Musculoskeletal Consequences of SCI (exam 2) Flashcards
Mechanisms of bone loss
Imbalance of formation and resorption
Loss of leading and normal pull of muscles
Kidney resorbs and excretes large amount of CA in blood
When does the decline in bone production happen?
Rapid decline in first two years
Greatest loss in first 6 months
Chronic and slow loss after
How does the bone change?
Cortical thinning and decreased trabecular bone
What bone is not impacted or only minimally impacted?
Spine!
Most common fracture site?
Distal femur and proximal tibia
When do most fractures occur?
During non traumatic events
Name at least 3 complications of fractures
Pressure ulcers
Altered position in WC
Respiratory illness
UTI
AD
Spasticity
Delirium
Mortality
Decreased functional mobility and independence
Muscle complications/cascade after an SCI
Neuromuscular junction degeneration
Fat deposition (smaller muscle)
Protein degradation
Macrophage type 2 becomes type 1
Insulin resistance
Muscle fibers become more fast twitch
Muscle cells apoptosis
Why is the switch from slow twitch to fast twitch fibers not ideal?
Muscle gets faster (and smaller) but also fatigues faster
What is the direct result from a reduced amount of anabolic hormones?
Muscle atrophy followed by reduced energy expenditure
What happens when we get more energy in than we’re putting out?
Increased adiposity!
Intramuscular adipose doubles
Increase in visual adipose tissue
How do determine if someone is obese after an SCI
Fat mass over 20% (impacts 66% of chronic SCI patients)
BMI and waist circumference under estimate obesity
What does obesity increase the risk of?
Hyperglycemia
Dyslipidemia (high cholesterol)
Diabetes (50% of the population)
What are the components of metabolic syndrome and what can it lead too?
Hyperglycemia
Dyslipidemia
Abdominal obesity
Hypertension
Can lead to cardiovascular disease
What is the primary cause of death in chronic SCI patients?
Cardiovascular disease
