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NPTE - Neuro > Pathology III - PPT for SCI FUNCTIONAL OUTCOMES > Flashcards

Pathology III - PPT for SCI FUNCTIONAL OUTCOMES Flashcards

1
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with no neural tissue protruding?

A

Occulta

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2
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with neural tissue/mininges protruding outside the neural arch?

A

Meningocele

SPINAL CORD IS not protruding like in myelomenigocele

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3
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with both meninges and SPINAL CORD protruding outside the neural arch?

A

Myelomeningocele

SPINAL CORD ITSELF IS PROTRUDING

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4
Q

Low levels of what is thought to contribute to the devleopment of spina bifida?

A

folic acid

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5
Q

In what percent of cases of myelomenigocele is a shunt required for hydrocephalus?

A

90%

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6
Q

What are 3 orthopedic conditions associated with spina bifida?

A
  1. scolosis
  2. hip dysplasia
  3. clubfoot
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7
Q

What condition is characterized by a failed closure of the cranial end of the neural tube in which most are born stillborn or die shortly after birth?

A

Anencephaly

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8
Q

What are the expected deficits with Brown-Sequard’s Syndrome?

A

Paralysis and loss of vibration/proprioception on the same side

Contralateral loss of pain and temperature

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9
Q

An injury occuring below what spinal level is considered a cauda equina injury?

A

L1

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10
Q

What are three characteristics of cauda equina injuries?

A

CONSIDERED A PERIPHERAL NERVE INJURY

  1. Flaccidity
  2. Areflexia
  3. Impairment of bowel and bladder funciton
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11
Q

What 3 things are lost with Posterior Cord syndrome and what is preserved?

A
  1. loss of proprioception
  2. Loss of two-point discrimination
  3. loss of sterognosis ( the ability to perceive and recognize the form of an object in the absence of visual and auditory information)

MOTOR FUNCTION IS PRESERVED

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12
Q

What is another name for heterotopic ossification whihc is a common complication of SCI?

A

Ectopic bone

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13
Q

Heterotopic ossification typicaly invovles pharmacological intervention with what drug?

A

Diphosphates

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14
Q

Autonomic dysreflexia can occur at what level?

A

T6 and above

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15
Q

How often should someone with an SCI change position? and how often should they weight shift in sitting?

A

Change position every 2 hours

Weight shift in sitting every 15-20 minutes

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16
Q

What 3 drugs are commonly used to treat spasticity after SCI?

A

Dantrium, Lioresal, and Baclofen

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17
Q

What is a surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function?

A

Myelotomy

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18
Q

What is a surgical procedure that involves removal of a segment of a nerve in order to decrease spasticity and improve function?

A

Neurectomy

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19
Q

What is a bladder that is flaccid as a result of cauda equina or conus medullaris lesion and the sacral reflex arc is damaged?

A

Neurogenic nonreflexive bladder

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20
Q

What is a bladder that empties reflexively for a patient with an injury above the level of T12 and the sacral reflex remains intact?

A

Neurogenic reflexive bladder

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21
Q

What is paradoxical breathing?

A

an abnormal form of breathing that is common in tetraplegia where the abdomen rises and the chest is pull inward during inspiration. With expriation the abdomen falls and the chest expands

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22
Q

What is the term for an incomplete lesion where some of the innermost tracts remain innervated?

A

Sacral sparing

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23
Q

What is a physiologic response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks presenting with total flaccid paralysis and loss of all reflexes below level of injury?

A

Spinal shock

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24
Q

What is a surgical release of a tendon in order to decrease spasticity and improve function?

A

Tenotomy

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25
Q

What is the zone of preservation?

A

a term used to describe poor or trace motor or sensory funciton for up to three levels below the neurologic level of injury

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26
Q

After a C7 complete tetraplegia injury what is the most distal segment of the spinal cord that both motor and sensory components remain intact?

A

C7

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27
Q

What are cardiopulm considerations with a C7 spinal cord injury?

A

impaired cough and ability to clear secretions, altered breathing pattern and poor endurance

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28
Q

If the removal of noxious stimuli does not occur quickly with autonomic dysreflexia what is the patient at risk for?

A

subarachnoid hemmorage

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29
Q

What 3 drugs are started immediately after SCI?

A

methylprednisolone (corticosteroid)
Lipid peroxidation inhibitors
opiate receptor blockers

30
Q

With C7 tetraplegia what is the expected functional outcome for feeding, grooming, and dressing?

A

indepent

31
Q

C7 function with self-ROM, WC mobility, and driving?

A

independent with all with adaptive equpiment

32
Q

Patients with complete L3 paraplegia will have at least partial innervation of what 5 lumbar/lower extremity muscles?

A
  1. Gracilis
  2. iliopsoas
  3. quadratus lumborum
  4. rectus femoris
  5. sartorious
33
Q

What type of bladder dysfunction is expected with a complete L3 paraplegia?

A

nonreflexive bladder

34
Q

Is cauda equina syndrome a central or peripheral nerve injury?

A

peripheral

35
Q

What is the term for the end of the spinal cord and what is beyond that?

A

Spinal cord ends at L1 with the CONUS MEDULLARIS

The cauda equiina extends beyond this with paired lower lumbar, sacral, and coccygeal nerve roots

36
Q

Why are nerves of the cauda equina more susceptible to damage?

A

these nerve roots have poorly developed protective epineurium and the tendency to form edema even with mild injury

37
Q

What is the function of the cauda equina with bowel/bladder?

A

parasympathetic innervation to the bowel and bladder adn voluntary control over the associated sphincters

38
Q

What are sources of compression of cauda equina nerve roots?

A

Spinal struture pathology (disk, fracture stenosis), trauma, infectious disease, tumor

39
Q

What is one symptom of cauda equina syndrome that can mimic other conditions?

A

severe bakc pain

40
Q

What condition is characterized by progressive degeneration of the anterior horn cell due to an autosomal recessive genetic inheritance?

A

Spina Muscular Atrophy (SMA)

41
Q

What are the 3 categories of Spinal Muscular Atrophy(SMA)?When do they occur?

A

Acute Infantile SMA - birth and two months. <1 year life expectancy

Chronic Childhood SMA - presents after 6 months - 1 year. Can survive into adulthood

Juvenile SMA - occurs 4-17 years old. Typically survive into adulthood

42
Q

What are characteristics of SMA?

A

progressive muscle weakness and atrophy, diminished or absent DTRs, intact sensation, and normal intelligence

43
Q

Nerve injury with throacic outlet syndrome can result in neuropraxia and progress to?

A

Axonotmesis

44
Q

with TOS diffuse pain in the arm is often experienced most often when?

A

at night

45
Q

Why might individuals with TOS have difficulty sleeping?

A

due to excessive pillows or malpositioning of the arm

46
Q

What is the ratio of men to women with TOS?

A

women affected 2-3x more than men

47
Q

If a patients symptoms with TOS persist for how long is surgical intervention warranted?

A

persisting 3 to 4 months

48
Q

Hypoxia, drug overdoes, near drowing, and acceleration/deceleration injuries are examples of what type of brain injury?

A

Closed injury

49
Q

Hematoma, hypoxia, ischemia, increased intracranial pressure, and post-traumatic epilepsy can result in what after an initial brain injury?

A

secondary injury

50
Q

What is the difference between an epidural and subdural hematoma?

A

Epidural: between skull and dura matter
Subdural: due to venous rupture between the dura and arachnoid

51
Q

What is the term for a state of genreal unresponsiveness with arousal occuring from repeated stimuli?

A

Stupor (not a coma, cause wouldnt arouse)

52
Q

What is the term for a state of consciousness that is characterized by a state of sleep, reduced alterness to arousal , and delayed responses to stimuli?

A

Obtundity

53
Q

What is the term for a state of consciousness that is characterized by disorientation, confusion, agitation, and loudness?

A

delirium

54
Q

What is the term for a sate of consciousness that is characterized by quiet behavior, confusion, poor attentions, and delayed responses?

A

Clouding of consciousness

55
Q

What is the term for a state of altertness, awareness, orientation, and memory?

A

consciousness

56
Q

What are the names of the 8 levels of the RLA Levels of Cognitive Functioning?

A 
I. No response
II. Generalized response
III. Localized Response
IV. Confused - Agitated
V. Confused - Inappropriate
VI. Confused - Appropriate
VII. Automatic - Appropriate
VIII. Purposeful - Appropriate
57
Q

What are the possible grades of a concussion?

A

Grade I
Garde II
Grade III

58
Q

What defines the different grades of concussion?

A

Grade I: transient confusion lasting 15 minutes of less
Grade II: confusion lasts longer than 15 minutes and may have retrograde and anterograde amnesia
Grade III: any form of loss of consciousness, form of injury resulting from diffuse axonal injury.

59
Q

Bizzare and non-purposeful behavior along with often nonexistent selective attention characterizes which RLA Level of Cognitive Functioning?

A

IV. confused-agitated

pg. 304

60
Q

What stage of Cognitive Functioning is characterized by going through a daily routine automatically, frequently robot like and showing minimal to no confusion but judgement remains impaired?

A

VII. Automatic Appropriate

pg. 304

61
Q

What stage of Cognitive Functioning is characterized by ability to reponsed to simple commands consistently but with lack of external structure or increased complexity has non-purposeful random responses. Also is highly distractible and lacks the ability to focus attention on specific tasks?

A

V. Confused - Inappropriate

pg. 304

62
Q

What stage of Cognitive functioning do they show gaol directed behavior that is dependent on external input or direction?

A

VI. Confused - Appropriate

pg. 304

63
Q

What stage of Congnitive functioning do they recall and integrate past and recent events and are aware of and responsive to environment showing carryover for new leaning?

A

VIII. Purposeful - Appropriate

pg. 304

64
Q

What are the different ranges on the Glasgow Coma Scale and what are the 3 categories on the scale?
Possible range of scores?

A

range from 3 to 15

<8 Severe brain injury
9-12 moderate brain injury
13-15 mild injury

Eye Opening, Best Motor Response, and Verbal Response

65
Q

what is the inability to create new memory?

A

Anterograde memory

66
Q

What is the time between injury and wehn the patient is able to recall recent events?

A

Post-traumatic amnesia

67
Q

what is the inability to remember events prior to injury?

A

Retrograde amnesia

68
Q

What type of memory is usually the last to recover after a comatose state?

A

Anterograde memory

69
Q

What causes trigeminal neuralgia?

A

Abnormal pressure or irritation of the trigeminal nerve

70
Q

Is trigeminal neurogalia typically unilateral or bilateral?

A

unilateral

71
Q

with trigeminal nerualgia how are chronic vs. episodic symptoms described?

A

Chronic: persistent aching or burning sensations
Episodic: sharp, jolting, stabbing, or shock like

72
Q

What 3 things are the most common causes of vestibular disorders in younger inviduals?

A
  1. ear infection
  2. whiplash injury
  3. head injury

NPTE - Neuro (23 decks)

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