SCI Flashcards
relative and absolute stenosis
12 mm, 10 mm
anterior spinal artery provides blood to
anterior 2/3 of spinal cord, posterior spinal arteries arise from vertebral arteries and give to posterior 1/3.
artery of adamkiewicz
major blood supply to lumbar and sacral cord, T9-L3, major supply to the lower 2/3 of spinal cord
watershed area of spine
lower thoracic region, T4-6, clamping of aorta can affect this area
most common level of SCI
C5
Most common level of jumped facets
C5-6, surgery
Jefferson fx
C1 bust fx, usually stable fx, usually no SCI, fragmentation of all 4 bone areas, cervical bracing Halo
C2 fracture, odontoid fx, MOA of the fx and then the types of fx and their tx
Rapid decelration injury of neck, Type II most unstable req surgery, Type I tip of the dens, stable, type 3 base fx extending into C2 vert itself, Type 2 is fx at BASE of odontoid req surg
C2 fracture, odontoid fx, hangman fracture, MOA of the fx and then the types of fx and their tx
Rapid decelration injury of neck, Type II most unstable req surgery, Type I tip of the dens, stable, type 3 base fx extending into C2 vert itself, Type 2 is fx at BASE of odontoid req surg and is most common type of the three
Chance fx
extends from spinour process all the way through the bones and into the VB , due to trauma/falls
Chance fx “seatbelt fracture”
Thoraco lumbar fx usually T12, L1, L2; extends from spinous process all the way through the bones and into the VB , due to trauma/falls…..avoid flexionHighest
Particularly in the pediatric population, intra-abdominal injuries occur 50% of the time. (Chance fractures are associated with motor vehicle collisions. Intra-abdominal injuries are associated with lap belt use).
lateral CS tract
arms/legs
central cord pattern of weakness
UE>LE, distal > proximal weakness…cervical is center most, as we proceed more lateral its thoracic and lumbar and finally sacral…so first to return is lower ext function, then bladder function, then proximal uppper ext and distal upper ext.
Pudendal nerve
S2-4, voluntary contraction of external urethral sphincter (storage
Parasympathetic nerve, pelvic nerve
S2-3, parasymp, pee pelvic, activate Muscarinic ACh receptors in bladder wall which cause detrusor contraction (emptying (using ACh)
Hypogastric nerve
T11-L2, sympathetic, makes your bladder big as hippo, activates alpha 1 and beta 2 receptors to allow bladder storage (Norepinephrine) , alpha 1 in internal urethral sphincter causes contraction (storage), B2 in bladder wall causes relaxation of detrusor (storage)
cp,,pm area fpr fx in SCI osteoporotic patient
distal femur , usually no surgery just splint and let heal with ROM and WB after several weeks
Common area fpr fx in SCI osteoporotic patient
distal femur , usually no surgery just splint and let heal with ROM and WB after several weeks
anterior cord syndrome
impaired pinprick/temperature sensation, strength, coordination
anterior cord syndrome
impaired pinprick/temperature sensation, strength, coordination…light touch is preserved as well as proprioception and vibratory sense..often associated with flexion injuries and vascular insufficiency from occlusion of anterior spinal artery
fist and second most common causes of SCI
Motor vehicle accidents remain the most common cause of SCI. Falls are the next most common cause.
fist and second most common causes of SCI
Motor vehicle accidents remain the most common cause of SCI. Falls are the next most common cause. FOllowed by Violence/GSW and fourth leading cause is sports related
Highest level of SCI for ind bowel care
Tetraplegics at the C7 level can potentially be independent with all components of bowel care with the use of bathroom equipment
what happens to skin collagen below level of injury in SCI
Decreased type I collagen and increased type III collagen below the level of injury
Studies have shown there is a decrease in amino acid content in the activity of enzymes of collagen synthesis, and in the proportion of type 1 to type 3 collagen fibers. These changes may lead to diminished tensile strength of the skin, increased risk of mechanical injury, and impaired healing of pressure ulcers in the spinal cord injured population.
anticoag ppx in complicated vs uncomplicated complete SCI
8 weeks uncomplicated, 12 weeks complicated (lower limb fractures, a history of thrombosis, cancer, heart failure, obesity or age over 70). Patients with AIS C SCI should receive chemoprohylaxis for up to 8 weeks, and those with ASI D injuries should receive chemoprohylaxis while remaining in the hospital.
C6 tetra dressing abilities
mod I upper ext dressing , some assist to total assist for lower ext dressing
HO onset
1-4 months
Positions for MMT upper ext and hip flexors
At C7 shoulder is neutral rotation, abducted and in 90 degrees of forward flexion with elbow in 45 degrees of flexion. L2: hip is flexed to 90 degrees. C5: elbow flexed at 90 degrees, arm at the patient’s side and forearm supinated. C6: wrist is full extension.