Ch 7 - SCI: Epidemiology and Anatomy

Question 1

What is the incidence of SCI in the US?

Answer 1

40 new injuries per million population/year = 12,000 new SCI cases/year

Question 2

What is the prevelance of SCI in the US?

Answer 2

Approximately 273,000 cases

Question 3

What is the average age of injury of SCI?

Answer 3

42.6 years of age

Question 4

What is the MCC of SCI in elderly?

Answer 4

Falls followed by MVC

Question 5

What are the MC times for SCI?

Answer 5

– Summer season (highest incidence in July)
– Weekends (Saturday > Sunday)
– Nighttime

Question 6

What is the MC level of spinal cord injury?

Answer 6

C5

Question 7

What is the MC level of injury of paraplgeia?

Answer 7

T12

Question 8

What is the MC type of SCI?

Answer 8

Incomplete tetraplegia

Question 9

Describe association with marriage and SCI.

Answer 9

MC to be single
Likelihood of marriage after SCI is reduced
Post-injury marriages survive better than pre-injury marriages

Question 10

Describe association with return to work after SCI.

Answer 10

1 year post-injury 11.8% employed

20 years post injury 35% employed

Question 11

What is the leading cause of death for chronic SCI?

Answer 11

Respiratory d/o

Pneumonia MCC

Question 12

What are secondary causes of death in chronic SCI?

Answer 12

2. Heart disease
3. Septicemia from pressure ulcers, UTI or respiratory infection
4. Cancer

Question 13

What is the relationship between SCI and suicide?

Answer 13

2nd MCC of death in <25 yo

MC in paraplegia than tetraplegia

Question 14

Where does the conus medullaris become the cauda equina?

Answer 14

L1-2

Question 15

What is the location of the Fasiculus gracilis?

Answer 15

Medial dorsal columns

Proprioception from the leg

Question 16

What is the function of the Fasiculus gracilis?

Answer 16

Light touch and vibration

Question 17

What is the location of the Fasiculus cuneatus?

Answer 17

Lateral dorsal columns

Proprioception from the arm

Question 18

What is the function of the Fasiculus cuneatus?

Answer 18

Light touch and vibration

Question 19

What is the location of the Spinocerebellar tract?

Answer 19

Superficial lateral column

Question 20

What is the function of the Spinocerebellar tract?

Answer 20

Muscular position and tone, unconscious proprioception

Question 21

What is the location of the Lateral spinothalamic tract?

Answer 21

Ventrolateral column

Question 22

What is the function of the Lateral spinothalamic tract?

Answer 22

Pain and thermal sensation

Question 23

What is the location of the Ventral spinothalamic tract?

Answer 23

ventral column

Question 24

What is the function of the Ventral spinothalamic tract?

Answer 24

Tactile sensation of crude touch and pressure

Question 25

What is the location of the Lateral corticospinal tract?

Answer 25

Deep lateral column

Question 26

What is the function of the Lateral corticospinal tract?

Answer 26

Motor: Theorized to have motor fibers running, medial (cervical)→ lateral (sacral) C → S (motor neuron distribution)

Question 27

What is the location of the Anterior corticospinal tract?

Answer 27

Medial ventral column

Question 28

What is the function of the Anterior corticospinal tract?

Answer 28

Motor: Neck and trunk movements

Question 29

Where do the Lateral corticospinal tracts cross?

Answer 29

80% to 90% of the axons cross over (decussate) to the contralateral side at the pyramidal decussation in the medulla

Question 30

What is the function of the spinocerebellar tracts?

Answer 30

Transmit unconscious proprioception from the ipsilateral side of the body and do not cross

Question 31

Where do Lateral spinothalamic tracts cross and run?

Answer 31

Fibers cross over to the opposite half of the cord within 1 to 3 vertebral segments, ascend in the lateral spinothalamic tracts to the thalamus on the opposite side and then ascend in the internal capsule to the postcentral gyrus of the cerebral cortex

Question 32

Where do the Dorsal columns cross and run?

Answer 32

Sensory fibers synapse at DRG and immediately ascend in to the ipsilateral dorsal white columns, travel up to the medulla, and decussated

Question 33

What is the blood supply of the spinal cord?

Answer 33

1 anterior spinal artery: supplies anterior 2/3

2 posterior spinal arteries supply posterior 1/3 of the cord

Question 34

What is the artery of Adamkiewicz?

Answer 34

Arises from the left intercostal or lumbar artery at the levels of T9–L3 and provides the major blood supply to the lower 2/3 of the lumbosacral spinal cord

Question 35

What is the watershed area of the spinal cord?

Answer 35

Fewer radicular arteries that supply T4–T6 and prone to ischemia during clamping of the aorta during surgery