BURSTING OF BLOOD
COLLAPSE VESSEL

MRI W/ CONTRAST WHOLE

WATER GLYCOSURIA SPINE:
LOSS EPIDURAL CERVICAL HEMORRHAGE
MRI SCAN CERVICAL & LUMBAR HEMATOMA
C3/C4: DIFFUSE DISC BULGE CAUSING HEMATOMA FROM C4-7 IN
(POLYURIA) BILATERAL MILD NEURAL FORAMINAL THE LEFT SIDE
STENOSIS
C4/C5: DIFFUSE DISC BULGE MAINLY EPIDURAL LESION
POSTERIORLY AND TO THE RIGHT SIDE MEASURING ABOUT 1X
W/ MILD NEURAL FORAMINAL
STENOSIS ON THE R. SIDE
0.5X7CM IN AP INCREASE NEUTROPHILS
C5/C6: DIFFUSE DISC BULGE CAUSING FREE
SALT LOSS BILATERAL MILD NEURAL FORAMINAL RADICAL
STENOSIS
C6/C7 DIFFUSE DISC BULGE MAINLY FORMATION PRODUCTION OF
POSTERIORLY AND TO THE R. SIDE W/ LEUKOTRIENES,
MILD NEURAL FORAMINAL STENOSIS ACTIVATION OF
ON THE R. SIDE ACUTE SPINAL CORD KALLIKREIN-KININ
L2-L3 MILD BULGE W/ NO SIGNIFICANT
F.S.
COMPRESSION SYSTEM
L3-L4/L4-L5/L5-L6 BILATERAL DISC
BULGE CAUSIN BILATERAL NEURAL F.S.
 CT SPINE LUMBAR & CT SPINE
CERVICAL
DECREASE
BLOOD VOLUME CT CERVICAL: STRAIGHTENING OF
THE C. SPINE
VASOSPASM
SEVERE NARROWING FOUND IN I.D
AT LEVEL C5-C6
MILD INDENTATION TO THE
CERVICAL CORD AT THE LEVEL OF
C4 C5 DECREASE SPINAL
HEMOCONCE CORD BLOOD FLOW
CT LUMBAR SPINE: STRAIGTHENING
NTRATION OF THE LUMBAR SPINE
DIFFISUE DISC SPACE BULGE AT
LEVEL L3-L4/L4-L5/L5-S1
UNREMARKABLE SACROILIAC JOINT

SEVERE SPONYLOSIS
POOR DIFFUSE DISC BULGE NOTED AT L3-
L4, L4-L5 AND L5-S1
TISSUE
PERFUSIO
N URINARY
INCONTINENCE

MENTAL STATUS MOTOR CEREBELLAR SENSATION REFLEXES

NECROTIC
TOE
INITIAL: ABNORMAL; DECREASE
GCS SCORE: POWER: 1/5 IN LEFT LOWER CAN’T WALK SENSATION
CONSCIOU
13/15 LIMB HYPO-
S, IN THE LEFT
POWER: 1/5 LEFT ARM AND REFLEXIA
ORIENTED, EYE OPENING: 4 SIDE
3/5 RIGHT ARM
SLIGHTLY VERBAL: 4 LOWER LIMB WEAKNESS
DROWSY MOTOR: 5 WITH LEFT ARM 3/10 PAIN
PROBLEMS SCALE
FOLLOW UP:
IN THE POWER R. SIDE ARM: 5/5
CIRCULATIO LEG 3/5 IN KNEE AND HIP
N FLEXION
DECREASE LEVEL OF
LEFT SIDE: DORSOFLEXION
CONSCIOUSNESS
1/5
PLANTAR FLEXION 2/5
KNEE EXTENSION 0/5
HIP FLEION EXTENSION 0/5
HAND GRIP 1/5
ELBOW FLEXION EXTENSION
0/5
SHOULDER ABDUCTION 5/5
DECREASE BACTERIAL INFECTION
CARDIAC IN THE URINARY
OUTPUT TRACT

ENDOTHELIAL CELL
DAMAGE
BP: 90/50
mmHg

ACTIVATES CNS AND

ENDOCRINE SYSTEM

MALDISTRIBUTION OF
CIRCULATING BLOOD
VOLUME

INITIAL SPO2
89%

DECREASE FOLLOW UP:

CELLELULAR SUPPLY 97%

INCREASE O2
DEMAND TISSUE HYPOXIA HYPOXIA