Final - Introduction and Classification Flashcards
How many vertebrae are there in each section
7 - cervical
12 - thoracic
5 - lumbar
5 - sacral
where the cervical nerves exit
C1-7 above the corresponding vertebrae
C8 below C7 vertebrae
T1 and below exit below
vascular supply of the SC
2 posterior spinal arteries
1 anterior spinal artery
most susceptible to injury/most common
cervical - poor mechanical stability (C5-6) - flexion injury - head on collision - diving in shallow water - surfing accident
most common COMPLETE SCI
thoracic T12-L1 (where the rib cage ends, most vulnerable) - gunshot wounds - MVA - falls *vessel of Adamkiewicz
most common INCOMPLETE SCI
lumbar abdominal muscles provide support - gunshot wounds - MVA - falls - direct impact from heavy objects
paraplegia
impairment in the thoracic, lumbar, and sacral segments
tetraplegia (quad)
impairment in the cervical segments
neurological level of injury
the most caudal (lowest) level of the spinal cord that has INTACT sensory and motor function bilaterally
“intact”
the key muscle has 3/5 or greater strength and the key muscle above has 5/5
complete
both sensory and motor function are absent in the lowest sacral segments (S4-5)
incomplete
both sensory and motor function is preserved in the lowest sacral segments (S4-5)
zone of partial preservation
only with complete injuries
partial function of sensory and/or motor in segments below neurological level
rehospitalizations
30% in 12 months
- pressure sores
- pneumonia
- infections: UTI, bladder
gender/age/race SCI
older and younger extremes
men - risk taking behaviors
non hispanic black
highest causes of SCI
- car accidents
- falls
other: violence, sports, medical
OT goals
- independence
- accept new lifestyle
- reintegrate into society
central cord syndrome
most common, incomplete, caused by falls; greater weakness in the upper limbs than LE, mostly older people, common with spinal stenosis
Brown-Sequard syndrome
incomplete, damage to half SC causing ipsilateral proprioceptive and motor loss and contralateral loss of pain/temp
anterior cord syndrome
rare, absent blood supply to the cord, loss of motor control, pain, temp below injury (light touch and prop are intact)
cauda equina syndrome
- just nerve roots
LMN injury to lumbosacral nerve roots, areflexic bladder/bowel and paralysis/weakness of lower limbs
conus medullaris syndrome
- tip of the cord plus nerve roots
similar to above but cord is also damaged, some preservation of reflex activity, bladder/bowel/LE impacted
LMN disorder
- disruption of the common motor pathway (what is on its way OUT)
- paralysis, flaccidity, loss of reflexes, muscle atrophy, areflexic atrophy
UMN disorder
- disruption of the descending pathways (IN the cord)
- paralysis, hypertonicity, spasticity, hyperreflexia, reflexive bowel/bladder
