Assessing Neurological Damage- Inductive Reasoning and the Babinski Sign in a Motorcycle Accident Victim

Assessing Neurological Damage- Inductive Reasoning and the Babinski Sign in a Motorcycle Accident Victim

The term used to refer to the inability to move the lower limbs is called paraparesis. However, the inability to move the lower limbs can be caused by another form of paralysis, such as diplegia, which affects both arms and legs. Based on the case scenario above, the patient reports an inability to move the legs only, and that justifies paraparesis as the appropriate diagnosis for this patient (Jankovic et al., 2021).

The process through which different structures of the body interact to achieve a function is called a reflex pathway. The basic reflex pathway in this scenario has its parts and functions outlined as follows. The sensory receptor detects a stimulus, for example, touch, pressure, or changes in temperature. The afferent neuron that transmits the impulses from the receptor to the nervous system, the integration center located in the spinal cord or the brain, processes sensory information, the efferent neuron takes messages to the effector organ from the integration center, and finally, the effector organ executes command from the integration center to for instance cause muscle contraction (Derderian & Tadi, 2023).

Babinski’s reflex indicates a pathological process that makes the big toes dorsiflex while the other toes fan out when the sole is stroked, contrary to the normal findings, which should be the toes flexing and curling downward when the sole is stroked. The Babinski’s sign is observed due to the loss of functioning of the corticospinal tract, which suppresses the Babinski’s reflex under normal circumstances. Mostly, it would result from a lesion in the upper motor neuron. This is not a first-order neuron because the patient is experiencing a loss of motor function rather than the sensory function that would be lost if it were a first-order neuron. A lesion responsible for the Babinski’s reflex suggests alteration of the corticospinal tract. Therefore, as backed up by François Sellal & Tatu (2020), the lesion located anywhere along the corticospinal tract can cause the signs in this scenario.

References

Derderian, C., & Tadi, P. (2023, January 3). Physiology, Withdrawal Response. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544292/

François Sellal, & Tatu, L. (2020). The Babinski sign in Renaissance paintings—a reappraisal of the toe phenomenon in representations of the Christ Child: observational analysis. BMJ. https://doi.org/10.1136/bmj.m4556

Jankovic, J., Mazziotta, J. C., & Pomeroy, S. L. (2021). Bradley’s Neurology in Clinical Practice E-Book. Elsevier Health Sciences.

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Scenario
Motorcycle accident

A 25-year-old male involved in a motorcycle accident was brought to your ER. The patient complains of being unable to move his legs voluntarily.

Assessing Neurological Damage- Inductive Reasoning and the Babinski Sign in a Motorcycle Accident Victim

The doctor orders a CT but the CT is currently out of commission so you must do some inductive reasoning. One thing you must determine is the severity and location of the patient’s lesion. You begin by scraping the bottom of their foot with the dull-pointed end of a reflex hammer starting at the heel moving to the small toe and then following the ball of the foot toward the big toe. The patient’s foot demonstrates a Babinski’s sign.

Instructions
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.

The term used for this condition (inability to move legs voluntarily) is called:
Name the parts of a basic reflex pathway.
Describe Babinski’s sign and compare it to what a normal response would look like.
Why would one see a Babinski sign rather than a normal sign?
Why do you think this is not a first order neuron issue? Hint: What would you see (or not see) if the nerves were damaged?
Where along the spinal cord could you see a lesion in the CT for this patient?