GMED3009- Spinal cord injury

Question 1

Definition of SCI

Answer 1

loss of function such as mobility or feeling

Question 2

Definition Quadriplegia

Answer 2

dysfunction of arms, legs, bowel & bladder due to spinal cord injury in the cervical region

Question 3

Definition Paraplegia

Answer 3

dysfunction of lower body, bowel & bladder due to spinal cord injury in the thoracic, lumbar or sacral region

Question 4

Definition Spinal shock

Answer 4

Temporary areflexic state with loss of autonomic control that lasts up to six weeks post injury. Usually occurs in spinal cord injury to cervical & upper thoracic spinal cord. Functional recovery may improve after spinal shock resolves

Question 5

Definition of Neurogenic shock

Answer 5

hemodynamic triad of hypotension, bradycardia, and peripheral vasodilation resulting from severe autonomic dysfunction and the interruption of sympathetic nervous system control in acute spinal cord injury

Question 6

What are the forces relating to SCI

Answer 6

• Hyperflexion – Forcible forward bending, may compress vertebral bodies and disrupt ligaments and intervertebral discs
  = cervical spine ruptures the posterior ligaments
• Hyperextension -Forcible backward bending, disrupts ligaments and causes vertebral fractures and stretching of the cord = cervical spine ruptures the anterior ligaments
• Axial loading/compression – A form of compression, is the application of vertical force to the spinal cold column e,g falling and landing on the feet or buttocks or by diving into shallow water=cervical spine ruptures the anterior ligaments
• Excessive rotation of the head may tear ligaments and cause compression fractures=in tearing of ligamentous structures that normally stabilise the spine.

Question 7

Primary Injury

Answer 7

time of the traumatic insult
-causes microscopic haemorrhage in the grey matter of the cord and oedema of the white matter of the cord.

Question 8

Secondary Injury

Answer 8

occurs over hours to days as a result of a complex inflammatory

Question 9

Signs and Symtpoms of acute SCI

Answer 9

• Flaccid paralysis below level of injury
• Loss of spinal reflexes below level of injury
• Loss of sensation (pain, touch, proprioception, temperature) below level of injury
• Loss of sweating below level of injury
• Loss of sphincter tone and bowel & bladder dysfunction

Question 10

What are the three classifications of SCI?

Answer 10

1) complete or incomplete cord injury
2) cause of injury
3) level of injury

Question 11

Define autonomic dysflexia

Answer 11

Life threatening complication that may occur. Usually occurs in injuries at or above T6. Is a massive sympathetic response to a noxious stimulus (such as full bladder, line insertion, faecal impaction, ingrown toe nail,) results in bradycardia, hypertension and facial flushing, The stimuli is unable to ascend down the cord, mass reflex stimulation of the sympathetic nerves below the level of injury triggers a massive vasoconstriction .In response the vagus nerve causes bradycardia and vasodilation above the level of injury Immediate intervention needed to prevent seizure, cerebral hemorrhage or acute pulmonary oedema. Treatment involves alleviating the noxious stimuli.