Bulbocavernosus Reflex, Spinal shock - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the Bulbocavernosus Reflex for spinal cord injuries, and telling you all you need to know about it an a simple and easy way.

The bulbocavernosus reflex indicates the absence or presence of spinal shock. Spinal shock usually occurs between 24 and 72 hours after spinal injury. Spinal shock is manifested by the absence of bulbocavernosus reflex, hypotension, bradycardia, and complete loss of motor, sensation and reflexes. When the reflex is absent, this means that the patient is in spinal shock. The anal sphincter will not contract when the reflex is absent. When the reflex is present, this signals the end of spinal shock. The anal sphincter will contract when the reflex is present. The reflex is checked by monitoring anal sphincter contraction in response to squeezing of the penis or clitoris, or by pulling on an indwelling Foley catheter. It is a polysynaptic response mediated by S2-S4.
What is spinal shock? Spinal shock is the loss of sensation and motor power following a spinal cord injury. After an injury to the spine, if the patient has no motor or sensory below the level of the lesion, the physician must determine if the patient is in spinal shock by checking the bulbocavernosus reflex. The anal sphincter will contract when reflex is present. If there is no anal contraction (Absent bulbocavernosus reflex), indicates that the patient is still in shock and prognosis cannot be determined. If anal contraction is present (positive bulbocavernosus reflex), this indicates the end of spinal shock.
The patient’s condition and prognosis at this point can be determined by examining sacral sparing (positive sacral sparing indicates incomplete lesion). Loss of sensation and motor power below the level of injury indicates complete spinal cord injury. Once the diagnosis of neurogenic shock is established, the blood pressure should be managed with vasopressors to prevent fluid overload.
Spinal shock usually occurs between 24 and 72 hours after spinal injury. With the end of spinal shock, the prognosis can be determined. Examine the patient thoroughly, including sacral sparing. The patient may be normal, partial or complete. Sacral sparing testing:
1-Testing of the anal sphincter muscle.
2-Testing of flexion of the great toe
3-Testing of the perianal sensation.

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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step

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