Lecture 4: Spinal Cord Injury Flashcards

1
Q

At what level does the spinal cord end?

A

L1-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What what spinal level os Conus Medullaris present?

A

~T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What what spinal level is Cauda Equina present?

A

L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the significance of knowing where Cauda Equina is?

A

This represents the change from UMN to LMN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the dorsal end of the spinal cord is known as?

A

Cauda Equina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What regions represent the UMN?

A
  1. Motor Cortex
  2. Internal Capsule
  3. Brainstem
  4. Spinal Cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What regions represent the LMN?

A
  1. Interneurons
  2. Anterior Horn Cell
  3. Peripheral Nerve
  4. Motor End Plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most important motor tract in the UMN?

A

Lateral Corticospinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where can the sensations of pain, temperature, and itch be found in the spinal cord?

A

Anterolateral system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where can the perception of proprioception be found in the spinal cord?

A

In the Gracile and Cunate Fasciles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The anterior horn cells are part of what system?
A. UMN
B. LMN
C. Both

A

B. LMN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the different types of Spinal cord Syndromes (8)

A
  1. Lateral Cord (Brown-Sequard)
  2. Compete Cord
  3. Central Cord
  4. Anterior Cord
  5. Posterior Cord
  6. Pure Motor
  7. Conus
  8. Cauda Equina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The spinal thalami tract can be found where in the Spinal Cord?

A

Anterior lateral aspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The Corticospinal tract can be found where in the spinal cord?

A

Posterior lateral aspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Loss of motor and sensation of the legs bilaterally will be classified as what?

A

Complete spinal cord lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If the contralateral side experiences loss of pain, temperature and itch, and the Ipsilateral side experiences loss of proprioception, what is true in this case?

A

DCML on the ipsilateral side will be impaired

ALS on the contralateral side will be impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the lateral corticospinal tract in the spinal cord?

A

Posterior lateral aspect of the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where are the anterior horn cells located in the spinal cord?

A

Anterior lateral aspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are of the spinal cord is responsible for vibration and position sense?

A

Posterior columns: Gracile and cunate fasciculus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the most common cases of spinal cord injuries?

A

MVA

Falls

Violence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who is affected more by spinal cord injuries, males or females?

A

Males 4:1 Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 4 different mechanisms of injury for a spinal cord injury?

A
  1. Impact w/persistent compression (burst fracture)
  2. Impact w/transient compression post hyper/injury
  3. Distraction: Forcible stretching of spinal cord or blood supply
  4. Laceration from miss LE injury, sharp bone fragment dislocation, or severe distraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When it comes to spinal cord injuries, what are the two types of injures classified as?

A
  1. Primary Injury

2. Secondary Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

With a primary spinal cord injury, what is the cause?

A
  1. Fracture
  2. Vascular disruption
  3. Axonal shearing/disruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

With secondary spinal cord injury, what is the course?

A
  1. Spine Trauma
  2. Inflammatory activation of microglia and astrocytes
  3. Chemoattraction of Neutrophils, macrophages, lymphocytes
  4. Release of Cytokines/Chemokines, RNS, ROS, Complete components, Proteases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

With primary and secondary spinal cord injuries, they both lead to …

A

=>Blood-Spinal cord barrier break-down

===>Spinal edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When someone experiences a spinal cord injury, what is the most critical component to consider during the acute stage?

A

Microenvironment is critical to prevent secondary injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Inflammation at the lesion site in the spinal cord is well-known, however less is known about what?

A

What level the inflammation is occurring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When a spinal cord injury, inflammation could occur up to how many segments away?

A

10 segments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most important aspect to reduce the effects of secondary spinal cord injury?

A

Reduce inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Inflammation in the spinal cord post injury can produce what? Specifically in the L/S region? (2)

A
  1. Maladaptive Neuroplasticity

2. No Motor Learning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Signs of UMN and LMN Lesions with respect to Spinal cord injury. Determine if UMN, LMN, or both are affected and how

Weakness

Atrophy

Fasciculations

Reflexes

Tone

A

Weakness: UMN & LMN

Atrophy: LMN
-UMN lesion may lead to atrophy from lack of muscle use
Fasciculations: LMN

Reflexes: Increased w/UMN; Decreased w/LMN
-w/acute UMN lesions, reflexes may be decreased

Tone: Increased with UMN; Decreased w/LMN
-w/acute UMN lesions, tone may be decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe the disease course of a Spinal cord injury

A
  1. Acute Onset

2. Progressive to stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the timeline for a Spinal Cord Injury

A
  1. Initial Traumatic Event
  2. Spinal Shock/Flaccid Paralysis, Loss of sensation, Loss of motor function
  3. Emergency response: Immobilization/Stabilization. Diagnose via MRI
  4. Stable: Possible UMN signs, Spasticity, Hyperreflexia
  5. Neurological return: Most recovery in 1 year. Most rapid recovery 1st 6 months, then slower pace up to 2 years.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the key diagnostic studies for determining a spinal cord injury?

(6)

A
  1. MRI (Gold Standard)
  2. X-Rays
  3. CT
  4. Somatosensory-Envoked Potentials
  5. EMG
  6. NCV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the standard medical care for a patient that presents with a SCI

A
  1. Immobilization: Halo TLSO (Avoid Prolonged Immobilization)
  2. Early Inervention: Closed Reduction, Spinal Decompression
  3. Corticosteroids: Early Methylprednisolone IV Bolus
  4. BP Management
  5. General Care
  6. Nutritional Support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

This drug, if given within 8 hours of injury, has been shown to have a significant effect on improvement with motor and sensation function within the first 6 months of therapy.

A

Corticosteroids: Early Methylprednisolone IV Bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the experimental medical management protocols for SCI?

A
  1. Therapeutic Hypothermia

2. Human Embryonic Stem Cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the mortality rate for someone with a SCI?

A

4-17%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the predisposing factors for a SCI?

A
  1. Age
  2. Higher levels
  3. Pulmonary Embolism
  4. Medical Co-Morbidities
  5. Suicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which SCI patients have the greatest potential for recovery?

A

Those who suffer from Brown-Sequard syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

With this SCI, the LE can recover, and bowel and bladder function is seen early

A

Central Cord Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the age cut off for faster, more successful recovery for SCI?

A

<50 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 7 issues in Rehab for patients who present with Spinal Cord Injuries?

A
  1. Bladder Dysfunction
  2. Bowel Dysfunction
  3. Decubitus Ulcers
  4. Autonomic Dysfunction
  5. Sexual Dysfunction
  6. Wheelchair Seating & Positioning
  7. Spasticity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

UMN lesions of the spinal cord are from what regions?

A

C1-L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

LMN lesions of the spinal cord are from what spinal levels?

A

L2-S5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

With respect to the bowels, UMN lesions (C1-L1) can cause…

A

Hyperreflexia (Spastic paralysis, reflex is intact)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

With respect to the bowels, a LMN lesion (L2-S5) can produce what effect?

A

Areflexia (flaccid paralysis)

-No Tone in the muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

With respect to the bladder, and UMN lesion (C1-L1) has what effect?

A

Spastic (Urinary bladder and sphincter are overactive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

With respect to the bladder, a LMN lesion (L2-S5) has what effect?

A

Areflexia (Detrusor is unable to contract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the symptoms associated with an UMN lesion in the spinal cord (C1-L1) for bowel and bladder?

A

Bowel: Constsipation, difficulty w/evacuation & Incontinence

Bladder: Increased frequency of urination/failure to store urine
-Inability to fully empty the bladder (Excessive spasms of the bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the symptoms associated with a LMN spinal cord lesion (L2-S5) on the bowel and bladder?

A

Bowel: Constipation, difficulty w/evacuation & Incontinence

Bladder: Retention/Failure to empty urine
-Possible damage to kidneys and bladder wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Clinical management of an UMN spinal cord lesion (C1-L1) for the bowels include… (5)

A
  1. Reflex defecation
  2. Stool Softener
  3. Laxative
  4. Suppository
  5. Rectal Stim
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Clinical management of the bladder with UMN lesion (C1-L1) includes…

A
  1. Catheterization
  2. Prevention of urinary tract complications
  3. Pharmacological management
55
Q

Clinical management of a spinal LMN lesion (L2-S5) includes what for the bowels?

A
  1. Stool Softener

2. Minimal Strain to void

56
Q

Clinical management of a spinal LMN lesion (L2-S5) includes what for the bladder?

A
  1. catheterization
  2. Prevention of urinary tract complications
  3. Pharmacological Management
57
Q

This is known as an exaggerated, massive autonomic response to noxious stimuli.

A

Autonomic Dysreflexia

58
Q

What are some causes for Autonomic Dysreflexia? (5)

A
  1. Constrictive clothing
  2. Tight shoes
  3. Kinked Catheters
  4. Bowel and bladder distention
  5. Ingrown Toe-nails
59
Q

Autonomic Dysreflexia is can described as a …

A

Loss of inhibitory control of sympathetic neurons

60
Q

For Autonomic Dysreflexia, the lesions are typically at what spinal level(s)?

A

T6 and above

61
Q

What are some common causes of Autonomic Dysreflexia?

A
  1. Bladder and Bowel Distention
  2. Ulcers
  3. Constrictive Clothing
  4. Ingrown Toenails
62
Q

How should one treat and individual who may be preventing with Autonomic Dysreflexia?

A
  1. Remove Noxious Stimulus
  2. Medical Emergency!
  3. Keep patient upright to reduce blood pressure
    - Do not place them in supine
  4. Reduce blood pressure which is likely to be elevated
63
Q

The sacral region of the parasympathetic nervous system is responsible for what autonomic functions?

A
  1. Reproductive organs
  2. Bladder
  3. Large Intestine (rectum)
64
Q

What are the sign and symptoms associated with Autonomic Dysreflexia? (10)

A
  1. Pounding headache (Caused by increased BP)
  2. Hypertension (BP > 200/100mmHg)
  3. Diaphoresis (Sweating) above the level of injury
  4. Red Blotches on the skin above level of spinal injury
  5. Goose Pimples
  6. Flushed (Red Face)
  7. Nausea
  8. Slow Pulse (<60bpm)
  9. Cold, clammy skin below level of spinal injury
  10. Nasal Congestion
65
Q

What system is essential to penile erections?

A

Autonomic nervous system

66
Q

What system initiates erectile response and what spinal levels contribute to this?

A
  1. Parasympathetic nervous system: Erectile response

2. Spinal level S2-S4

67
Q

This autonomic nervous system is essential for ejaculation. What spinal levels contribute to this?

A
  1. Sympathetic nervous system: Ejaculation

2. L1-L3

68
Q

What are the 3 most common issues with sexual dysfunction?

A
  1. erectile Dysfunction
  2. Ejaculation
  3. Fertility
69
Q

What are the 3 most common treatment options for Erectile Dysfunction?

A
  1. Surgical prosecutes (Penile Prosthesis)
  2. Vacuum Devices
  3. Pharmacology
70
Q

This is copied as “Velocity-Dependent increase in tonic stretch reflexes with passive movement”

A

Spasticity

71
Q

For a Spinal cord injury to be classified as an UMN lesion, where does the injury have to occur?

A

Above Cauda Equina (UMN Lesion)

72
Q

How long does it take for spasticity to be evident post spinal cord injury?

A

Initially absent immediately post acute injury

-Develops over weeks

73
Q

How should a PT manage a patient who presents, or may not yet present with spasticity?

A

Stretching to prevent contracture

74
Q

What medications are there available for Spasticity management?

A
  1. Baclofen
  2. Tizanidine
  3. Diazepam
  4. Dantrolene
  5. Clonodine
75
Q

Botox, Xeomin, phenol nerve blocks, and intrathecal baclofen pumps are used to treat what?

A

Spasticity

76
Q

For severe cases of spasticity, what medical treatment can be used to reduce pain and other related symptoms?

A

Intrathecal Baclofen Pump

-Can decrease pain and spasticity, but not very common. Only used in severe cases.

77
Q

When using the ASIA form, how do you determine sensory level loss?

A

The most caudal level normally innervated dermatome for both pin prick and light touch (grade 2)

-May Differ from right to left

78
Q

When using the ASIA form, how do you determine the motor neurological level effected?

A

The most caudal level, normal or intact innervated spinal nerve

-Must be a grade ≥3, provided the next most rostral key muscle tests are normal

79
Q

ASIA Impairment Scale

A = ?

A

Complete: No motor or sensory function is preserved in the sacral segments S4-S5

80
Q

ASIA Impairment Scale

B = ?

A

B = Incomplete: Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5

81
Q

ASIA Impairment Scale

C = ?

A

C = Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade of 3 or more.

82
Q

ASIA Impairment Scale

D = ?

A

D = Incomplete: Motor function is preserved below the neurological level, and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.

83
Q

ASIA Impairment Scale

E = ?

A

E = Normal: Motor and sensory function are normal

84
Q

What are the 6 Non-Traumatic disorders of the spinal cord?

A
  1. Syringomyelia
  2. Myelitis
  3. SC Infarction
  4. Spinal Epidural Abscess
  5. Spinal Epi/Subdural Hematoma
  6. Spina Bifida
85
Q

This is a fluid-filled gliosis-lined cavity

A

Syrungomyelia

86
Q

Syringomyelia is a fluid filed gliosis-lined cavity. It is an irregular cavity and disrupts ___________

A

Anterior horns of Grey Matter

87
Q

Syringomyelia is associated with …

A

Spinal column or Brainstem abnormalities

88
Q

Patients with Scoliosis, Klippel-Feil syndrone, and arnold chairs malformation are at risk for what SC non-traumatic injury?

A

Syringomyelia

89
Q

At what decade in the human life does someone experience Syringomyelia?

A

3rd or 4th decade

90
Q

What is the key diagnostic(s) study for determining if someone has syringomyelia?

A

MRI & CT Scane

91
Q

What is the general progression Syringomyelia?

A
  1. Long motor tracts affected

2. Sensory tracked affected

92
Q

What are the 4 signs and symptoms associated with Syringomyelia?

A
  1. Segmental Atrophy
  2. Loss of pain and temperature (ALS system)
  3. Areflexia (LMN)
  4. Proprioception Intact
93
Q

What are the conservative measures for someone who presents with Syringomyelia? (4)

A
  1. Avoid High-Force isometric contractions
  2. Avoid Valsalva Expiration
  3. Head Elevation at night
  4. Maintain neutral neck
94
Q

What are the 3 surgical interventions for Syringomyelia?

A
  1. Decompression
  2. Shunt Replacement
  3. Tumor resection & Radiation (Intra-Medullary Spinal cord tumors)
95
Q

This is a birth defect with incomplete closure of the spine and membranes

A

Spina Bifida

96
Q

What are the two types of Spina Bifida?

A

Spina Bifida Aperture

Spina Bifida Occulta

97
Q

This type of Spina bifida is visible or open

A

Spina Bifida Aperta

98
Q

This type of Spina Bifida is hidden or not visible

A

Spina Bifida Occulta

99
Q

What are the two sub-types of Spina Bifida Aperta?

A
  1. Myelomeningocele

2. Meningocele

100
Q

This type of Spina bifida is a clear bump on the individuals back with a visible lesion. the spinal cord and membranes are protruding out.

It is a visible open lesion

The extent of damage depends on where and how much the nerves are protruding out

A

Spina Bifida Aperta: Myelomeningocle

101
Q

This type of Spina bifida has the spinal cord protruding out away from the vertebral body towards the bump on the skin

A

Spina Bifida Aperta: myelomeningocle

102
Q

This type of spina bidifa just has the subarachnoid space protruding out towards the skin

A

Spina Bifida Aperta: Meningocele

103
Q

What is the most Mormon form of Spina Bifida?

A

Myelomeningocele

104
Q

This type of Spina Bifida has protrusions of the spinal meninges and spinal cord through a defect in the vertebral column

A

Myelomeningocele

105
Q

Spina Bifida Aperta is an OPEN SPINAL CORD DEFECT, which means it is ….

A

Not Skin Covered

106
Q

This type of Spina Bifida is associated with nerve paralysis, but not always

A

Spina Bifida Aperta

107
Q

What are the 3 clinical findings for Spina bifida Aperta: Myelomeningocele

A
  1. Multi-system involvement
    - Degree motor and/or sensory loss varies
    - Extrusion of neural tissue
    - Musculoskeletal deformities
  2. No two patients are clinically identical
  3. High risk for loss of function over time
108
Q

What are the surgical and medical managements for Spina Bifida Myelomeningocele? (4)

A
  1. Surgical closure of the Myelomeningocele
  2. Surgical correction of orthopedic deformities
  3. Placement of VP Shunt
  4. Medications for management of Bowel and Bladder function
109
Q

What is the prognosis of Spina Bifida Aperta: Myelomeningocele

(2)

A
  1. Despite surgery, affected nerves may not function normally.
  2. Higher the location of the defect on the baby’s back, the more nerves will be affected
110
Q

What is true of a child with Spina Bifida Aperta: Myelomeningocele with respect towards intelligence?

A
  1. Typically normal intelligence
111
Q

What are the two risks with respect to intelligence for a child with Spina Bifida Aperta: Myelomeningocele?

A
  1. Hydrocephalus

2. Meningitis

112
Q

Children with Spina Bifida Aperta: Myelomeningocele are prone to what two issues?

A
  1. Learning Disabilities

2. Seizure episodes

113
Q

Spinal cord issues with Spina Bifida Aperta can occur later in life. What are the 3 most common ones?

A
  1. Rapid growth during puberty
  2. Possible increase loss of function
  3. Orthopedic problems
    - Scoliosis, Foot or ankle deformities, dislocated hips, and joint tightness or contractures
114
Q

Where does the spinal cord end for UMN?

A

L1-L2 (UMN Ends)

115
Q

The (Blank) is a collection of nerve roots that begins at the end of the spinal cord and exits from the third lumbar vertebrae to the 5th sacral vertebra

A

Cauda Equina (LMN)

116
Q

Where does the LMN begin in the spinal cord?

A

Cauda Equina (L2-S5

117
Q

This is an exaggerated autonomic response to a noxious stimuli that is a medical emergency typically for SCI levels T6 and above.

A

Autonomic Dysreflexia

118
Q

What is the etiology of an UMN Lesion and what are the spinal levels associated with it?

A

Trauma

Spinal Level C1-L1 UMN

119
Q

What is the etiology of a LMN injury and what is its associated spinal cord level?

A

Trauma

L2-S5

120
Q

What is the etiology of Syringomyelia?

A

Non-Traumatic

121
Q

What is the etiology of Myelomeningocele?

A

Non-Traumatic

122
Q

What are the signs and symptoms associated with an UMN Lesion (C1-L1)? (4)

A
  1. Atrophy
  2. Weakness
  3. Hyperreflexia
  4. Spasticity
123
Q

What are the signs and symptoms associated with a LMN lesion in the spinal cord (L2-S5)? (3)

A
  1. Atrophy
  2. Weakness
  3. Areflexia
124
Q

Where are lesions typically in the spinal cord for one to experience spasticity?

A

UMN C1-L1

125
Q

What are the signs and symptoms associated with Syringomyelia (4)

A
  1. Segmental Atrophy
  2. Areflexia
  3. Pinprick impaired
  4. Vibration intact
126
Q

What are the signs and symptoms associated with Myelomeningocele? (3)

A
  1. Multisystem involvement
  2. Degree of motor and sensory loss
  3. Musculoskeletal deformities
127
Q

What are the Key Diagnostic tests for UMN/LMN lesions in the spinal cord, Syringomyelia, and Myelomeningocele?

What is the extra test for Myelomeningocele?

A

MRI and CT Scan

Myelomeningocele has the addition of an X-Ray

128
Q

What is the typical progression of an UMN/LMN lesion in the spinal cord?

A

varies expending on predictive factors

129
Q

What is the prognosis and progression of Syringomeyelia?

A

Varies depending on

  1. Classification
  2. Expansion
  3. Treatment
130
Q

What is the prognosis and progression of Myelomeningocele?

A
  1. Varies depending on
    A. Extend of damage
    B. Surgical Intervention
    C. Therapeutic Intervention
131
Q

What is the typical treatment plan for one who presents with a n UMN lesion (C1-L1)? (5-6)

A
  1. Immobilization
  2. Surgical Intervention
  3. Corticosteroids
  4. Neuro protective Strategies
  5. BP Management
  6. General Care
132
Q

What is the general treatment plan for someone who presents with a LMN lesion (L2-S5)? (5-6)

A
  1. Immobilization
  2. Surgical Intervention
  3. Corticosteroids
  4. Neuro protective strategies
  5. BP Management
  6. General Care
133
Q

What is the general treatment plan for someone who presents with Syringomyelia? (2)

A
  1. Conservative

2. Surgical Decompression

134
Q

What is the general treatment plan for someone who presents with Myelomeningocele? (4)

A
  1. Surgical closure of Myelomeningocele
  2. Surgical Correction of Orthopeadic Deformities
  3. Placement of VP Shunt
  4. Medications: Bowel and Bladder Management