SCI Flashcards
A _ lesion is a lesion to the spinal cord where there is NO preserved motor or sensory function below the level of the lesion.
A COMPLETE LESION is a lesion . . .
An _ _ is a lesion to the spinal cord in which there may be scattered motor function, sensory function or both below the level of the lesion.
An INCOMPLETE LESION is a lesion to the
_ _ _ is an incomplete lesion that results from compression and damage to the anterior part of the spinal cord or anterior spinal artery. Mechanism of injury is usually _ _. There is loss of _ function, _ and _ sense below the lesion due to damage to the corticospinal and Spinothalamic tracts.
ANTERIOR CORD SYNDROME is an incomplete . . .
Mechanism of injury is usually CERVICAL FLEXION
There is loss of MOTOR function, PAIN AND TEMPERATURE sense below the lesion due to . . .
_ _ _ is an incomplete lesion usually caused by a stab wound, which induces hemi section of the spinal cord. There is _ and loss of _ and _ sense on the same side as the lesion due to damage to the corticospinal tract and dorsal columns. There is loss of _ and _ sense on the contralateral side of the lesion for damage to the lateral Spinothalamic tract.
BROWN SEQUARD SYNDROME is an incomplete . . .
There is PARALYSIS and loss of VIBRATORY AND POSITIONAL sense on the SAME SIDE
There is loss of PAIN AND TEMPERATURE sense on the- CONTRALATERAL SIDE
_ _ _ are injuries that occur below the L1 spinal leve wher the long nerve roots transcend. Can be _, however they are frequently _ due to the large number of nerves in the area. Is considered a _ _ injury.
CAUDA EQUINA INJURIES are injuries that . . .
Can be COMPLETE, however they are frequently INCOMPLETE due to the large. . . .
Is considered a PERIPHERAL NERVE injury
_ _ _ is an incomplete lesion that results from compression and damage to the central portion of the spinal cord. Mechanism of injury is usually _ _ that damages the Spinothalamic and corticospinal tracts and the dorsal columns.
CENTRAL CORD SYNDROME is an incomplete . . .
Mechanism of injury is usually CERVICAL HYPEREXTENSION that damages . . .
With central cord syndrome the _ _ present with greater involvement than the _ _ and greater _ deficits exist compared to _ deficits.
The UPPER EXTREMITIES present with greater involvement than the LOWER EXTREMETIES and greater MOTOR deficits exist compared to SENSORY deficits.
_ _ _ is a relatively rare syndrome that is caused by compression of the posterior spinal artery. It is characterized by loss of _, - _, and _. Motor function is _.
POSTERIOR CORD SYNDROME is relatively rare . . .
It is characterized by loss of PROPRIOCEPTION, TWO-POINT DISCRIMINATION and STEREOGNOSIS.
Motor function is PRESERVED.
How many grades are there on the ASIA scale?
5 (A-E)
Level _ on the ASIA scales is a complete spinal cord injury with no sensory or motor function preserved in the sacral segments (S4-S5)
Level A On the ASIA . . .
Key UE muscles tested during ASIA for C5? C6? C7?
C5- Elbow flexors (biceps, brachioradialis)
C6- Wrist extensors (ECRL, ECRB)
C7- Elbow extensors (triceps)
Key muscles tested during ASIA assessment for C8? T1?
C8- finger flexors (flexor digitorum profundus) at middle finger
T1- small finger abductors (adductor digiti minimi)
Key muscles tested during ASIA assessment for L2? L3? L4?
L2- hip flexors (Iliopsoas)
L3- knee extensors (quadriceps)
L4- ankle dorsiflexors (tibialis anterior)
Key muscles tested during ASIA assessment for L5? S1?
L5- big toe extension (extensor hallucis longus)
S1- ankle plantar flexors (gastroc, Soleus)
With ASIA B, _ but not _ function is preserved below the level of lesion AND includes the _ _ of _ and _ (can _ but cannot _ bowel function)
With ASIA B (incomplete), SENSORY but not MOTOR function is preserved below the level of the lesion and includes the SACRAL SEGMENTS of S3 and S4 (can FEEL but cannot CONTROL bowel function)
With ASIA C motor function is _ below the neurological level and _ than 1/2 of the key muscles below the neurological level have a muscle grade of _ than _/5.
With ASIA C motor function is PRESERVED below the neurological level and MORE than half of the key muscle below the neurological level have a muscle grade of LESS THAN 3/5
With ASIA D, motor function is _ below the neurological level and _ _ _ of key muscles below the neurological level have a muscle grade of _/5 _ _.
Motor function is PRESERVED below the neurological level and AT LEAST HALF of key muscles below the neurological level have a muscle grade of 3/5 OR GREATER
ASIA E, motor and sensory function are? Valid for?
. . . Are NORMAL
Valid only for people who have had a a spinal cord injury
The neurological level is the most caudal level that exhibits? Exceptions? Associated levels?
Most caudal level that exhibits intact sensory AND motor function
SCI’s that are in levels that are not testable using MMT are considered to be the same as the sensory level
Levels that cannot be tested by MMT include: C1-C4; T2-L1; S2-S5
_ of _ _ is sensory and/ or motor function below the neurological level excluding S4-S5. Dermatomes and/ or myotomes below the neurological level remain? Only applies to?
ZONES OF PARTIAL PRESERVATION is sensory and motor . . .
Dermatomes and/ or myotomes below the neurological level remain PARTIALLY INNERVATED
Only applies to ASIA A (COMPLETE SCI)
With _ _ syndrome there is flaccid paralysis of the lower extremities and areflexic bowel and bladder.
With CONUS MEDULLARIS syndrome there is . . .
Most spinal cord injuries are a combination of? _ T12 is more _ () and _ T12 is more _ ().
Most spinal cord injuries are a combination OF UMN AND LMN
ABOVE T12 is more UMN (SPASTICITY)
BELOW T12 is more LMN (FLACCIDITY)
What are the first and second line (2)of pharmacological agents used to treat spasticity in SCI?
First- BACLOFEN
Second- GABAPENTIN (also good for cerebral spasticity- in addition to spinal) and BENZIDIAZAPINE (diazepam/ Valium)
_ _ occurs with SCI above the T1 level.
THERMOREGULATION DSYFUNCTION
_ _ is ectopic bone formation in the connective tissue outside of the skeleton. Occurs at the _ joints (_, _, _), always occurs _ _ _ of the spinal lesion. May occur in / of high tetraplegics and those with accompanying TBI.
HETEROTOPIC OSSIFICTION is ectopic bone . . .
Occurs at the LARGE joints (HIP, KNEES, ELBOWS), always occurs BELOW THE LEVEL of the spinal lesion.
May occur in SHOULDERS/ ELBOWS of high tetraplegic . . .
HO occurs in _% of people with SCI. Most commonly develops - _ post injury with peak incident around _ _. However it can occur _ after injury.
HO occurs in 50% of people with SCI
Most commonly develops 1-4 MONTHS post injury with peak incidence around 2 MONTHS
However it can occur YEARS after injury
How many stages of HO are there? How is it diagnosed by imaging? Lab?
4 STAGES
It is diagnosed via BONE SCAN (most accurate test)
Lab results: ELEVATED PHOSPHATASE LEVELS
Stage _ occurs 11-20 days after injury. Symptoms include: _, _ _ swelling, _, local _ and _ near the joint. _ _ _on X-Ray. ROM may be _ _.
Stage I occurs 11-20 days after . .
Symptoms include: FEVER, SOFT TISSUE swelling, local WARMTH and REDNESS near the joint
NO DETECTABLE CHANGE on X-Ray
ROM may be SLIGHTLY LIMITED
Stage 2: symptoms are? X-Ray- _ _ is now visible. ROM?
Symptoms ARE SAME AS STAGE 1
X-Ray- ECTOPIC BONE is not visible
ROM: MAY BE SLIGHTLY LIMITED (same as stage 1)
Stage 3: symptoms- __ and _ subside. X-Ray shows _ _. ROM is _ limited.
Symptoms- SWELLING AND REDNESS subside
X-Ray shows CONTINUED CALCIFICATION
ROM is INCREASINGLY limited
Stage 4: _- _ _ after onset. X-Ray shows _ _. ROM- _ _. Complications include? (2)
2-4 WEEKS after onset
X-rays show EXTENSIVE CALCIFICATION
ROM- JOINT ANKYLOSIS
COmplications include- CONTRACTURE AND PRESSURE SORES
ADA COMPLIANCE: handrail/ grab bar height? Toilet seat? Counter height?
Handrail/ grab bar height: 34-38 inches
Toilet seat height: 17-19 inches
Counter height: 34 inches MAX
ADA Ramp requirements: width? Slope should not exceed _ _ in height for ever _ _ in length. Ramps greater than 6 feet should have?
Width: 36 inches
Slope should not exceed 1 INCH in height for every 12 INCHES in length
Ramps greater than 6 feet in length should have BILATERAL HANDRAILS.
