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Spinal Cord Bootcamp > Final - Introduction and Classification > Flashcards

Final - Introduction and Classification Flashcards

1
Q

How many vertebrae are there in each section

A

7 - cervical
12 - thoracic
5 - lumbar
5 - sacral

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2
Q

where the cervical nerves exit

A

C1-7 above the corresponding vertebrae
C8 below C7 vertebrae
T1 and below exit below

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3
Q

vascular supply of the SC

A

2 posterior spinal arteries

1 anterior spinal artery

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4
Q

most susceptible to injury/most common

A 
cervical - poor mechanical stability
(C5-6)
- flexion injury
- head on collision
- diving in shallow water
- surfing accident
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5
Q

most common COMPLETE SCI

A 
thoracic
T12-L1 (where the rib cage ends, most vulnerable)
- gunshot wounds
- MVA
- falls
*vessel of Adamkiewicz
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6
Q

most common INCOMPLETE SCI

A 
lumbar
abdominal muscles provide support
- gunshot wounds
- MVA
- falls
- direct impact from heavy objects
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7
Q

paraplegia

A

impairment in the thoracic, lumbar, and sacral segments

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8
Q

tetraplegia (quad)

A

impairment in the cervical segments

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9
Q

neurological level of injury

A

the most caudal (lowest) level of the spinal cord that has INTACT sensory and motor function bilaterally

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10
Q

“intact”

A

the key muscle has 3/5 or greater strength and the key muscle above has 5/5

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11
Q

complete

A

both sensory and motor function are absent in the lowest sacral segments (S4-5)

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12
Q

incomplete

A

both sensory and motor function is preserved in the lowest sacral segments (S4-5)

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13
Q

zone of partial preservation

A

only with complete injuries

partial function of sensory and/or motor in segments below neurological level

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14
Q

rehospitalizations

A

30% in 12 months

  • pressure sores
  • pneumonia
  • infections: UTI, bladder
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15
Q

gender/age/race SCI

A

older and younger extremes
men - risk taking behaviors
non hispanic black

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16
Q

highest causes of SCI

A
  1. car accidents
  2. falls
    other: violence, sports, medical
17
Q

OT goals

A
  1. independence
  2. accept new lifestyle
  3. reintegrate into society
18
Q

central cord syndrome

A

most common, incomplete, caused by falls; greater weakness in the upper limbs than LE, mostly older people, common with spinal stenosis

19
Q

Brown-Sequard syndrome

A

incomplete, damage to half SC causing ipsilateral proprioceptive and motor loss and contralateral loss of pain/temp

20
Q

anterior cord syndrome

A

rare, absent blood supply to the cord, loss of motor control, pain, temp below injury (light touch and prop are intact)

21
Q

cauda equina syndrome

A
  • just nerve roots

LMN injury to lumbosacral nerve roots, areflexic bladder/bowel and paralysis/weakness of lower limbs

22
Q

conus medullaris syndrome

A
  • tip of the cord plus nerve roots

similar to above but cord is also damaged, some preservation of reflex activity, bladder/bowel/LE impacted

23
Q

LMN disorder

A
  • disruption of the common motor pathway (what is on its way OUT)
  • paralysis, flaccidity, loss of reflexes, muscle atrophy, areflexic atrophy
24
Q

UMN disorder

A
  • disruption of the descending pathways (IN the cord)

- paralysis, hypertonicity, spasticity, hyperreflexia, reflexive bowel/bladder

25
Q

autonomic dysreflexia

A

sudden dangerous increase in BP, levels T6 and above, causes include distended bladder, UTI, bladder or kidney stones, ulcers, etc (symptoms are HTN, headache)

26
Q

orthostatic hypotension

A

sudden drop in BP when a person sits upright, T6 and above, caused by impaired autonomic regulation, blood pools in LE when in bed all day

27
Q

heterotrophic ossification

A

pathological bone formation in joints, connective tissue calcifies around the joint, usually 1-4 months after injury; symptoms are warm, wollen extremity, fever, ROM limits

28
Q

recovery within the zone of injury

A

muscles that are completely paretic have a fair possibility of regaining some motor power (but nonfunctional)

muscles that had even a small contraction have a very good possibility of attaining functional motor power

29
Q

zone of injury

A

considered the first 3 abnormal dermatomes or myotomes

30
Q

What levels of SCI affect respiration?

A

Lesions above C4 (damage to phrenic nerve results in partial or complete paralysis of diaphragm)
Lower cervical and thoracic can paralyze other breathing muscles

31
Q

How often should someone turn in bed to avoid pressure sores?

A

every 2 hours

32
Q

At what levels are the bowel and bladder controlled?

A

S2-S5 (so lesions above will lose this function)

33
Q

What are the 7 key factors in shaping the optimal rehabilitation experience based on Hammell (2007)

A

The importance of specific staff qualities, the need for a vision of future life possibilities, the importance of peers, the relevance of program content, the institutional context of rehab, importance of reconnecting past to the future, importance of meeting the needs of the real world

34
Q

What are the main focus areas for OT during acute care recovery?

A

Focus on support and prevention
Foster autonomy in making decisions
Facilitate solving problems
Engage the person in activities that are personally relevant and meaningful
Provide some environmental controls for the patient
Maintain normal UE joint ROM and preventing edema and deformities, positioning, splinting

35
Q

What are the main focus areas for OT during rehabilitation?

A 
Educating patients and family
Self efficacy and self management skills
Choosing appropriate equipment
Transitions, home and community roles
Adaptation to focus on facilitation/improved quality of life
36
Q

Describe one assistive device or compensatory method that an individual would use with SCI. At what levels of injury would this device/method likely be appropriate (ie, tetraplegia, paraplegia, etc)?

A

Mobile arm support (ball-bearing feeder) - C5 tetraplegia
Mechanical device attached to a wheelchair, shoulder and elbow support carries the weight of the arm so that the pt can drive the wheelchair, feed, groom, do tabletop activities
Wrist must be stabilized with splint/orthosis; universal cuff on the palm

Spinal Cord Bootcamp (12 decks)

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