central cord syndrome

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central

 [sen´tral]
pertaining to a center; located at the midpoint.
central cord syndrome injury to the central portion of the cervical spinal cord resulting in disproportionately more weakness or paralysis in the upper extremities than in the lower; pathological change is caused by hemorrhage or edema.
 Central cord syndrome. From Ignatavicius and Workman, 2002.
central fever sustained fever resulting from damage to the thermoregulatory centers of the hypothalamus.
central nervous system the portion of the nervous system consisting of the brain and spinal cord. See also Plate 14.
central venous catheterization insertion of an indwelling catheter into a central vein for administering fluid and medications and for measuring central venous pressure. The most common sites of insertion are the jugular and subclavian veins; however, such large peripheral veins as the saphenous and femoral veins can be used in an emergency even though they offer some disadvantages. The procedure is performed under sterile conditions and placement of the catheter is verified by x-rays before fluids are administered or central venous pressure measurements are made.

Selection of a large central vein in preference to a smaller peripheral vein for the administration of therapeutic agents is based on the nature and amount of fluid to be injected. Central veins are able to accommodate large amounts of fluid when shock or hemorrhage demands rapid replacement. The larger veins are less susceptible to irritation from caustic drugs and from hypertonic nutrient solutions administered during parenteral nutrition.
Patient Care. Patients who have central venous lines are subject to a variety of complications. Air embolism is most likely to occur at the time a newly inserted catheter is connected to the intravenous tubing. Introduction of air into the system can be avoided by having the patient hold his breath and contract the abdominal muscles while the catheter and tubing are being connected. This maneuver increases intrathoracic pressure; if the patient is not able to cooperate, the connection should be made at the end of exhalation.

Sepsis is a potential complication of any intravenous therapy. It is especially dangerous for patients with central venous lines because they are seriously ill and less able to ward off infections. Careful cleansing of the insertion site, sterile technique during insertion, periodic changing of tubing and catheter, and firmly anchoring the catheter to prevent movement and irritation are all essential for the prevention of sepsis.

Formation of a clot at the tip of the catheter is indicated if the rate of flow of intravenous fluids decreases measurably or if there is no fluctuation of fluid in the fluid column. Preventive measures include maintaining a constant flow of intravenous fluids by IV pump or controller, periodic flushing of the catheter, heparin as prescribed, and looping and securing the catheter carefully to avoid kinks that impede the flow of fluids. Cardiac arrhythmias can occur if the tip of the catheter comes into contact with the atrial or ventricular wall. Changing the patient's position may eliminate the problem, but if ectopic rhythm persists, additional interventions are warranted.
central venous pressure (CVP) the pressure of blood in the right atrium. Measurement of central venous pressure is made possible by the insertion of a catheter through the median cubital vein to the superior vena cava. The distal end of the catheter is attached to a manometer (or transducer and monitor) on which can be read the amount of pressure being exerted by the blood inside the right atrium or the vena cava. The manometer is positioned at the bedside so that the zero point is at the level of the right atrium. Each time the patient's position is changed the zero point on the manometer must be reset. For a multilumen catheter the distal port is used to measure central venous pressure; for a pulmonary artery catheter the proximal port is used.

An arterial line can also be used to monitor the central venous pressure. The waveform for a tracing of the pressure reflects contraction of the right atrium and the concurrent effect of the ventricles and surrounding major vessels. It consists of a, c, and v ascending (or positive) waves and x and y descending (or negative) waves. Since systolic atrial pressure (a) and diastolic (v) pressure are almost the same, the reading is taken as an average or mean of the two.

The normal range for CVP is 0 to 5 mm H2O. A reading of 15 to 20 mm usually indicates inability of the right atrium to accommodate the current blood volume. However, the trend of response to rapid administration of fluid is more significant than the specific level of pressure. Normally the right heart can circulate additional fluids without an increase in central venous pressure. If the pressure is elevated in response to rapid administration of a small amount of fluid, there is indication that the patient is hypervolemic in relation to the pumping action of the right heart. Thus, CVP is used as a guide to the safe administration of replacement fluids intravenously, particularly in patients who are subject to pulmonary edema. Central venous pressure indirectly indicates the efficiency of the heart's pumping action; however, pulmonary artery pressure is more accurate for this purpose.

A high venous pressure may indicate congestive heart failure, hypervolemia, cardiac tamponade in which the heart is unable to fill, or vasoconstriction, which affects the heart's ability to empty its chambers. Conversely, a low venous pressure indicates hypovolemia and possibly a need to increase fluid intake.

cen·tral cord syn·drome

quadriparesis most severely involving the distal upper extremities, with or without sensory loss and bladder dysfunction, usually due to ischemia from osteophytic or traumatic compression of the central part of the cervical spinal cord and/or artery.
A post-traumatic condition affecting the cervical spinal cord, in which necrosis spreads from the central gray matter peripherally to the myelin, resulting in focused damage to the corticospinal tracts; voluntary myelinated motor fibers to the arms are more central and those to the legs more peripheral; in CCS, lower motor neuron changes occur in the arms and are accompanied by leg spasticity; sensory defects reflect the degree of anterolateral and posterior column destruction, often accompanied by altered pain and temperature sensation in hands; CCS of acute onset may be accompanied by urinary retention and incontinence

central cord syndrome

Neurology A post-traumatic condition affecting the cervical spinal cord, in which necrosis spreads from the central gray matter peripherally to the myelin, resulting in focused damage to the corticospinal tracts; voluntary myelinated motor fibers to the arms are more central and those to the legs more peripheral; in CCS, lower motor neuron changes occur in the arms and are accompanied by leg spasticity; sensory defects reflect the degree of anterolateral and posterior column destruction, often accompanied by altered pain and temperature sensation in hands; CCS of acute onset may be accompanied by urinary retention and incontinence. Cf Central spinal cord syndrome.

cen·tral cord syn·drome

(sen'trăl kōrd sin'drōm)
Quadriparesis most severely involving the distal upper extremities, with or without sensory loss and bladder dysfunction, usually due to ischemia from osteophytic or traumatic compression of the central part of the cervical spinal cord and/or artery.

central

pertaining to a center; located at the midpoint.

central artery
of the optic nerve, the source of the retinal artery. See also Table 9.
central channel
the fast-flowing channel through the capillary bed, the rate controlled by the metarterioles which exert a sphincter-like action on the system.
central convulsions
convulsions arising from stimulation of the central nervous system, as distinct from those caused by lesions elsewhere.
central cord syndrome
injury to the central portion of the cervical spinal cord resulting in disproportionately more weakness or paralysis in the forelimbs than in the hindlimbs; pathological change is caused by hemorrhage or edema.
central diabetes insipidus
central European tick-borne encephalitis
central layer
central of the three layers of gray matter in the cerebellum; the principal cell type is piriform.
central nervous system
see central nervous system.
central peripheral neuropathy
see Boxer progressive axonopathy.
central progressive retinal atrophy
see central progressive retinal atrophy.
central projection law
the laws of physics applied to the primary x-ray beam of photons, e.g. the closer the object being x-rayed is to the film the sharper will be its definition.
central respiratory oscillator
pool of nerve cells in the pons and medulla oblongata which are responsible for the rhythmic to-and-fro movements of respiration.
central retinal degeneration
see retinal.
central sulcus
fissure of Rolando.
central tarsal bone
the bone of the hock which lies between the proximal and distal rows of tarsal bones.
central tendon of diaphragm
see diaphragmatic tendon.
central vein
the centrally placed drainage vessel of each hepatic lobule, receiving blood from the hepatic sinusoids.
central venous catheterization
insertion of an indwelling catheter into a central vein for the purpose of administering fluid and medications and for the measurement of central venous pressure (see below).
central venous pressure (CVP)
the pressure of blood in the right atrium, measured by an in situ catheter in the right atrium, is a much better guide of the degree of vasogenic peripheral failure than is arterial blood pressure. The technique is used mainly in dogs and cats.

Patient discussion about central cord syndrome

Q. what does c4-5 mild central disk bulging impinging upon cervical cord without spinal stenosis or distortion of the cord . mild righ neural foraminal narrowing from uncovertebral joint hypertropy mean

A. Well this basically means there is a very small narrowing of the cervical (your neck area) spinal canal (where the spinal cord is), however the narrowing does not cause any damage to the spinal cord, therefore probably does not cause any major symptoms involving the nerves. The c4-5 bulging part refers to the part in between the two cervical vertebras c4 and c5, in which the disc (a part in the spinal cord) is sliding a bit side-ways, but again, it does not seem to be causing any trouble.

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