SC lesions/injury Flashcards
Outcome for C3 complete SCI
Transfers: Total dependence. W/C powered with breath
Key movements: Mouth, face, head. (talking, sipping, chewing, blowing) Ventilator required.
Outcome for C4 complete SCI
Transfers: Total dependence. W/C powered with moith or chin. Key movements: Scap elevation, respiration. Traps & deltoid
Outcome for C5 complete SCI
Transfers: Can assist with transfers. W/C with hand controls. Key movements: Elbow flx, Sh. ER, Sh. Abd to 90. Biceps & deltoid.
Outcome for C6 complete SCI
Transfers: Independent with slide board. W/C (I) with wheel projections, likely to still use power w/c. Key movements: Sh. flx, wrist ext, Tenodesis grasp, bed mob with rails, (I) with pressure relief. Pec major, Ext. Carpi Radialis, Teres major.
Outcome for C7 complete SCI
Transfers/Mob: (I) transfers, (I) w/c propulsion, (I) living possible. Key movements: Elbow ext, wrist flx, finger ext. Triceps, lats, extrinsic finger extensors, flexor carpi radialis.
Outcome for C8-T1 complete SCI
Transfers/Mob: (I) with transfers & w/c. Key movements: Full innervation of UE. Intrinsic & extrinsic muscles of hand, flexor carpi ulnaris.
Outcome for T1-T8 complete SCI
Mobility: T6-T8 physiological standing with orthoses in parallel bars. Fair trunk control. Top half of intercostals.
Outcome for T9-T12 complete SCI
Mobility: Household ambulation with KAFOs and assistive device, (I) with household ADLs. Good trunk control. Abdominals innervated.
Outcome for T12 complete SCI
Mobility: Community ambulation with bilateral KAFOs and assistive device. W/C still may be used for primary mobility due to no hip flexor function.
Outcome for L1-L2 complete SCI
Mobility: (I) with community ambulation using KAFOs and assistive device. May still use w/c as primary mobility. Key movements: Hip hiking, weak hip flexion. Quadratus lumborum, illiopsoas and sartorious.
Outcome for L3-L5 complete SCI
Mobility: Ambulation with AFOs and canes possible. May continue to use w/c for efficiency. Key movements: hip flexion, knee ext. L3-L4 strong illiopsoas, L4-L5 strong quads, medial hamstrings.
Outcome for S1-S2 complete SCI
Mobility: May ambulate with articulated AFOs. Key movements: plantar flexion, hip extension. Plantar flexors and hip extensors.
What to know about Autonomic dysreflexia
Can occur with SCI at or above T6. Caused by noxious stimulus below the level i.e. full bladder, occluded urinary catheter, extreme temperature change. Symptoms: High BP, blurred vision, vaso dilation above level of injury and goosebumps below. Lying a pt down is contraindicated!!!
Cauda equina injury
Injury that occurs below below L1 of the spine. Considered LMNL.
Spinal Shock
A physiological response that occurs 30-60 minutes after trauma to the SC, presenting with total flaccid paralysis and loss of reflexes below the level of injury. Can last several weeks.
Anterior cord syndrome
Incomplete lesion. MOI: Cervical flexion, compression and damage to the anterior part of the SC or anterior spinal artery. Loss of motor, pain, and temperature sense below the lesion.
Central cord syndrome
Incomplete lesion. MOI: Cervical hyperextension resulting in compression and damage to the central portions of the SC. UE motor deficits > LE. Motor loss > sensory loss.
Posterior cord syndrome
Relatively rare incomplete lesion. MOI: Caused by compression to the posterior spinal artery. Los of pain, perception, proprioception, and 2-point discrimination & stereognosis. Motor function preserved.
What level SCI would have adequate muscle control to drive an adapted van?
C6
What is Brown-Sequard’s syndrome?
Incomplete lesion typically from a stab wound causing a hemisection of the spinal cord. Ipsilateral loss of vibratory & proprioception, contralateral loss of pain and temperature sense.
Typical level for a lumbar puncture (spinal tap)?
Below level of L2, typically between L3 & L4 vertebrae
