SCI Flashcards
how many pairs of spinal nerves
31
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
causes of SCI
trauma
infection
benign, malign tumor
vascular disorder
syringeoma
spinal cord filled with spinal fluid
spinal shock
loss of sensory, motor, sympathetic autonomic function due to loss of facilitation from tonic pattern
UMNL
lesion of spinal cord
cortical control is lost below lesion
LMNL
lesion of cauda equina and peripheral nerve roots
flaccid paralysis
tetraplegia/quadriplegia
lesions above T1
also known as incomplete tetraplegia
paraplegia
lesion below T1
lesion of cauda equina and conus medullaris
Brown Sequard syndrome
-lateral half of spinal cord is injured
-loss of ipsilateral motor vibration and proprioception
-contralateral pain and heat sensation
- stab wounds and cervical hyperextension
central cord syndrome
-central part of spinal cord is injured
-often in cervical region
-sacral sensation is preserved
-may be bladder dysfunction
cauda equina syndrome
-lesion under L1-L2
-lumbosacral lesion
-there is areflex bladder and flaccid paralysis of intestine and lower extremities
-motor fibers affected
-sensation preserved
-reflexes do not return
corticospinal tract
descending motor tract
motor loss same side of the tract
spinothalamic tract
ascending sensory ganglia
loss of heat and pain on opposite side
loss start two level lower
cross
dorsal column damage
doesn’t cross
carry deep sensation and vibration
anterior cord syndrome
damage to corticospinal and spinothalamic tract
posterior cord syndrome
impaired coordination of limb movements
factors determining functional outcome
neurological level
complete-incomplete injury
other medical problems
age-cardiovascular endurance
motivation
c2-3
fully dependent
c4
diaphragm preserved, wheelchair control by head and chin
c5
can use hand controlled wheelchair
c6
can use toilet with special handle
c7
independent in transfer- cannot go up and down the ramp
c8-T1
independent,bowel,bladder
T2-T10
exercise ambulation
T11-L2
in home ambulation
L3-S3
can be ambulated with orthotics
-ve effects of immobilization
musculoskeletal system
cardiovascular system and lungs
genitourinary and gastrointestinal
metabolic and endocrine
cognitive and behavioral
when is ASIA scale used
right-left sensory scoring
complete or incomplete lesion
neurological level
motor and sensation are normal
motor level
upper segment is normal
motor score
100
sensory level
most caudal level, needle and light touch are normal
sensory score
112+112
skeletal level
the most damaged vertebra and radiological examination
complete lesion
sensory and motor loss in the lowest sacral segment
incomplete lesion
preservation of sensation and/lesion below lesion
partial protection area
incomplete injuries, it shows partial innervated dermatomes and/myotomes
asia scale
A] complete=no sense or motor in sacral segments [4-5]
B] sensory incomplete= sense that extends to sacral region
C] motor incomplete=motor force below 3
D] motor incomplete=more than 3 motor forces
E] normal
SCI disability evaluation scales
-fundamental independent measurement
-SCI measurement
-walk index for SCI
-quadriplegia index for function
-modified Barthel index
mobilizations
tilt table
in bed activities
transfer
cushion exercises
ambulation
how does flexor contracture occurs
develops due to increase in flexor reflex activity after SCI but prone position can help
partial spinal cord injuries
central cord syndrome [ccs]
anterior cord syndrome [acs]
brown Sequard syndrome [bss]
conus medullaris [cms]
cauda equina syndrome [ced]
CCS
cervical region
more upper limb weakness
ACS
altered motor function pain and heat loss
BSS
semi-incision and lesion of spinal cord
ipsilateral weakness
contralateral pain and heat loss
CMS
conus medularis
injury to sacral cord and lumbar nerves
