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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
Q

prognosis of posterior cord syndrome - amb

A

poor

need to take in account other neuro factors

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26
Q

what is anterior cord syndrome impacting in the SC

A

the anterior 2/3 of the cord

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27
Q

trauma that causes anterior cord syndrome

A

2ndary spinal injuries

flexion -flexionteardrop fractures

direct damage to bone fragments

disc compression

and/or

anterior spinal art occlusion

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28
Q

clincal presenation of anterior cord syndrome

A

complete paralysis and hypoalgesia below the level of the lesion

preservation: touch, position sense, vibration, 2 point below the lesion

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29
Q

what is Hypoalgesia

A

diminished pain in response to stimulation that typically produces pain

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30
Q

prognosis of ant cord syndrome

A

poor for functional improvement

10-20% have a chance of muscle recovery, poor muscle power and coordincation

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31
Q

what is colonus medullaris syndrome due to

A

damage to the sacral cord and lumbar nerve roots

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32
Q

what is colonus medullaris due to traumawise

A

traumas and tumors

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33
Q

Clinical presentation of what is colonus medullaris

A

UMN and LMN signs

flaccid or spastic

varied about of LE weakness

areflexic bladder and bowel

saddle anesthsia

may retain sacral reflexes

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34
Q

is what is colonus medullaris complete or incomplete

A

could be both

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35
Q

what is an areflexic bladder

A

has lost its ability to contract and can be easily stretched, allowing large amounts of urine to accumulate

urnine spill over

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36
Q

prognosis of colonus medullaris syndrome - spinal shock

A

ecreases 2 weeks following injury

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37
Q

prognosis of colonus medullaris syndrome - is based on

A

severity

age

comorbities

previous level of function

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38
Q

what is CES due to

A

injury to the CE of the spine

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39
Q

MOI of CES

A

trauma

disc compression

tumor

spinal stenosis

s/p epidural hemotoma

lumbar fracture

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40
Q

is CES acute or chronic

A

either

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41
Q

CES clinical presentation- complete or imcomplete

A

either

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42
Q

CES clinical presentation - relfexia

A

hyporeflexia

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43
Q

CES clinical presentation - sensation

A

varied

saddle parathesia

44
Q

CES clinical presentation - weakness where

A

DF/PF

hip ext

hip abd

45
Q

CES clinical prognosis - spinal shock

A

~2 weeks

46
Q

CES clinical prognosis - general

A

depends when the patient received treatment

47
Q

what is Hyperesthesia

A

neurological condition that causes a person extreme sensitivity to touch, pain, pressure, and thermal sensations

48
Q

what is Hypoalgesia

A

diminished pain in response to stimulation that typically produces pain

49
Q

is voluntary motor control an issue that we can see with SCI

A

yes

you have LMN and UMN paralysis

50
Q

what is UMN paralysis sue to

A

damage to the descending motor tracts

51
Q

what is LMN paralysis due to

A

damage to the spinal nerve and the cauda equina

(peri nerves as well)

52
Q

what do we see with UMN issues

A

dirsuption of the cortical spinal connection

hyper-reflex/tone

discoordination

+bab, clonus, other UMN

53
Q

what do we see with LMN issues

A

hypo-reflex

hypotonicity

flaccidity

no UMN signs

54
Q

what happen to the motor system with SCI

A

this leads to a inablity to contract of ineffieceent contraction of the muscles with innervation below the level of the lesion

55
Q

with motor system issue and SCI what does regaining strength depend on

A

increasing strength depends on the completeness of the injury

preservation of motor units connections

propriospinal connections

56
Q

what is happening with we increase strength following a SCI

A

recovery of existing connections

making new connections through other intact propriospinal connections

57
Q

voluntary motor control is interrupted with SCI due to

A

UMN and LMN

58
Q

is the sensory system normally impacted with SCI

A

yes

59
Q

what does sensory impairment lead to

A

incoordination of body movements and impaired awareness

60
Q

what does Light touch represent

A

DCML and SPT

61
Q

what does pain and temp represent

A

spinothalamic tract

62
Q

what does vibration, JPS, and proprioception mean

A

DCML

63
Q

where does the DCML tract cross

A

brainstem

they travel up the cord

64
Q

where does the spinothalamic tract cross

A

the cord

65
Q

what does sensory loss depend on

A

the location and the severity of the damage

66
Q

what does sensory recovery depend on

A

repeated sensory input

restoration of connections
or new connection throught intact pathways

67
Q

is autonomic dysreflexia of version of hypo or hyper-reflexia

A

hyper-reflexia

68
Q

at what level does autonomic dsyreflexia occur

A

after a spinal cord injury at or above the sixth thoracic vertebrae (T6)

69
Q

what occurs in autonomic dysreflexia

A

a massive reflex sym surge from the thoracolumbar sym nerves that causes widespread vasocontriction

peri art HTN occurs

70
Q

sympathetic NS

A

fight or flight

71
Q

parasympathetic NS

A

rest and digest

72
Q

what are the two components of the autonomic NS

A

sym and para

73
Q

what can dysreflexia lead to

A

stroke or death

74
Q

what are the sym of AD

A

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
Q

what is the normal systolic BP for SCI above T6

A

90-110

76
Q

a sudden rise in BP with AD is normally associate

A

brady

77
Q

how much of a BP jump do we expect with AD

A

20 to 40

78
Q

what are you thinking it could be is not AD

A

HTN

pheochromoytoma

79
Q

what do you if you think someone has AD

A

act quick

sit them up (not down)

remove abdominal binder and compression socks

search for the source of the stimuli

80
Q

what are some causes of AD

A

Ingrown toenail, kink/clogged in the catheter, full bladder, UTI, pressure injury

81
Q

what is postural hypotension

A

when there is a decrease in BP when assuming an upright position

82
Q

what is postural hypotension due to

A

reduced cerebral flow and decreased venous return to the heart

83
Q

as a PT what do you do for postural hypotension

A

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
Q

when does thermoregulation get thrown off - anatomy

A

interruption between the spinal cord the hypothalamus

85
Q

what do we see if thermoregulation is off

A

absence of thermoreg sweating below the level of the lesion

shiver absesnt below the LOL

86
Q

what is the primary muscle of inspiration

A

the diaphragm

87
Q

what level is the diaphragm innevervating

A

C3-C4 (C4)

88
Q

a lesion at BLANK level results in the inability to breath

A

C4

therefore is you have lesion at C$ you need a mechanical ventilator

89
Q

intercostal innervation level

A

T1-12

involved in quiet insirpation

90
Q

what muscles do expiration

A

abdominal and intercostals

loss of these muscles decrease expirtory efficency

91
Q

abd are innervated at what level

A

T5 - T12

92
Q

what are arefelxic muscles

A

complete absence of reflexes.

seen during spinal shock

93
Q

as time passes following a SCI what happens to the muscles

A

reflexes return and tone increases

spascity

clonus

increase DTR

94
Q

with SCI when spascity most noticed

A

higher lesions with incomplete lesions

95
Q

what are the advatages of muscle tone

A

circulation aided by muscles

functional assist

may reduce OP

96
Q

what are the disadvantages of muscle tone

A

decreased safetly for ADLs

mask the return of volitional movement

contractures

skin breakdown

bowel/bladder dys

97
Q

what are some treatment we can do for muscle tone

A

stretch

positioning

cryotherapy

E-stim

aquatic therapy

EMG biofeedback

98
Q

are more caudal lesions more UMN or LMN

A

LMN

99
Q

what is needed for volunatary control of bowel and bladder

A

intact sacral cord communication with the brain

100
Q

what is a neuro bladder

A

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
Q

how can a neuro bladder be delt with

A

can manage with a foley catheter

102
Q

what is a LMN bladder

A

when the bladder has loss its ability to contract and can be easily stretched

spills over into the urinary tract

103
Q

what do you do with a LMN bladder

A

brief or a condom catheter

104
Q

SCI pt and knowing when to go to the bathroom

A

they will not know when they need to go no communication between the bladder/bowels and the brain

105
Q

UMN injury bowel vs LMN bowel

A

UMN - reflexive, when the bowel is full it will empty by reflex

LMN - the anal muscl remain relaxed

106
Q

sexual function is controlled by

A

sacral nerves

107
Q

is preg possible in those with SCI

A

yes

Neuromus 2 (17 decks)

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