SCI Flashcards
70% of SCI are?
traumatic
30% of SCI are?
vascular (AVM, clot, hemorrhage)
vertebral subluxatons (RA, DJD)
neoplasms
infection (syphillis, transverse myelitis, abcessess)
syringomyelia
disc prolapse
neurological diagnosis (ALS, MS)
hysterical diagnosis
how is the lesion level designated?
skeletal level (medical dx)
neurological level- defined as the most caudal level of SC that exhibits intact sensory and motor function. Evaluated using key sensory and motor function
- motor
- sensory
what are key muscles ?
defined as demonstrating intact intact innervation from the cord segment that it represents if:
- it exhibits 3/5 or > = strength and
- the next more rostral key muscle exhibits 5/5 strength
what are key muscles for classification?
c1-c4: sensory level c4: diaphragm, upper trap C5: biceps/brachialis C6: wrist extensors C7: triceps C8: flexor profundus middle finger T1: abductor digiti minimi T2-L1: sensory level/Beevor's sign L2: iliopsoas L3: quadriceps L4: tibialis anterior L5: extensory hallicus longus S1: gastroc/soleus S2-S5: sensory level
what is the ASIA impairment scale?
A = complete: no motor or sensory function is preserved in the sacral segments S4-S5
B = sensory incomplete: sensory but not motor function is preserved below the neurological level and includes sacral segments S4-S5. No motor function more than 3 levels below the motor level on either side.
C = motor incomplete: motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade of less than 3 (0-2). Sacral sensory sparing with sparing of motor function more than 3 levels below the motor level.
D = motor incomplete: motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of a 3 or more. Sacral sensory sparing of motor function more than 3 levels below the motor level
E = normal: motor and sensory function are normal. The pt. had prior deficits
what is the clinical presentation of a central cord syndrome?
motor> sensory loss
`
UE> LE
normal sacral function
what is the clinical presentation of brown squared syndrome?
asymmetrical deficits- ipsilateral loss of motor and vibration and movement sense; contralateral loss of pain and temp
what is the clinical presentations of anterior cord syndrome?
motor loss
P&T loss
what is the clinical presentation of caudal equine injuries?
flaccid paralysis of LEs areflexia areflexic bowel and bladder sensory loss loss of sexual function
what is spinal shock?
no reflexes, tone, motor or sensory function below the lesion
usually resolves w/in 24 hours but may last weeks
resolved when a + bulbocavernosus reflex is elicited
if no motor or sensory function below lesion after spinal shock –> complete lesion
what are hetertrophic ossifications?
abnormal bone formation, extraarticular, extra capsular below lesion. Usually large joints (rarely seen in peds). Onset w/in 4 months and will cease after 1 year.
cause unknown
TX: didronel may be given prophylactically or to stop new growth. Surgery may be recommended after 1 year if function is impeded
PT- ROM w/in tolerance, positioning and US is contraindicated
what is DVT?
symptoms: swelling and warmth; may increase spasticity
cause: decrease vasomotor tone, lack of muscle pumping and prolong pressure
TX/prevention: anticoagulants prophylactically for 2-3 months; pressure garments, early mobilization/ROM, position changes
what is osteoporosis?
symptoms: below level of lesion, onset w/in first few months;; increase risk of fractures
cause: unknown
TX: handle w/ care; WB activities; FES; meds (bisphophonate)
extremely common bc lack of WB and bone stimulation
what are causes and tx of spinal deformities?
causes: MS imbalances in muscle tone and poor postural alignment in any prolonged position
TX/prevention: w/c seating, bed positioning and postural exercises for stretching and strengthening
