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SCI Flashcards

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1
Q

DCML Tract controls…

A

-Fine touch
-Proprio
-Vibration

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2
Q

2-pt Discrimination assesses what? Explain the procedure

A

DCML
Ability to discern whether 2 separate objects versus just one touching the skin

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3
Q

Sterognosis assesses what? Explain the procedure

A

DCML
Identify objects with eyes closed

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4
Q

Barognosis assesses what? Explain the procedure

A

DCML (pressure)
Put 2 objects in each hand, identify which is heavier

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5
Q

Graphesthesia assesses what? Explain the procedure

A

DCML
Like drawing on the back & have them guess

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6
Q

Anterior Spinothalamic Tract controls…

A

Crude touch

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7
Q

Crude touch vs fine touch

A

Crude = just yes or no
Fine = localizing where the touch is

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8
Q

Lateral Spinothalamic Tract controls…

A

Pain & temp

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9
Q

Corticospinal Tract controls…

A

Motor function

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10
Q

Posterior SCI Syndrome: MOI

A

Iatrogenic (medical error)

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11
Q

Posterior SCI Syndrome: tract(s) involved

A

DCML (usually bilateral)

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12
Q

Posterior SCI Syndrome: what is impaired

A

-Proprio
-Fine touch
-Vibration
Sxs on the same side (if unilateral)

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13
Q

Anterior SCI Syndrome: MOI

A

Hyperflexion

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14
Q

Anterior SCI Syndrome: tract(s) involved

A

Spinothalamic & Corticospinal (usually bilateral)

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15
Q

Anterior SCI Syndrome: what is impaired?

A

-Pain & temp (opp side if unilateral)
-Motor (same side if unilateral)

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16
Q

Brown Sequard Syndrome: MOI

A

Hemi-section (gunshot, stab)

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17
Q

Brown Sequard Syndrome: tract(s) involved

A

DCML
Spinothalamic
Corticospinal

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18
Q

Brown Sequard Syndrome: what is impaired?

A

Same side: sensory & motor
Opp side: pain & temp

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19
Q

Central SCI Syndrome: MOI

A

Hyperextension

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20
Q

Central SCI Syndrome (small lesion): tract(s) involved

A

Lateral spinothalamic

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21
Q

Central SCI Syndrome (large lesion): tract(s) involved

A

DCML
Lateral Spinothalamic
Anterior Spinothalamic
Corticospinal

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22
Q

Central SCI Syndrome (small lesion): what is impaired?

A

Pain & temp (bilateral)

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23
Q

Central SCI Syndrome (large lesion): what is impaired?

A

Partial loss of everything (bilateral).
UE motor more affected bc central part of corticospinal = UE.

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24
Q

Conus Medullaris vs Cauda Equina: location

A

Conus Medullaris: end of spinal cord (~L1)
Cauda Equina: horse tail, nerves extending down

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25
Conus Medullaris vs Cauda Equina: presents like
Conus Medullaris: UMN + LMN Cauda Equina: LMN
26
Conus Medullaris vs Cauda Equina: symmetry of sxs
Conus Medullaris: bilateral symmetric Cauda Equina: unilateral asymmetric
27
Conus Medullaris vs Cauda Equina: key symptoms
Both: saddle anesthesia, bowel/bladder
28
Conus Medullaris vs Cauda Equina: medical emergency?
Both = YES
29
Key differentiation between Complete vs Incomplete SCI
Complete: NO sensory or motor function at S4-S5 (perineal). Incomplete: "sacral sparing" - sensory and/or motor intact at S4-S5
30
ASIA Motor Level
Lowest level that has at least 3/5 bilaterally. Everything above is 5/5.
31
ASIA Sensory Level
Lowest level where both light touch & pinprick are 2/2 bilaterally. Everything above is 2/2.
32
How to determine NLI
Between motor & sensory levels, pick the one that is most superior. E.g., if sensory is C7 and motor is C8, NLI is C7.
33
ASIA motor grading scale
Same as MMT
34
ASIA sensory grading scale
0 = absent 1 = impaired 2 = normal
35
ASIA A definition
Complete SCI No motor/sensory at S4-S5
36
ASIA B definition
Incomplete SCI Sensory present below NLI
37
ASIA C definition
Incomplete SCI < half mm below NLI are >/=3
38
ASIA D definition
Incomplete SCI > half mm below NLI are >/=3
39
ASIA E definition
No SCI Normal
40
Common cardiac complications
Orthostatic hypotension Autonomic dysreflexia Respiratory dysfunction
41
Common non-cardiac complications
Urinary/bowel retention or incontinence Pressure ulcers Contractures Mm weakness Mm tone
42
Autonomic Dysreflexia: most often occurs under what circumstances
Injuries at/above T6 Typically Complete (ASIA A) Typically 3-6mo after injury
43
Autonomic Dysreflexia: cause
Noxious stimuli below level of lesion
44
Autonomic Dysreflexia: key dx criteria
SBP increase by 20-30mmHg
45
Autonomic Dysreflexia: common sxs
-Decreased HR -Severe HA -Constricted pupils, blurred vision -Increased spasticity -Confusion, anxiety -Flushing & piloerection above level of lesion -Dry, pale skin below level of lesion
46
Autonomic Dysreflexia: intervention
MED EMERGENCY! -Sit them up, lower the legs. -Remove painful stimuli (unclamp & drain catheter, loosen clothing, remove abdominal binder). -Monitor vitals (if no improvement, Rx management needed).
47
At what level of injury is respiratory function near-normal?
T11 and below
48
Bowel & bladder function is controlled by...
S2-S4
49
Reflexic Bladder: definition & where is the injury located?
AKA spastic or UMN bladder Injury above S2
50
Areflexic Bladder: definition & where is the injury located?
AKA Flaccid or LMN bladder Injury at/below S2
51
Reflexic Bladder: treatments
-Intermittent catheter -Suprapubic tapping
52
Areflexic Bladder: treatments
-Intermittent catheter -Valsalva maneuver -Crede's maneuver
53
CTSIB Conditions
1: EO, stable 2: EC, stable 3: Conflict, stable 4: EO, unstable 5: EC, unstable 6: Conflict, unstable
54
If a pt falls in CTSIB Condition 1, which systems are affected & which systems are they dependent on?
Affected: all 3 Dependent: none
55
If a pt falls in CTSIB Condition 2, which systems are affected & which systems are they dependent on?
Affected: somatosensory Dependent: vision
56
If a pt falls in CTSIB Condition 3, which systems are affected & which systems are they dependent on?
Affected: somatosensory Dependent: vision
57
If a pt falls in CTSIB Condition 4, which systems are affected & which systems are they dependent on?
Affected: vision Dependent: somatosensory
58
If a pt falls in CTSIB Condition 5, which systems are affected & which systems are they dependent on?
Affected: vestib Dependent: somatosensory & vision
59
If a pt falls in CTSIB Condition 6, which systems are affected & which systems are they dependent on?
Affected: vestib Dependent: somatosensory & vision
60
If a pt is dependent on VISION, which CTSIB conditions will be most unstable?
2, 3, 5, 6
61
If a pt is dependent on SOMATOSENSORY, which CTSIB conditions will be most unstable?
4, 5, 6
62
If a pt is dependent on VESTIBULAR, which CTSIB conditions will be most unstable?
5, 6

NPTE (28 decks)

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