60 - Spinal Cord Injury

Question 1

Spinal Shock

Answer 1

loss of deep tendon/sphincter reflex, loss of sensation, flaccid paralysis below lvl of injury

-occurs shortly after SCI
-lasts days to weeks

Question 2

SCI is classified by,,,

Answer 2

1 mchanism
2 level
3 degree

Question 3

level of injury may be…

Answer 3

cervical
thoracic
lumbar
sacral

Question 4

level of injury that can cause paralysis of all 4 extremities (TETRAPLEGIA)

Answer 4

C1-T1

Question 5

Paraplegia can occur in SCI below…

Answer 5

below T2

Question 6

Degree of spinal involvement is either…

Answer 6

Complete or Incomplete

Question 7

complete cord involvement

Answer 7

total loss of sensory and motor function below level of injury

Question 8

incomplete cord involvement’s 5 major syndromes

Answer 8

1 central cord syndrome
2 anterior cord syndrome
3 brown-sequard syndrome
4 cauda equina syndrome
5 conus medullaris sundrome

Question 9

anterior cord syndrome
damage

Answer 9

anterior spinal artery

Question 10

anterior cord syndrome
manifestations

Answer 10

-motor paralysis
-loss of pain + tempt sensatn

-sensations of touch, positn, vibrtn, motion intact

Question 11

brown-sequard syndrome
damage

Answer 11

-half of spinal cord
-usually fr penetrating injury

Question 12

brown-sequard syndrome
manifestations

Answer 12

contralateral (opp side): loss pain + temp sensatn

ipsilateral (same side of injury): loss of motor function, light touch, pressure, position, + vibration sense

Question 13

cauda equina syndrome
damage

Answer 13

lumbar + sacral nerve roots

Question 14

cauda equina syndrome
manifestations

Answer 14

-asymm weakness
patchy sensatn
-maybe flaccid paralysis
-complete loss of sensation of saddle area
-areflexic/flaccid bladder

Question 15

central cord syndrome
damage

Answer 15

-central spinal cord
-usually cervical
-hyperextension
-common in old ppl

Question 16

central cord syndrome
manifestations

Answer 16

-
upper extremities: motor weakness + altered sensation
»burning pain

lower: usually unaffected

Question 17

conus medullaris syndrome
damage

Answer 17

lowest part of spinal cord

Question 18

conus medullaris syndrome
manifestations

Answer 18

-decr or loss of sensatn in perineal area
-areflexic bladder/bowel
-impotence

-lower extremities may not be affected

Question 19

any cord above T6 leads to…

Answer 19

dysfunctn of SNS
-brady, hypotension, periph vasodilation

Question 20

____ injuries are assoc w greater loss of ability to regulate temp

Answer 20

cervical

Question 21

complete injury above _____ should be intubated immediately

Answer 21

C5

bc C3 and above are assoc w complete loss of resp muscles

Question 22

preferred imaging study to diagnose location + degree of injury

Answer 22

CT scan

Question 23

common meds for SCI

Answer 23

heparin - VTE prophylaxis w/in 72hr
vasopressors
atropine - anticholinergic to raise HR

Question 24

vagus nerve stimulation causes…

Answer 24

low HR

Question 25

vagus nerve stimulation causes...

Answer 25

slows HR

Question 26

maintain BP at.. keep MAP bw...

Answer 26

>90 85-90

Question 27

autonomic dysreflexia

Answer 27

return of reflexes after the resolution of spinal shock -can occur in injuries at T6 or higher

Question 28

what happens in autonomic dysreflexia?

Answer 28

massive uncompensated cardiovascular reaction mediated by SNS -reflex arteriolar vasoconstricion

Question 29

what stims autonomic dysreflexia

Answer 29

distended bladder/rectum stim of skin or painreceptors