S14 Spinal cord injury

Question 1

Differentiate between an UMN and a LMN.

Answer 1

UMN: brain, brainstem, spine, cerebellum.
LMN: anything that comes off the brainstem or spinal cord.

Question 2

What is the epidemiology of spinal cord injury?

Answer 2

4M : 1F
Bimodal age: 20’s - car crash
50’s - increased fall injuries

Question 3

4 congenital causes of spinal cord injury.

Answer 3

Birth trauma.
Spina bifida.
Congenital spinal anomaly.
Spinal muscular atrophy.

Question 4

Which levels of spinal cord injury cause tetraplegia vs paraplegia?

Answer 4

Tetra: C1 to T1
Para: T2 to L5

Question 5

What are stages in the AISA (spinal cord) impairment scale?

Answer 5

A: no motor/sensory S5 function
B: sensory, no motor below S5
C: motor preserved, more than 0.5 muscles below level have grade less than 3
D: more than 0.5 muscles below level have grade more than 3

Question 6

What is the acute complication after a spinal cord injury involving an NG tube?
How is this prevented?

Answer 6

Excessive vagal stimulation causes loss of parasympathetic output, leading to bradycardia and asystole.
Atropine prior to intubation.

Question 7

What is autonomic dysreflexia after a spinal cord injury?

Answer 7

Painful stimuli causes hypertension, headache, facial flushing and possible intracerebral haemorrhage.

Question 8

3 common acute complications after a spinal cord injury:

Answer 8

UTIs -> stones -> renal failure.
Respiratory infection -> failure.
Pressure sores -> osteomyelitis.

Question 9

5 chronic complications after a spinal cord injury:

Answer 9

Syringomyelia (SC cavities).
Neuronal "drop-out".
Pain and spasticity.
Degenerative joint disease.
Hetertopic ossification.