Cours 10 : Spinal Cord Injury Flashcards
What are SCI?
Quadraplegia and paraplegia acquired through some kind of trauma
What are the causes of SCI?
48% motor vehicles (more car accidents)
21% falls ( increase of construction workers + seniors)
14% violence
14% sport injuries : recreational & competitive sports
3% others
- Diving (pool, lake) is the #1 for spinal cord injuries *
Can you walk after spinal cord injury?
It depends
What is the incidence of SCI?
1100 new cases per year and 44 000 Canadians now living with the impacts of a SCI
Annual health care costs of 3.6 billion
Lifetime health care costs between 1.6 to 3 million dollars
Why the wide range?
Because of age and severity
About 89% are males and most range in age between 16 and 30 years old because they tend to take more risks when they are young
Lesions can be complete or incomplete (50%-50%)
What is the organization of the nervous system for sensory information?
Sensory information –> ascending pathways (dorsal tracts ) from the cutaneous info proprioceptive info (cutaneous info + proprioception = somatosensory system)
Are sensations intact above the lesion?
Yes
What is the organization of the nervous system for motor commands?
Descending pathways (ventral tracts)
Can an individual with a spinal cord lesion t the lumbar level contract his arm muscles?
Yes, the signal from the motor cortex goes to the motor neurones from cervical. cord and since the lesion is lower, you will be able to contract the arm muscles
How can we determine the severity of the condition?
It depends on the level of the lesion + whether it is complete or incomplete (injury can affect more than one vertebra)
What is quadriplegia?
involvement of all 4 limbs and trunk
Cause : damage tot he cervical segments
C5-C6 : most common, why? because of car accidents, this is why airbags are important to limit the forward and back movement of the head during the crash
C7 : elbow extension : important for wheelchair users because if triceps innervation –> movement of the elbow flexion –> extension use of your triceps to use a manual chair
What is paraplegia?
Involvement of the lower limbs and/or trunk (trunk is not always involved.. why? because it depends on the lesion
Cause : damage to the thoracic or lumbar spine
Complete lesions
T1 to T6 = no sitting balance
T7 to L1 = some useful sitting
L2 to lower = normal trunk of control
What are the health concerns in Spinal cord injury people?
Sensation loss
- complete lesion = total loss (below lesion)
- incomplete lesion = partial loss (below lesion). ** you lose some sensations but not others (hot vs cold.. type of fibres ) + vulnerable to injury (visual inspection after playing sports to get treated if injured before going into septic shock.)
Contractures and injury prevention (spasticity)
- Shortening and tightening of muscles (flexors in upper limbs + extensors in lower limbs)
- Stretching 2x/day (Full ROM)
What are the other health concerns in SCI
Lower limb atrophy
Osteoporosis
Weight management - more prone to hypo kinetic diseases
Autonomic Nervous System (ANS) Dysfunction during exercise
- decrease in heart beat, decrease in blood pressure, sweating impairment + impairment of the vasoconstrictor function = decrease in blood which gives less oxygen tot he muscles = early fatigue
What is the autonomic nervous system?
Part of the nervous system that regulates involuntary function
- Sympathetic system during exercise : increase heart rate, and blood pressure in active muscles and organs (cardiac sympathetic fibres originate from T1 to T5
Ans dysfunction can be present in quadriplegics and high paraplegics *lesions at T5 and above)