TABLE SHOWING NERVOUS MANIFESTATIONS FOLLOWING TRAUMATISMS OF THE SPINE [Dennis] 
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The muscles governed by the injured segment are paralysed and become flabby and atrophied. Those governed by segments below 
the point of injury are paralysed as to motion and sensation, but do not atrophy. This is due to the fact that their centres of nutrition in 
the cord are uninjured. If no treatment is instituted however, ascending and descending degeneration of the cord takes place, causing 
atrophy of the muscles governed by the various segments. 
PRIAPISM is frequently seen in fractures of the upper part of the spinal column, and is due to the cutting off of inhibitory impulses 
from the higher centres. 
The BLADDER and RECTAL centres are in the lower lumbar segments, and traumatism in this region causes incontinence of urine 
and faeces. Injuries higher up cause retention. 
TYMPANITES is seen in injuries to the upper part of the cord: it is due to paralysis of peristalsis. 
BROWN-SEQUARD’S paralysis (loss of motion on one side and of sensation on the other) is seen in unilateral lesions of the cord, 
such as might be caused by a bullet. It is due to the immediate decussation of the sensory fibres on entering the cord. It is not seen at 
first, as the general bruising causes bilateral paralysis. 
REFLEXES. PUPIL: Dilatation produced by pinching side of neck. SCAPULAR: Scratching skin over scapula causes muscles to 
contract. SUPINATOR: Tapping tendon at wrist causes flexion of arm. TRICEPS: Tapping elbow tendon causes extension of arm. 
POSTERIOR WRIST: Tapping tendons causes extension of hand. ANTERIOR WRIST: Tapping tendons causes flexion of wrist. 
PALMAR: Scratching palm causes flexion of fingers. EPIGASTRIC: Stroking mammae causes retraction of epigastrium. ABDOMINAL: 
Stroking abdomen causes retraction. CREMASTERIC: Stroking inner thigh causes retraction of scrotum. PATELLAR: Striking patellar 
tendon causes extension of leg. GLUTEAL: Stroking buttock causes dimpling in gluteal fold. PLANTAR: Stroking sole of foot causes 
flexion of foot and retraction of leg. ANKLE CLONUS: Forcible extension causes rhythmical flexion.