醫學筆記匯整 ED Notes

T6 is the demarcation 分界 for differentiating the high cord from the low cord lesions

- Abdominal pain/tenderness is completely absent
- Signs of fever and leukocytosis are surprisingly infrequent.

Tenderness despite a perforation is often absent
but when present should be taken seriously as is highly likely to be owing to perforation.

* 會有的 sign :
An important symptom is referred pain to the shoulder.
This feature has been commonly noted and tends to be more common in high cord lesions

Other features that may be seen in the spectrum of acute abdomen include :
loss of bowel sounds,abdominal distension,nausea/vomiting and increased abdominal spasticity

A special mention must be made to the presence of autonomic dysreflexia in SCI 自主神經反射異常
hypertension (enough to cause headaches), sweating and tachycardia/bradycardia.
Dysreflexia has been reported by several authors and is more likely in higher cord lesions above T6.

AD 的徵兆包括：
* 血壓高（高於200/100 ）
* 捶打型頭痛，面部潮紅
* 脊髓損傷部位以上出汗
* 鼻塞，噁心
* 脈搏緩慢，每分鐘低於60次
* 脊髓損傷部位以下出現雞皮疙瘩
AD 由損傷以下部位的刺激引起, 通常與膀胱或腸道功能有關

- The most important signs were :

• Autonomic dysreflexia
• Referred shoulder tip pain
• Abdominal pain, abdominal distension, increased spasticity
• Abdominal pain with nausea and vomiting.

- Less importance was given to the classical signs :

• Abdominal tenderness
• Abdominal muscle rigidity
• Rebound
• Fever and leukocytosis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618775/