SCI Flashcards
What age group do SCI’s occur in most frequently? What is average age of SCI?
16-to-30 year olds; average age is 43 yoa
Most common level of SCI? Most common level for paraplegia? Most common type of injury?
C5;
T12;
incomplete tetraplegia, followed by incomp para, comp para, comp tetra
What type of marriage survives better with SCI, post-injury or pre-injury?
Post-injury
Most likely causes of death for someone with SCI?
- Respiratory disorders (pneumonia most common)
- Heart disease
- Septicemia
- Cancer
What vessel provides major blood supply to lumbar and sacral cord?
Artery of Adamkiewicz
Describe the 4 types of C-spine flexion/hyperextension injuries and common levels
- Flexion/axial loading (Burst/compression fx): C5
- Flexion/rotation injury (Unilateral facet): C5-6
- Flexion (Bilateral facet): C5-6
- Hyperextension (central cord): C4-5
Causes of non-traumatic SCI
Spinal stenosis, transverse myelitis, NMO, epidural abscess, radiation myelopathy, sub-acute combined degen, spinal cord tumors
NMO: What does it affect in CNS? M or F predominance? Lesions are more ______ on MRI compared to MS. Treatment?
Optic nerves and spinal cord;
F;
longitudinal (more than 3 spinal segments);
IV glucocorticoids, plasmapharesis
Extradural tumors are largely comprised of
spinal metastases and primary bone tumors
Inpatient rehab lengths of stay are ______ for persons with NT injury 2/2 tumors vs. traumatic SCI
shorter
List cervical orthoses from least to most restrictive
- Soft collar
- Head cervical orthosis (Philadelphia, Aspen, Miami J)
- SOMI brace
- Four poster
- Minerva
Halo most restrictive and not removable
When are you likely to see complete lesions vs. incomplete lesions?
Complete:
- B/l cervical facet dislocations
- Thoracolumbar flexion-rotation injuries
- Trans-canal gunshot wounds
Incomplete:
- Cervical spondylosis (falls)
- Unilateral facet joint dislocations
- Non-penetrating gunshot/stab injuries
Treatment for C1 and C2 fractures typically?
Halo vest if stable; surgery if unstable
Most common type of odontoid fx?
Type 2 (through base of odontoid); type 1 is through tip of dens, type 3 goes into C2 body
What does zone of partial preservation mean?
Refers to dermatomes and myotomes caudal to neurological level of injury remaining partially innervated for historically complete injuries
Define spinal shock
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
What does a low cauda equina lesion cause with regards to B/B?
Areflexic bowel and bladder
Highest complete SCI level when one can live independently without aid of attendant is what? What’s the usual level for achieving independence?
C6;
C7
Pathophys of autonomic dysreflexia?
Brainstem unable to send messages through injured spinal cord to decrease symp outflow and allow vasodilation of splanchnic bed to decrease BP
What innervates internal and external urethral sphincters?
T11-L2 hypogastric nerve (sympathetic);
S2-4 pudendal nerve (somatic efferent)
What bladder receptors respond to sympathetic efferents?
Alpha-1 and beta-2
LMN bladder is failure to _______, while UMN bladder is failure to _________
empty; store;
LMN bladder with increased tension at internal sphincter;
UMN with no suppression of sacral micturition center
What is physiology behind detrusor sphincter dyssynergia?
Neuro injury b/w sacral (S2-4) and pontine micturition centers causes lack of coordinated regulation of bladder function
Poor semen quality 2/2
- Stasis of prostatic fluid
- Testicular hyperthermia
- Recurrent UTI’s
- Abnormal testicular histology
- Changes in hypothalamic-pituitary-testicular axis
- Possible sperm Ab’s
- type of bladder management
- Long-term use of various meds
