Question

You are assessing a patient involved in a motorcycle accident. He states that he saw an oncoming car and "laid the bike down" to avoid an outright collision. He was wearing a helmet. Which of the following injuries would make sense given the action of the motorcyclist?

Select one:
a. Bilateral broken forearms
b. Burn to the inside of the leg
c. "Road rash" to the entire body
d. Angulation to both femurs

Answer 1

In a hemisection of the spinal cord, motor control on the injured side would be lost, resulting in hemiplegia. Touch and proprioception would be reduced ipsilaterally, while contralateral loss of pain and temperature sensation would occur below the level of injury.

Step-by-step explanation:

Sensory Deficits Following a Hemisection of the Spinal Cord

Following a motorcycle accident, a victim experiencing the inability to move the right leg but retaining normal control over the left leg suggests a hemisection of the spinal cord in the thoracic region. In such cases, the motor control on the side of the hemisection would be lost, resulting in hemiplegia. The affected side would show paralysis due to disruption of the corticospinal tract which is responsible for voluntary motor control.

The sensory deficits after a spinal cord hemisection are more complex. Touch and proprioception would be diminished on the same side as the injury because these pathways ascend ipsilaterally. However, pain and temperature sensation would be lost on the opposite side of the body below the level of injury because the spinothalamic tract crosses over to the opposite side of the spinal cord shortly after entering.

Therefore, in the case of a right-side hemisection, the patient would experience reduced touch and proprioception on the right side, along with loss of pain and temperature sensation on the left side below the level of injury. These deficits arise from the nature of the separate pathways for different types of sensory information within the spinal cord.