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Neuromus 2 > SCI basics - SCI > Flashcards

SCI basics - SCI Flashcards

1
Q

what is the spinothalamic tract for

A

pain

temp

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2
Q

what is the DCML for

A

JPS

pressure touch

vibration

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3
Q

what is global sensory loss normally due to

A

the cortex and peri nerves

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4
Q

what is the lateral corticospinal tratct

A

To control the voluntary movement of contralateral limbs

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5
Q

ventromedial pathway function

A

innervate axial and antigravity muscles to help keep the head positioned during antigravity activities

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6
Q

complete SC vs one-sdie of the SC

A

complete: loss of motion bilaterally and have global sensory loss below the lesion

one-sided:
o vibration and proprioceptive sense isp
o pain and temp from the contra

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7
Q

what is the anterior spinal art

A

look at slide

is supplies 2/3 of the spinal cord
- most grey matter
- descending tracts
- both lateral and anterior
- spinothalamic
- spinocere

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8
Q

what is sacral sparing

A

the patient maintains sensation around that anal region

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9
Q

where does the posterior spinal artery supply

A

the dorsal column and part of the dorsal horn

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10
Q

what are things that can lead to spinal cord damage

A

trauma

disease

cog defects

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11
Q

what is the most common cause of SCI in the adult population

A

trauma

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12
Q

was are the two type of SCI injury

A

direct

indirect

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13
Q

direct damage to the spinal cord example

A

bullet

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14
Q

indirect spinal cord injury example

A

impingment of bony/soft structures

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15
Q

does the spinal cord injury have to be complete for deficits to appear

A

no

brusied tissue can cause neuro damage that is just as sig as if the SCI was severed

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16
Q

what is are of the spine is most vulnerable to injury

A

cervical

most injury is seen in the lower SC areas

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17
Q

what kind of injuries have the highest incidence of neuro injury

A

flexion force injury

seen with whip lash

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18
Q

what are the forces that lead to vert injury

A

flexion

compression

extension (hyper)

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19
Q

how do compression injuries occur

A

axial blow to the head

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20
Q

how to hyperextension injuries occur

A

when the head and chin strike in a fall or a MVA

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21
Q

what kind of causes of SCI is mostly seen in the elderly population

A

hyperextension injury

think falls

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22
Q

how large is the thoracic region

A

1-12

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23
Q

in the lumbar region of the spine - where does injury omstly occur at

A

thoraco lumbar section

t12- L1

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24
Q

how long is the lumbar segment of the spine

A

5 segments

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25
how long is the scaral segment of the spine
5 segments
26
how long is the cervical segment of the spine
8 segments
27
in neuro damage in thelumbar region normally complete or imcomplete and why
incomplete they have good vascular supply - large vertebral canal in that section the cord is not present at L1- L2
28
what are some examples of non-traumatic lesions
tumors vascular syndromes MS ALS
29
tumors in the spinal cord
they normally have a compressive effect
30
what is the most common type of tumor in the spinal cord
extradural
31
what could lead to weakness, sensory loss, pain with an extradural tumor
located near the nerve root
32
intramedullary what kind of pain do we expect
back pain is common radicular pain is not common
33
what vascular syndromes common in the spinal cord
no when it is present I can be hard to diagnose
34
what is an infraction
tissue death or necrosis due to inadequate blood supply to the affected area
35
what are the vascular syndromes that we see with SCI
infraction of the anterior spinal cord and hemmorage from vascular malformations and trauma
36
what is anterior spinal art syndrome
occlusion in the ant spinal cord that produces damage to most of the cord except for the dorsal horns and the dorsal aspect of the dorsal horn
37
what do patients present if they have anterior spinal art syndrome
paralysis below the level below the level of injury deficits in pain and temp below that level perservation of vibration and propioeption
38
is posterior spinal art occlusion common
less common
39
what do patient present with if they have posterior spinal art occlusion
loss of propioception and vibration below the level of injury
40
what is arteriovenous malformations
tangle and art and veins that represent the persistance of embroyotic pattern of blood vessels hemo of these thin vessels occur in 20-30 yo
41
what can arteriovenous malformations be preceeded by
headaches and seizures
42
are aneurysms common with SCI
uncommon
43
what is a complication of aortic aneurysm
spinal cord ischemia this can also be a complication of vascular surgery
44
what were the two degenerative disease that we where introduced to
MS ALS
45
how to we treat SCI
surgical and non-surgical
46
what are examples of SCI surgical interventions
fusion decompression
47
what are examples of non-surgical intervention for spinal cord
miami J TLSO LSO stablization and bracing steriod infusion
48
what are the cervical precautions
no excessive movements Miami J, aspen collar at all times no active shoulder abd or flexion above 90 no lifting over 5 lbs no pillow under your head
49
pillow under head cervical precautions
sometime 1 thin pillow is allowed the goal is avoid putting the head into extra flexion
50
what are TLS precautions
no BLT no lifting greater then 10 lbs log rolling only no HOB > 30 -deg OOB with TLSO no hip felxion past 90-deg
51
what does TLS stand for
thoracic and lumbar spine precasutions
52
what does BLT stand for
bending lifting and twisting
53
what does TLSO stand for
Thoracic-Lumbar-Sacral Orthosis (TLSO)
54
what is spinal shock
occurs after there is trauma to the cord temp ceases function below the level of the lesion spinal reflexes, voluntary motor and sensory function, and automnomic control are absent below the level of the lesion the spinal cord is knock out like when you are knock out for a fight - takes a little to regain function
55
how long does spinal shock last
clears within the first 24 hrs and usually resolves in a few weeks
56
what is the cause for spinal shock other then the trauma that is experienced
unknown
57
what is neurological return
the resumption of voluntary movement and sensory function that has been lost as a result of the injury not the return of reflexive functioning below the lesion
58
what is neuro return evidence of
evidence of a connection between the brain and the muscles or dermatones have resumed function
59
does neuro return occur quickly or slowly
slow
60
when does most neuro recovery occur
in the first 6 months and platues after the first 2 years
61
what are the mech of neuro return
nerve root recovery remyleination of f surving neurons resolution of patho processes injuring induced platisity making new connection
62
what leads to fast recovery of neuro return
resolution of patho process that were causing neruo deficits edema hemorrhage as these are clearing out we will see a return
63
does spinal shock occur acutely or chronically
acutely
64
what does neuro return depend on
completeness of the injury and degree
65
what does inadequate inspiration result in
reduced ventilation of the lungs
66
what does inadequate coughing lead to
allows for secretions to build up in the lungs
67
with SCI why do we often see complications with respiration
because of weakness in the accessory muscles
68
breathing and higher leveel of injury
the pt may need a ventilator
69
why do we often see pressure ulcers with complete lesion and tetra
lack of sensation and lack of mobility
70
what are some options that can lead to pressure relief
push up forward lateral weight shifts power chair seat functions cushion options patient education about pressure relief
71
how often should the pt move to prevent pressure sores
2 min every 20-30 mins
72
what are some factors that lead to DVTs
absent or reduced LE muscular activity immobilty
73
how is DVT related to muscles
the venous system relies on the musculature to pump the blood back up to the heart
74
what are contractures
deformity is likely to form when there are muscle strength imbalances, spasicty, gravity, and postural causes 1 or more joint to remain in one position for extended periods
75
how do we treat contracture
periodic ROM
76
where is heterotrophic ossification normally located
hip, shoulder, knees
77
how do we treat heterotrophic ossification
moderate intensive stretching to maintain ROM
78
where do we mostly see osteoporosis (OP)
LE female low BMI older
79
OP and SCI
after SCI there is a net loss of bone mass becasue the rate of resportion is greater then new bone formation

Neuromus 2 (17 decks)

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