Multiple Sclerosis Flashcards
What is the definition of a spinal cord injury?
A disruption to the spinal cord
(usually due to trauma)
A cauda equina injury is a disruption to the nerve roots that lie with in the spinal column
What are congenital causes of spinal cord injury?
Spina bifida
Birth trauma
spinal muscular atrophy
congenital spinal anomaly
What are acquired causes of spinal cord injury?
Trauma - Vehicles, falls etc. Infection - bacterial Inflammatory Metabolic Degenerative Vascular - arterial, venous Tumour - benign, malignant
What type of paralysis can a cervical lesion (C1-T1) cause?
Tetraplegia - loss of all 4 limbs
What type of paralysis can a thoracic lesion (T2-L5) cause?
Paraplegia - loss of legs
What is the AISA impairment scale and what does it mean?
A (Complete) - No motor or sensory function is preserved
B (Incomplete) - Sensory but not motor function is preserved
C (Incomplete) - Motor function preserved and more than half of key muscles have muscle grade less than 3
D (Incomplete) - Motor function preserved and at least half of key muscles have muscle grade less than 3
What are the descending motor tracts?
Lateral corticospinal
Anterior corticospinal
What are the ascending motor tracts?
Dorsal columns
Anterolateral spinothalamic
Spinocerebellar
What are excessive vagal stimulation?
lesions ABOVE T6
stimulation of the right vagus nerve
Loss of parasympathetic control
Overwhelming vagal output - Bradycardia, Asystole
Prevent with atropine prior to intubation, suctioning
What is autonomic dysreflexia?
lesions ABOVE T6
syndrome causing acute, uncontrolled hypertension
Before it occurs there are symptoms such as:
Bladder distension, constipation
Skin, soft tissue, bony injuries
Symptoms include:
headache, hypertension, facial flushing
What is the management of acute spinal cord injury?
Bed rest/positioning/skull traction Prevent further damage to spinal cord Skin care Bladder and bowel care Prevention of thromboembolic and GI complications
What are the chronic complications that can occur after spinal injury?
Progressive neurological decline:
Syringomyelia - longitudinal cavities form in the cervical region of the spinal cord
Pain and spasticity
Rheumatological complications:
Degenerative joint disease
Hetertopic ossification - presence of bone in soft tissue where bone normally does not exist
What is optic neuritis?
Inflammation of the optic nerve
Causes pain and loss of vision
Frequently not visible (retrobulbar)
What is the treatment for optic neuritis?
High dose steroids speed up rate of recovery but have no effect on final acuity
What is transerve myelitis?
Inflammation inside the spinal chord Often mild with good prognosis Often pure sensory Lhermittes phenomenon - electrical sensation that runs down the back and into the limbs May affect bladder
