SCI Flashcards
Damage to surrounding tissues/ blood vessels
Indirect SCI
Causes paralysis/ loss of ability to move or feel sensation in body
SCI
Total motor and sensory loss below lesion
Complete lesion - Full lesion of SC
Partial loss of sensory/motor function
Incomplete partial lesion of SC
Immediate damage caused directly from trauma
Primary damage
Delayed damage caused by complication after injury
Secondary damage
MVA, Diving, contact sports, violent injury
Trauma etiology
Spinal hematoma, infection, radiation, neoplasm
Vascular complication: cardiac arrest, aortic aneurism, surgery
Non-traumatic etiology
Damage to one side of SC. Caused by trauma i.e. gunshot, stab
Brown-Sequard Syndrome
Brown-Sequard Syndrome: motor function, proprioception, sensation (vibration, 2 point discrimination)
Ipsilateral impairment symptoms
Brown-Sequard Syndrome: NORMAL: pain and temperature perseption
Ipsilateral impairment symptoms
Brown-Sequard Syndrome: Loss of pain and temperature perception
Contralateral impairment symptoms
Brown-Sequard Syndrome: Normal: Motor function
Contralateral impairment symptoms
Damage to centre with periphery unaffeccted
Central Cord Syndrome
M/C Incomplete spinal injury
Central Cord Syndrome
Hyperextension or arthritic changes to c-spine
Central Cord Syndrome
Motor and sensory abilities affected, mm weakness, flaccidity in upper limbs
Central Cord Syndrome S&S
Lower limbs less affected
Central Cord Syndrome S&S
Bowel and bladder control normal or partially affected
Central Cord Syndrome S&S
Hyperflexion injury to the SC
Anterior Cord Syndrome
Bilateral loss of motor function, perception (pain, temperature, crude touch)
Anterior Cord Syndrome S&S
Most vulnerable part of spine
C4-C6
Why C4-C6 most vulnerable part of spine
mobility over stability
No function maintained from neck down. Need ventilator to breathe
C1-C3
Diaphragm, which allows breathing
C4-C5
Some arm and chest mm
C6-C7
Intact arm function
T1-T3
Control of trunk above umbilicus
T4-T9
Most thigh mm, allows walking with long leg braces
T10-L1
Most leg mm, allows walking with short leg braces
L1-L2
Paralysis of one limb
Monoplegia
Paralysis of both upper or lower limbs
Diplegia
Paralysis of both lower limbs
Paraplegia
Paralysis upper limb, trunk, and lower limbs unilaterally
Hemiplegia
mm weakness in legs
Paraparesis
Paralysis of all four limbs
Quadriplegia
mm weakness in all limbs
Quadriparesis
Stimulus sends nerve impulse to spinal cord which is blocked by lesion and cannot reach brain
Autonomic Dysreflexia
Reflex activated that increases activity of sympathetic portion of ANS
Autonomic Dysreflexia
Acute Exaggerated sympathetic response. Usually with lesion at or above T6
Autonomic Dysreflexia
Caused by painful or uncomfortable stimulus in abdomen or pelvic area
Autonomic Dysreflexia
Results in spasms and narrowing of blood vessels, which causes a rise in BP
Autonomic Dysreflexia
No “voluntary” movements on affected side can be initated
- Flaccidity (immediately after onset)
Basic synergy patterns appear minimal voluntary movements may be present
- Spasticity appears
Patients gains voluntary control over synergies
- Increase in spasticity
Some movement patterns out of synergy are mastered, but synergy still predominates
- Decrease in spasticity
Move complex movement combinations are learned as basic synergies lose dominance over motor acts
- Further decrease in spasticity
Individual joint movements become possible and coordination approaches normal
- Disappearance of spacticity
PROM
Passive stretching (gentle)
Position to support upper limb, especially shoulder (subluxations
common in this stage)
Stage 1 - Flaccidity
Continue with PROM (very slow, gentle to not provoke spasticity)
Massage for sensory stimulation
Stage 2 – Spasticity develops and abnormal
synergies may be present
Continue with above techniques
Increased emphasis on stress reduction
Massage to relax spastic/synergistic areas
May be using splints
Stage 3 – Spasticity increases
Continue with above techniques
Added emphasis on using the recovering arm as much as possible
with home care and ADLs
PNF patterning (PROM, AROM)
Stage 4 – Spasticity decreases
Continue with above
Begin strengthening routine (as opposed to ROM-based exercises)
PNF patterning (RROM)
Stage 5 – Spasticity continues to decrease (minimal)
Continue with above and focus on fine motor skills (e.g. hand and
finger exercises(
Stage 6 – Spasticity disappears and coordination
reappears
