13. Spinal Injuries Flashcards
Where does the Spinal Cord travel, in relation to Vertebrae?
Within the Vertebral Foramen
What type of curvature exists in the:
- Cervical Spine?
- Thoracic Spine?
- Lumbar Spine?
- Lordosis
- Kyphosis
- Lordosis
In which plane is the Spine Straight?
The Coronal Plane
Note - If the Spine is not straight then that = Scoliosis
Where are the nerves of the Lumbar Plexus found?
Within the Psoas Major Muscle
What is found in the Intervertebral Foramen?
Spinal Nerves
At what level does the Spinal Cord end?
L1 - Below that is the Conus Medularis
What is the definition of a Dermatome?
An area of Skin that is mainly supplied by a Single Spinal Nerve
What is the definition of a Myotome?
The group of Muscles that a Single Spinal Nerve innervates
What are the Myotomes of the Upper Limb?
- C5 - Deltoid (Shoulder Abduction)
- C6 - Biceps Brachii (Elbow Flexion / Wrist Extension)
- C7 - Triceps Brachii (Elbow Extensors)
- C8 - Flexor Digitorum Superficialis / Flexor Digitorum Profundus (Long Finger Flexors)
- T1 - Interossei (Finger Abduction
What are the Myotomes of the Lower Limb?
- L2 - Iliopsoas (Hip Flexion)
- L3, L4 - Quadriceps (Knee Extension)
- L4 - Tibialis Anterior Muscle (Ankle Dorsiflexion)
- L5 - Extensor Hallicus Longus (Big Toe Extension)
- S1 - Gastrocnemius Muscle (Ankle Plantar Flexion)
What is the relationship between a Spinal Injury (Bone) and a Spinal Cord Injury (SCI)?
15% of people with a Fracture / Dislocation will have a Spinal Cord Injury (SCI)
Note - The majority of people with an SCI will have an accompanying Column Injury
Who is most likely to get a Spinal Cord Injury?
- Male
- Peak at 20-29 years old
- Second Peak at <65 years old
What are the most common causes of Spinal Cord Injury?
- Falls (41.7%)
- Road Traffic Accidents (36.8%)
- Sport (11.6%)
What are the ASIA Classifications for Spinal Cord Injury?
- Grade A - Complete. No Sensory or Motor Function in Sacral Segments S4-S5
- Grade B - Incomplete. Sensory but not Motor Function Preserved in Sacral Segments S4-S5
3 / 4. Grade C / D - Incomplete. Motor Function Preserved below the Neurological Level - Grade E - Normal Motor / Sensory Function
What are the 2 Broad Categories of Spinal Cord Injury? What is the difference?
- Complete - no motor / sensory function distal to the Lesion - No chance of recovery
- Incomplete - Some function is present below the site of Injury - more favorable prognosis
What are the different Patterns of Spinal Cord Injury?
- Tetraplegia / Quadriplegia
- Paraplegia
- Partial Cord Syndromes:
- a) Central Cord Syndrome
- b) Anterior Cord Syndrome
- c) Brown-Sequard Syndrome
What does Tetraplegia (Quadriplegia) mean?
- Partial / Total loss of use of all 4 limbs and the Trunk
2. Loss of Motor / Sensory Function in Cervical Segments of the Spinal Cord
What is the most common cause of Tetraplegia (Quadriplegia)?
Cervical Fracture
What is the main concerns with Tetraplegia (Quadriplegia), after a Cervical Fracture?
- Respiratory Failure due to loss of innervation of the Diaphragm (Phrenic Nerve (C3-5))
- Spasticity - UMN Lesion (Above L1) causing increased Muscle Tone
What does Paraplegia mean?
- Partial / Total loss of the use of the Lower Limbs (Arm Function is Spared)
- Impairment of Motor / Sensory Function in Thoracic, Lumbar, and Sacral Segments of the Spinal Cord
What is the most common cause of Paraplegia?
Thoracic / Lumbar Fracture +/- associated Chest / Abdominal Injuries
What is also commonly affected with patients with Paraplegia?
- Spasticity - UMN Lesion (Above L1) causing increased Muscle Tone
- Bladder / Bowel Function
What are the 3 Partial Cord Syndromes?
- Central Cord Syndrome
- Anterior Cord Syndrome
- Brown-Sequard Syndrome
What is the common presentation of a Central Cord Syndrome?
- Older Patient with a Hyper-Extension injury
- Centrally Cervical Tracts more Involved
- Weakness of Arms > Legs
- Perianal Sensation and Lower Extremity Power is Preserved
