3.6 + 3.7 Spinal Cord injury Flashcards
two types of primary spinal injury
fracture dislocation
burst fractures
there are 3 types of ways that spinal injury can occur that this can occur
flexion
compression
hyperextenion
most vulnerable parts of spinal cord
C1-C2
C4-C6
T11-L2
c1-4 injury 2 characteristics
tetrapelgia
respiratory failure
c5-7 injury 2 characteristics
enables neck and shoulder movement
T1-12 injury characteristics 1
paraplegia
common spinal cord injury syndromes 3
central cord syndrome
anterior cord syndrome
brown-sequard syndrome
central cord syndrome
loss of movement in arms and hands but legs have normal function.
Why? Arms are centrally represented in the centre of spinal cord whereas legs are not.
anterior cord syndrome 2
trauma to anterior spinal cord or blockage of blood supply from anterior spinal artery
results in loss of movement, loss of sensation and pain and temp sensation
what is commonly associated with anterior spinal cord syndrome
flexion injuries of cervical spine
brown sequard syndrome 2
hemisectional damage;
results in paralysis on side of injury and loss of pain and temp sensation on other side
autonomic dysregulation 3
stimuli from afferent sources sent but cannot be received by higher brain processes.
Results in massive sympathetic nervous response causing:
- vasoconstriction = profound hypertension
Then have opposing affect of vagus nerve action to resolve hypertension causing:
- bradycardia
-headache
-blurred vision
most common triggers of autonomic regulation in someone w spinal cord injury
bladder and bowel distension
pressure sores
if untreated what does autonomic dysregulation result in
intracranial haemorrhage
retinal detachment
seizures
cardiac arrhythmias
primary survey
DRABCDE
Danger
Response
Airways
Breathing
Circulation
Disability - using GCS
E exposure
identify if they are stable and identify life threatning conditions
secondary survey in spinal injury
directed physical examination
AMPLE history
what is AMPLE history
AMPLE
Allergies
Medications
Past medical history
Last meal
Events leading to injury
initial assessment and management to spinal cord injury 4
primary survey
secondary survey
C-spine immobilisation
Cannulate + Catheter
why do we put in a catheter? 2
during spinal cord injury can get neurogenic bladder/urinary retention
this can trigger autonomic dysregulation which can be fatal
Spinal shock
temporary condition post SCI where loss of:
spinal cord function
low tone
decreased reflexes
resolves in 48hrs
DESCRIBE AS flaccid paralaysis and areflexia
When does spinal shock injury resolve, what shows this?
Return of Bulbocavernousus reflex:
- catheter tug results in contraction of anal sphincter
-if it doesn’t return then poor prognosis
neurogenic shock
results in autonomic dysfunction
imaging in spinal cord injury 3:
US abdomen - see any internal bleeding
CT spine - spine visualisation
CXR - damage to lungs, broken ribs etc
blood investigations in spinal cord injury
ABGs, CBEs, EUCs, LFTs
