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Neuromus 2 > SCI basics 2 - SCI > Flashcards

SCI basics 2 - SCI Flashcards

1
Q

hwta is central cord syndrome

A

when the center of the cord is injuried sparing the the peri portion of the SC

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2
Q

when does central cord syndrome normally occur

A

the cervical region

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3
Q

when does central cord syndrome normal occur

A

may result from hemorhage and necrosis does not process peri

descruction of the sucal arties the supply this section of the cord

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4
Q

what kidn in juries normally lead to central cord syndrome

A

hyperext/flex syndrome

ext - oder adults

1 - falls
2 - MVA

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5
Q

what is the most common SCI syndrome

A

central cord syndrome

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6
Q

clinical presentation of central cord syndrome

A

more weakness in the UE compared to LE

sparing sensation and motor to the sacral region

may have neuro bowl bladder

may have somasensory deficits, paralysis in the hands are common

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7
Q

what is neurological bowel and bladder

A

A spinal cord injury sometimes interrupts communication between the brain and the nerves in the spinal cord that control bladder and bowel function.

This can cause bladder and bowel dysfunction known as neurogenic bladder or neurogenic bowel.

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8
Q

neuro return and central cord

A

neuro return is likely

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9
Q

functional mobility and central cord

A

likely to achieve functional independence during rehab

spv to modI

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10
Q

ADL vs mobility central cord

A

harder time with ADLs then mobility

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11
Q

hand recovery ceentral cord

A

hands have increased recovery time

there are a high number of sensory and motor connections in the hands

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12
Q

older patient and central cord syndrome

A

older patient have worse outcome for amb then younger patients

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13
Q

what are good prognosis factors for central cord syndrome

A

good hand function

evidence of early mob

young age

absence of spasticy

pre-injury employment

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14
Q

what does brown squared syndrome look like in the cord

A

hemi section of the cord is effected and the other side is preserved

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15
Q

brown squared syndrome seen more with incomplete or complete

A

incomplete

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16
Q

brown squared syndrome is a result of what most likely

A

stab wound or tumor

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17
Q

brown squared syndrome clinical presentation

A

isp motor and proprioceptive defects

contra: pain and temp or hypersensity

spascity may be present below the level of the lesion

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18
Q

brown squared syndrome prognosis - neuro return

A

likely to experience neuro return

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19
Q

brown squared syndrome prognosis - functional independence

A

likely to experience functional indp

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20
Q

brown squared syndrome prognosis - amb

A

75% - 90% amb indpendently

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21
Q

posterior cord syndrome cause

A

neck hyperext

post spinal art occlusion

tumor

disc compression

it B12 deficit

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22
Q

what is the least common SCI syndrome

A

posterior cord syndrome

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23
Q

posterior cord syndrome clinical presentations

A

loss/impaired: proprioception, vibration, JPS below the level of the lesion

perserved: muscle strength, temp and pain sensation

sensory ataxia

may have weakness depending on the amount damage

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24
Q

what is sensory ataxia

A

a form of ataxia caused by the impairment of the somatosensory nerves, leading to the interruption of sensory feedback signals.

It is characterized by postural instability and lack of coordination that worsen when visual input is removed.

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25
prognosis of posterior cord syndrome - amb
poor need to take in account other neuro factors
26
what is anterior cord syndrome impacting in the SC
the anterior 2/3 of the cord
27
trauma that causes anterior cord syndrome
2ndary spinal injuries flexion -flexionteardrop fractures direct damage to bone fragments disc compression and/or anterior spinal art occlusion
28
clincal presenation of anterior cord syndrome
complete paralysis and hypoalgesia below the level of the lesion preservation: touch, position sense, vibration, 2 point below the lesion
29
what is Hypoalgesia
diminished pain in response to stimulation that typically produces pain
30
prognosis of ant cord syndrome
poor for functional improvement 10-20% have a chance of muscle recovery, poor muscle power and coordincation
31
what is colonus medullaris syndrome due to
damage to the sacral cord and lumbar nerve roots
32
what is colonus medullaris due to traumawise
traumas and tumors
33
Clinical presentation of what is colonus medullaris
UMN and LMN signs flaccid or spastic varied about of LE weakness areflexic bladder and bowel saddle anesthsia may retain sacral reflexes
34
is what is colonus medullaris complete or incomplete
could be both
35
what is an areflexic bladder
has lost its ability to contract and can be easily stretched, allowing large amounts of urine to accumulate urnine spill over
36
prognosis of colonus medullaris syndrome - spinal shock
ecreases 2 weeks following injury
37
prognosis of colonus medullaris syndrome - is based on
severity age comorbities previous level of function
38
what is CES due to
injury to the CE of the spine
39
MOI of CES
trauma disc compression tumor spinal stenosis s/p epidural hemotoma lumbar fracture
40
is CES acute or chronic
either
41
CES clinical presentation- complete or imcomplete
either
42
CES clinical presentation - relfexia
hyporeflexia
43
CES clinical presentation - sensation
varied saddle parathesia
44
CES clinical presentation - weakness where
DF/PF hip ext hip abd
45
CES clinical prognosis - spinal shock
~2 weeks
46
CES clinical prognosis - general
depends when the patient received treatment
47
what is Hyperesthesia
neurological condition that causes a person extreme sensitivity to touch, pain, pressure, and thermal sensations
48
what is Hypoalgesia
diminished pain in response to stimulation that typically produces pain
49
is voluntary motor control an issue that we can see with SCI
yes you have LMN and UMN paralysis
50
what is UMN paralysis sue to
damage to the descending motor tracts
51
what is LMN paralysis due to
damage to the spinal nerve and the cauda equina (peri nerves as well)
52
what do we see with UMN issues
dirsuption of the cortical spinal connection hyper-reflex/tone discoordination +bab, clonus, other UMN
53
what do we see with LMN issues
hypo-reflex hypotonicity flaccidity no UMN signs
54
what happen to the motor system with SCI
this leads to a inablity to contract of ineffieceent contraction of the muscles with innervation below the level of the lesion
55
with motor system issue and SCI what does regaining strength depend on
increasing strength depends on the completeness of the injury preservation of motor units connections propriospinal connections
56
what is happening with we increase strength following a SCI
recovery of existing connections making new connections through other intact propriospinal connections
57
voluntary motor control is interrupted with SCI due to
UMN and LMN
58
is the sensory system normally impacted with SCI
yes
59
what does sensory impairment lead to
incoordination of body movements and impaired awareness
60
what does Light touch represent
DCML and SPT
61
what does pain and temp represent
spinothalamic tract
62
what does vibration, JPS, and proprioception mean
DCML
63
where does the DCML tract cross
brainstem they travel up the cord
64
where does the spinothalamic tract cross
the cord
65
what does sensory loss depend on
the location and the severity of the damage
66
what does sensory recovery depend on
repeated sensory input restoration of connections or new connection throught intact pathways
67
is autonomic dysreflexia of version of hypo or hyper-reflexia
hyper-reflexia
68
at what level does autonomic dsyreflexia occur
after a spinal cord injury at or above the sixth thoracic vertebrae (T6)
69
what occurs in autonomic dysreflexia
a massive reflex sym surge from the thoracolumbar sym nerves that causes widespread vasocontriction peri art HTN occurs
70
sympathetic NS
fight or flight
71
parasympathetic NS
rest and digest
72
what are the two components of the autonomic NS
sym and para
73
what can dysreflexia lead to
stroke or death
74
what are the sym of AD
HTN brady pounding headache sweating above the level of the lesion (face neck and shoulders) goosebump above the level of the lesion flushing/blochy skin blurred vision
75
what is the normal systolic BP for SCI above T6
90-110
76
a sudden rise in BP with AD is normally associate
brady
77
how much of a BP jump do we expect with AD
20 to 40
78
what are you thinking it could be is not AD
HTN pheochromoytoma
79
what do you if you think someone has AD
act quick sit them up (not down) remove abdominal binder and compression socks search for the source of the stimuli
80
what are some causes of AD
Ingrown toenail, kink/clogged in the catheter, full bladder, UTI, pressure injury
81
what is postural hypotension
when there is a decrease in BP when assuming an upright position
82
what is postural hypotension due to
reduced cerebral flow and decreased venous return to the heart
83
as a PT what do you do for postural hypotension
allow the cardiovascular system to gradually adapt by a graded progression to vertical elevate the head of the bed reclining wheelchair with elevating leg rests tilt table use of compression socks and abdominal binder
84
when does thermoregulation get thrown off - anatomy
interruption between the spinal cord the hypothalamus
85
what do we see if thermoregulation is off
absence of thermoreg sweating below the level of the lesion shiver absesnt below the LOL
86
what is the primary muscle of inspiration
the diaphragm
87
what level is the diaphragm innevervating
C3-C4 (C4)
88
a lesion at BLANK level results in the inability to breath
C4 therefore is you have lesion at C$ you need a mechanical ventilator
89
intercostal innervation level
T1-12 involved in quiet insirpation
90
what muscles do expiration
abdominal and intercostals loss of these muscles decrease expirtory efficency
91
abd are innervated at what level
T5 - T12
92
what are arefelxic muscles
complete absence of reflexes. seen during spinal shock
93
as time passes following a SCI what happens to the muscles
reflexes return and tone increases spascity clonus increase DTR
94
with SCI when spascity most noticed
higher lesions with incomplete lesions
95
what are the advatages of muscle tone
circulation aided by muscles functional assist may reduce OP
96
what are the disadvantages of muscle tone
decreased safetly for ADLs mask the return of volitional movement contractures skin breakdown bowel/bladder dys
97
what are some treatment we can do for muscle tone
stretch positioning cryotherapy E-stim aquatic therapy EMG biofeedback
98
are more caudal lesions more UMN or LMN
LMN
99
what is needed for volunatary control of bowel and bladder
intact sacral cord communication with the brain
100
what is a neuro bladder
detrusor muscle stays relfexed and the bladder continues to fill sphinter stays tight - cannot contract or relax when a person lack bladder control because of the lack of SC and brain communication
101
how can a neuro bladder be delt with
can manage with a foley catheter
102
what is a LMN bladder
when the bladder has loss its ability to contract and can be easily stretched spills over into the urinary tract
103
what do you do with a LMN bladder
brief or a condom catheter
104
SCI pt and knowing when to go to the bathroom
they will not know when they need to go no communication between the bladder/bowels and the brain
105
UMN injury bowel vs LMN bowel
UMN - reflexive, when the bowel is full it will empty by reflex LMN - the anal muscl remain relaxed
106
sexual function is controlled by
sacral nerves
107
is preg possible in those with SCI
yes

Neuromus 2 (17 decks)

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