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Clin Med 2 > SCI > Flashcards

SCI Flashcards

1
Q

hyperflexion mechanism of cervical SCI: CAUSE

A
  • head on collision in which head strikes steering wheel
  • blow to back of the head
  • compression anteriorly, distraction posteriorly
  • commonly C5-C7
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2
Q

hyper flexion of cervical spine : TISSUES INJURED

A

wedge fx of vertebral body, tearing of posterior ligaments, anterior dislocation of vertebral body, disruption of disc, fx of post elements(spinous process, laminae, pedicles)

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3
Q

Flexion with rotation mechanism of cervical SCI: CAUSE

A
  • often seen in SB
  • results in dislocation and locking of a single facet joint
  • often stable situation
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4
Q

Flexion rotation of cervical spine: TISSUES INJURED

A
  • unilateral facet dislocation
  • fx of lamina or pedicle
  • neurologic:brown squared (injury to one side of the spinal cord in which the spinal cord is damaged but is not severed completely. ), nn roots
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5
Q

vertebral compression of cervical SCI: CAUSE

A
  • high velocity blow to top of head
  • have burst fx (comminuted)
  • fx fragments may migrate post & enter SC
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6
Q

vertical compression/axial loading cervical spine: TISSUES INJURED

A
  • rupture of disc

- frequently occurs to C4-C5 resulting in complete quadriplegia

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7
Q

hyperextension of cervical spine: CAUSE

A

• strong post force‐rearend collision,fall and hit chin or
forehead (on tub)
• distraction anteriorly,compression posteriorly

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8
Q

hyperextension of cervical spine: TISSUES INJURED

A

• fractures of post elements (spinousprocesses, laminae, facets)
• avulsion fractures of anterior aspect of vertebrae
-ant structures torn
-rupture or disruption of disc
-C4-C5 most common location

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9
Q

Flexion distraction of the lumbar (chance fx): CAUSES

A
  • results from use of the lap belt without shoulder restraint
  • lap belt becomes a pivot point (fulcrum)
  • flexion-distraction force from that point
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10
Q

flexion distraction of the lumbar spine: TISSUES INJURED

A
  • bony fx and ligamentous tears are horizontally oriented
  • injury in thoracic-lumbar area
  • may also have sever internal injuries
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11
Q

Penetrating Wound of Lumbar spine: CAUSES

A
  • ->low velocity: knife, ice pick, low velocity bullets
  • ->high velocity: high powered rifles, explosion-does not have to penetrate spine or spinal cord to cause damage to neural tissues-concussive force
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12
Q

Diagnosing SCI

A
  1. C-spine-lateral radiograph (85% accuracy)
  2. CT
  3. Myelography (used in conjunction with CT)
  4. MRI
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13
Q

Pathophysiology of SCI

A
  • physical alteration of the cord/cutting of the cord fibers
  • cord intact with auto destructive process (gunshot wound)
  • Cord intact with vascular compromise
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14
Q

Non-Traumatic SCI etiologies

A
  1. vascular malformations (aneurism, thrombus,embolus,hemorrhage)
  2. vertebral degeneration/subluxation
  3. primary or secondary neoplasms
  4. infections
  5. abscess (necrosis of SC tissue)
  6. congenital defect (spina bifida)
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15
Q

Traumatic SCI etiologies

A

MVA cause 46 % of all SCI

80% of individuals with SCI are males w/ 1/2 between age of 15 & 30 and 11.5 % in over 60y/o

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16
Q

factors affecting vertebral injury

A
  • direction of force
  • position of persons head at the time
  • magnitude, rate of application and duration of injuring force
  • point of application
17
Q

Cervical Spine injuries

A
  • poor stability (designed for mobility)
  • 40% incidence in cord injury with damage to cervical vertebrae
  • 52% of SCI occur in cervical region
18
Q

3 most common damaging forces to the cervical spine

A
  1. flexion
  2. vertical loading
  3. extension
19
Q

SCI to thoracic spine

A

typically caused by GSW, MVA, Falls

  • T12-L1 junction is most common injured
  • **not typically injured by isolated extension or lateral flexion forces
20
Q

SCI of thoracic spine: Flexion

A

wedge fractures-most common

-post ligamentous complex damaged d/t distractive forces (severe)

21
Q

SCI of thoracic spine: Vertical Compression

A

burst fx, bone fragments into spinal cord

22
Q

flexion-rotation of lumbar spine : CAUSES

A

-post to ant directed force at rotated vertebral column

23
Q

flexion-rotation of lumbar spine : Tissues Injured

A
  • fx dislocation
  • post ligamentous complex ruptured and accompanied by the vertebral body fx
  • ->highly unstable injury
24
Q

Functional classification of SCI

A

quadriplegia-cervical injury, visceral involvement paresis=incomplete, plegia-complete
paraplegia-LE trunk involvement, visceral involvement

25
Q

Extent of injury classification of SCI

A

COMPLETE (plegia)- all motor and sensory functions are lost BELOW that level of injury
INCOMPLETE (paresis)- preservation of sensory/motor function below the level of injury

26
Q

Level of Injury classification

A

lowest level in which functional motor power and sensation remain intact
–>funcional motor power=MMT 3/5

Clin Med 2 (8 decks)

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