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Neuro > SCI > Flashcards

SCI Flashcards

1
Q

SCI is more prevalent in (males/females)

A

males (80%)

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2
Q

What age range does SCI most commonly occur?

A

16-30 y/o

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3
Q

definition: damage due to impingement by bony or soft tissue structures in the vertebral column

A

vertebral injury

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4
Q

(true/false) non-penetrating injuries can still penetrate blood vessels.

A

true

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5
Q

(true/false) the spinal cord has to be severed for irreversible damage

A

FALSE

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6
Q

(true/false) Trauma that results in bruising or hemorrhaging of the spinal cord can often cause neurological damage that is just as complete as a severed cord.

A

true

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7
Q

definition: neuronal damage to cell bodies and axons

A

primary injury

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8
Q

Where does most damage occur? Primary or secondary injury?

A

secondary injury

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9
Q

definition: injury/damage that may last from several days to 4 weeks- ______ damage is most prevalent in the gray matter and then spreads outward into the white matter as time passes.

A

secondary injury

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10
Q

What are the underlying mechanisms of secondary damage?

A

Ischemia (injury to BV)

inflammation (contributes to expansion of the lesion)

ion derangement (abnormal sodium and potassium levels)

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11
Q

definition: programmed cell death

A

apoptosis

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12
Q

When does apoptosis occur with trauma? How long does it occur?

A

4-6 hours after trauma

  • occurs for 24 hours at the level of injury
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13
Q

Apoptosis occurs after (cns/pns) injury

A

CNS injury

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14
Q

How long can apoptosis occur for if the site of injury is rostral or caudal?

A

up to 3 weeks

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15
Q

definition: spinal reflexes, voluntary motor and sensory function is absent or depressed after injury

A

spinal shock

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16
Q

Spinal shock occurs (caudal/rostral) to the lesion

A

caudal

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17
Q

What are the 2 predictors of motor return?

A
  1. degree of impairment
  2. preserved motor function
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18
Q

(true/false) It is possible to predict motor return within the 24 hours after the injury.

A

FALSE (wait 72 hours to 1 week)

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19
Q

definition:
- Axonal sprouting

Alterations of neuronal function:
- Unmasking of latent pathways
- Changes in conductive velocity
- Responsiveness to neurotransmitters

A

plasticity

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20
Q

definition: plasticity in response to afferent input

“use it or lose it”

  • task specific
A

Activity dependent plasticity

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21
Q

Tetraplegia is damage to the nervous tissue in the ___ region of the spinal cord.

A

cervical

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22
Q

definition: Refers to impairment or loss of motor and/or sensory function in the UE AND LE, trunk, and pelvic organs

A

tetraplegia

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23
Q

Paraplegia is damage to nervous tissue in the _____ regions of the spinal cord.

A

Thoracic, lumbar, or sacral

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24
Q

With paraplegia, Motor and sensory function is normal in the (UE/LE).

A

UE

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25
Q

definition: Most caudal level of the SC that exhibits intact sensory and motor function bilaterally

A

neurologic level of injury

26
Q

definition: Lesion where some sensory and/or motor function is preserved below the level of the lesion

*includes preserved function in the lowest sacral segments of the spinal cord (S4, S5) *

A

incomplete lesion

27
Q

definition: lesion where both sensory and motor function are absent in S4 and S5

A

complete lesion

28
Q

definition: Refers to partial preservation (or sparing) of function in dermatomes and myotomes caudal to the neurological level

A

zone of partial preservation

29
Q

Central cord syndrome is almost always in the ____ region.

A

cervical

30
Q

Central cord syndrome has more pronounced weakness in the (UE/LE)

A

UE

31
Q

(true/false) central cord syndrome spares sensation in the sacral region.

A

true

32
Q

definition: Results from damage to central aspect of the spinal cord

A

central cord syndrome

33
Q

(true/false) peripheral aspects are NOT spared when a patient has central cord syndrome.

A

FALSE

34
Q

definition: When one side of the spinal cord is damaged

A

brown-séquard syndrome

35
Q

Brown- séquard syndrome is common for (incomplete/complete) lesions.

A

incomplete

36
Q

definition:
- Preserved proprioception

Variable loss of:
- Motor function
- Pain
- Temperature

Results from damage to the anterior and anterolateral areas of the spinal cord

A

anterior cord syndrome

37
Q

definition: Results from damage to the sacral cord and lumbar nerve roots

A

conus medullaris syndrome

38
Q

Patients with conus medullaris syndrome mostly exhibit flaccid paralysis of the (UE/LE) along with areflexic bowel and bladder function

A

LE

39
Q

definition:Results from injury to the cauda equina, lumbar and sacral nerve roots

  • Exhibit flaccid paralysis of the LE
  • Areflexic bowel and bladder
  • Pattern may vary depending on where the damage occurs
A

cauda equina syndrome

40
Q

What is the best diagnostic test to look at spinal cord compression and changes in spinal cord tissue?

A

MRI

41
Q

What are surgical indications for Fx?

A
  • Unstable fracture that will not reduce without surgery
  • Gross spinal misalignment
  • Evidence of continued cord compression with an incomplete injury
  • Deteriorating neurological status
  • Continued instability following conservative management
42
Q

The spine is often fused with bone grafts from where?

A

iliac crest
fibula
spinous processes

43
Q

What cervical spinal orthoses are most effective for preventing cervical motion?

A

Halo and Minerva

44
Q

Autonomic dyslexia often occurs in lesions above ___.

A

T6

45
Q

Autonomic dysreflexia often occurs ___ months or more after initial injury.

A

6 months or more

46
Q

What are s/s of autonomic dysreflexia?

A
  • Elevated BP
  • Bradycardia
  • pounding HA
  • Sweating above the lesion
  • Vasodilation above the lesion
47
Q

What should you do if you identify s/s of autonomic dysreflexia?

A
  1. Place patient in upright position with legs dependent
  2. Remove source of problem
48
Q

definition: elevation of the umbilicus when abdominal contraction occurs.

A

Beevor’s sign

49
Q

Beevor’s sign is common with _____ segmental lesions.

A

T5-T12 lesions

50
Q

(true/false) With SCI, both men and women have an equal change of becoming infertile.

A

FALSE (men have a higher possibility of becoming infertile)

51
Q

Soon after SCI, ___ can occur due to peripheral vasodilation.

A

hypothermia (can be replaced by the tendency to move toward hyperthermia)

52
Q

Performance-based measure designed to objectively evaluate manual wheelchair skills and safety

Multiple versions of this measure
- manual chairs
- powered chairs
- scooters
- both wheelchair users and their caregivers

–may be administered by a tester/trainer that supervises and scores the test or in self-report/questionnaire form (WST-Q)

A

Wheelchair skills test (WST)

53
Q

What levels do NOT have myotomes or dermatomes?

A

C1-C4
T2-L1
S2-S5

54
Q

For the ASIA scale, intact innervation is considered when the patient exhibits what?

A

3/5 or more strength
AND
The next rostral key muscle exhibits 5/5 strength

55
Q
  • a clinician-administered, self-report and performance-based SCI-specific ambulation measure focusing on gait abnormalities

Areas measured consist of:
- gait parameters, assistive device use, and walking mobility

only applies to SCI individuals who CAN ambulate independently

A

The Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI)

56
Q
  • Functional capacity scale designed to measure improvements in ambulation in persons with SCI
  • Evaluates the amount of physical assistance, braces or devices required to walk 10 meters
  • A score is possible even if the individual cannot walk 10m because the furthest walk distance is 10m, it may not be suitable for individuals with minor impairments
A

Walking Index for Spinal Cord Injury II (WISCII)

57
Q
  • A 2-component self-report measure of the frequency of reported muscle spasms, which is commonly used to quantify spasticity.
  • was developed to augment clinical ratings of spasticity and provide a more comprehensive understanding of an individual’s spasticity status
  • self-report measures of spasticity, in general, correlate only moderately with clinical examination
A

Penn Spasm Frequency Scale (PSFS)

58
Q

ASIA score ___: patient has a complete impairment with no motor or sensory function

A

ASIA A

59
Q

ASIA score ___: patient only has sensation

A

ASIA B

60
Q

ASIA score ___: patient has minimal motor function below the lesion along with sensation

A

ASIA C

61
Q

ASIA score ___: patient has a high degree of functional potential

A

ASIA D and E

Neuro (45 decks)

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