Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PM&R > SCI > Flashcards

SCI Flashcards

1
Q

What age group do SCI’s occur in most frequently? What is average age of SCI?

A

16-to-30 year olds; average age is 43 yoa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common level of SCI? Most common level for paraplegia? Most common type of injury?

A

C5;
T12;
incomplete tetraplegia, followed by incomp para, comp para, comp tetra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of marriage survives better with SCI, post-injury or pre-injury?

A

Post-injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most likely causes of death for someone with SCI?

A
  1. Respiratory disorders (pneumonia most common)
  2. Heart disease
  3. Septicemia
  4. Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What vessel provides major blood supply to lumbar and sacral cord?

A

Artery of Adamkiewicz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the 4 types of C-spine flexion/hyperextension injuries and common levels

A
  1. Flexion/axial loading (Burst/compression fx): C5
  2. Flexion/rotation injury (Unilateral facet): C5-6
  3. Flexion (Bilateral facet): C5-6
  4. Hyperextension (central cord): C4-5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of non-traumatic SCI

A

Spinal stenosis, transverse myelitis, NMO, epidural abscess, radiation myelopathy, sub-acute combined degen, spinal cord tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

NMO: What does it affect in CNS? M or F predominance? Lesions are more ______ on MRI compared to MS. Treatment?

A

Optic nerves and spinal cord;
F;
longitudinal (more than 3 spinal segments);
IV glucocorticoids, plasmapharesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Extradural tumors are largely comprised of

A

spinal metastases and primary bone tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inpatient rehab lengths of stay are ______ for persons with NT injury 2/2 tumors vs. traumatic SCI

A

shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List cervical orthoses from least to most restrictive

A
  1. Soft collar
  2. Head cervical orthosis (Philadelphia, Aspen, Miami J)
  3. SOMI brace
  4. Four poster
  5. Minerva
    Halo most restrictive and not removable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When are you likely to see complete lesions vs. incomplete lesions?

A

Complete:

  1. B/l cervical facet dislocations
  2. Thoracolumbar flexion-rotation injuries
  3. Trans-canal gunshot wounds

Incomplete:

  1. Cervical spondylosis (falls)
  2. Unilateral facet joint dislocations
  3. Non-penetrating gunshot/stab injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for C1 and C2 fractures typically?

A

Halo vest if stable; surgery if unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common type of odontoid fx?

A 
Type 2 (through base of odontoid);
type 1 is through tip of dens, type 3 goes into C2 body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does zone of partial preservation mean?

A

Refers to dermatomes and myotomes caudal to neurological level of injury remaining partially innervated for historically complete injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define spinal shock

A

temporary loss or depression of all spinal reflex activity below level of lesion;
see loss of motor function and sensation accompanied by atonic paralysis of bladder and bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does a low cauda equina lesion cause with regards to B/B?

A

Areflexic bowel and bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Highest complete SCI level when one can live independently without aid of attendant is what? What’s the usual level for achieving independence?

A

C6;

C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pathophys of autonomic dysreflexia?

A

Brainstem unable to send messages through injured spinal cord to decrease symp outflow and allow vasodilation of splanchnic bed to decrease BP

20
Q

What innervates internal and external urethral sphincters?

A

T11-L2 hypogastric nerve (sympathetic);

S2-4 pudendal nerve (somatic efferent)

21
Q

What bladder receptors respond to sympathetic efferents?

A

Alpha-1 and beta-2

22
Q

LMN bladder is failure to _______, while UMN bladder is failure to _________

A

empty; store;
LMN bladder with increased tension at internal sphincter;
UMN with no suppression of sacral micturition center

23
Q

What is physiology behind detrusor sphincter dyssynergia?

A

Neuro injury b/w sacral (S2-4) and pontine micturition centers causes lack of coordinated regulation of bladder function

24
Q

Poor semen quality 2/2

A
  1. Stasis of prostatic fluid
  2. Testicular hyperthermia
  3. Recurrent UTI’s
  4. Abnormal testicular histology
  5. Changes in hypothalamic-pituitary-testicular axis
  6. Possible sperm Ab’s
  7. type of bladder management
  8. Long-term use of various meds
25
Q

Decreased libido after SCI likely due to combo of

A

psychological and physical changes after injury, including change in self-image and altered sensation in genital region

26
Q

What may be the only clinical manifestation of labor?

A

AD

27
Q

What happens to likelihood of pregnancy after SCI?

A

Unchanged, as fertility is unimpaired

28
Q

What is treatment of choice for AD in pregnant patient?

A

Epidural anesthesia extending to T10

29
Q

With UMN lesion from SCI, what happens with GI system?

A

Lose symp and parasymp input at transverse and descending colon, with decreased fecal movement

30
Q

What are two different reflexes that help with bowel program for SCI patients?

A

Gastrocolic and rectocolic reflex; latter can be manipulated by digital stimulation of rectum

31
Q

What occurs with SMA syndrome? What can cause it?

A

Third portion of duodenum compressed by overlying SMA resulting in GI obstruction;
rapid weight loss, supine, spinal orthosis like Halo, flaccid abdo wall

32
Q

When does hypercalcemia manifest usually for SCI? How to manage?

A

4-8 weeks post-SCI;

may need IV fluids with NS

33
Q

How to manage fx in patients with chronic SCI?

A

Non-op with soft padded splints;

distal femur and prox tibia most common

34
Q

Most freq respiratory complications in SCI?

A

Pneumonia, atelectasis, ventilatory failure

35
Q

What is leading cause of death among chronic SCI patients?

A

Pneumonia

36
Q

What lung pattern do tetraplegics develop?

A

Restrictive (all volumes except residual volume decrease)

37
Q

When to mechanically ventilate?

A

VC < 1 L
ABG with increasing PCO2 or decreasing PO2 levels;
PO2 less than 50 or PCO2 greater than 50
Severe atelectasis

38
Q

When can HO manifest in SCI? Which joint is most common?

A

1-3 months after injury;

Hip

39
Q

Gold standard to diagnose DVT? What complication of DVT is leading cause of death in acute SCI?

A

LE venogram;

PE

40
Q

Gold standard to diagnose pulmonary embolism

A

Pulmonary arteriogram

41
Q

What are 2 uses of e-stim for SCI?

A
  1. Exercise to avoid complications of muscle inactivity
  2. Producing extremity motion for functional activities (FES can be used to provide a cardiovascular conditioning program)
42
Q

For pain in SCI patient, what is most commonly affected joint?

A 
Shoulder; 
tendonitis/bursitis;
rotator cuff tear
sub-acromial bursitis
capsulitis
43
Q

Why is carpal tunnel prevalent in SCI population?

A

Stress from transfers, WC propulsion, and pressure relief

44
Q

For post-traumatic syringomyelia, most common presenting symptom? Earliest sign? How to diagnose?

A

Pain;
ascending loss of DTR’s;
MRI with gadolinium is gold standard

45
Q

What psychological co-morbidity can co-exist with SCI?

A

Depression;

suicide rate is higher among SCI patients, and is leading cause of death in youngest age groups

46
Q

Most common location of pressure ulcer injuries

A

Sacrum, ischium, heels, trochanter;

occiput in kids

47
Q

Most important risk factors for developing pressure injuries

A

pressure and shear forces

PM&R (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions