SCI Pathology Flashcards
What is Hematomyelia? Is it an Inflammatory condition?
Acute hemorrhage into central grey matter(CGM). It is not an inflammatory condition occurs when blood leaks into CGM
Is hematomyelia a chronic degenerative condition
False, The oedema in the spinal cord subsides and blood is reabsorbed.
Hematomyelia Patients presentation includes: Flaccid Paralysis and and muscle atrophy
True, though spastic paralysis gradually increases with segmental loss in pain and temperature.
Function in Hematomyelia does not return?
False, returns in posterior and lateral columns,
Anterior cord syndrome is when there is damage to the front half of the spinal cord?
False this is when there is damage to the front two thirds of the spinal cord (includes Corticospinal and Spinothalamic tracts), preserving posterior columns.
Causes of Anterior cord syndrome included retrograde disc or bone fragments
False, ACS is caused by retropulsed disc or bone fragments and injuries resulting from compression of anterior segments like, flexion injuries.
Anterior cord syndrome has a loss in Muscle power, pain, temperature, and plight touch below NLI.
False, ACS does not affect Light touch, as well as Deep pressure and proprioception.
Central cord syndrome distribution occurs across equally the spinal cord
False, it almost exclusively occurs in the cervical region due to hyperextension with simultaneous compression of the spinal cord in more central regions.
Central Cord Syndrome is common in elderly patients with pre existing spondylosis/stenosis
True
Central cord syndrome is common in which population of people
Elderly
Central cord syndrome results from anterior and posterior cord compression.
True
Central Cord syndrome symptoms include ?
1) Motor loss UL more than LL
2) Sensory loss, more server in UL
3) Flaccid paralysis(LMN) in arms
4) Relatively Strong but sparsity(UMN) legs
5) Sacral sensation and bowel and bladder function partially spared
There is spasticity in UL’ IN Central Cord syndrome?
False, Flaccid paralysis.
Is Recovery possible in Central cord syndrome ?
Yes, occurs from legs first then bladder then UL extremity before intrinsic hand muscles.
What are the 2 causes of poor gait issues in posterior cord syndrome?
1) Difficulty is seen due to profound sensory and proprioception loss.
2) Difficulty and with coordination
Posterior cord syndrome is common
False
Posterior Cord syndrome is commonly found in patients with Compression injuries
False, Hyper-extension injuries that lead to posterior columns contusions.
Motor function, temperature and pain are partially affected in Posterior cord syndrome.
True
Motor function, temperature and pain are partially affected in Posterior cord syndrome.
True
Motor function, temperature and pain are partially affected in Posterior cord syndrome.
True
Signs and symptoms of Posterior cord syndrome
Poor coordination, Ataxia (unsteady walking), Poor proprioception, poor vibration sense, Hypotonia, Frequent falls.
What is the prognosis fro Posterio cord syndrome
Good as most patietns are able to rreatign good fucntion and mobility, including walking.
Signs and symptom of Posterior cord syndrome includes a Positive Romberg Signs
True
What is Brown-Sequard Syndrome?
It is an injury that affecters half the spinal cord, Hemi section lesion, results in paralysis and proprioception ipsilaterally and contralateral loss of pain and temperature. Generally, caused by stabs/Gunshot wounds.
Brown-syndrome is more common than Brown-Sequard syndrome plus.
False.
Ipsilateral symptoms of Brown-Sequard include: 2 Point discrimination.
True, includes, 2-point discrimination, motor loss, vibration, form perception. True, includes, 2-point discrimination, motor loss, vibration, form perception.
Contralateral brown Sequard syndrome include: Light touch
True
Ipsilateral symptoms of Brown-Sequard include: form perception:
False, it falls apart of Contralaterlay loss that includes, 2-point discrimination, motor loss, vibration, form perception.
Ipsilateral symptoms of Brown-Sequard include: Proprioception:
True, includes, 2-point discrimination, motor loss, vibration, form perception.
Spinal Shock occurs after spinal cord injury and remains fro about 9- 12 months.
False, last about 4-6 weeks (some cases 12 weeks)
Spinal Shock sympotmsin the acute pase include: Hypotonia, increased reflexes and increased babinski reflex
False it deos include hypotonia, arefelxia and absent reflex
Spinal shock after complete transaction will result in?
Hypotension, anhidrosis, urine retention with bladder distension
Post spinal Shock motor signs include.
Muscle paralysis, muscle paralysis, clonus, increased reflexes (including positive Babinski), Spastic bowel and bladder.
LMN symptoms occur at which level?
Anterior horns cells or Nerve root.
LMN lesion symptoms seen @ level of injury include,
Hypotonia, Reduced reflexes, fasciculations, Muscle paralysis, Muscle Atrophy
Spinal root lesion symptoms include:
Sensory loss, muscle weakness, muscle atrophy, reduced reflexes, segmental weakness, destruction of Anterior horn cells.
C1 - C3 functional status?
Limited talking
C3- Limited head & Neck movement.
Ventilator needed for breathing.
Needs pressure relief care.
C3 - C4 functional status?
Usually have head control
C4 = ability to shrug shoulders (Trapezius muscle controlled by CN XI, C3 & C4
Initially requires a ventilator
C5 functional status?
1) Elbow flexion present (Biceps Bracchi), as well as supination
2) Head, neck and shoulder control present
3) Independently eat drink, brush teeth
4) Patient will mainly use power wheelchair though can use manual for short distances over smooth surfaces
5) Pressure relief care through side and forward leans.
C6 functional status?
1) Able to extend wrist and has tendinous grip - WORK ON THIS
- grip strengthened with flexor-hinge orthotics or brace
2) May independently do bladder and bowel management
3) May be independent in household chores, transfers and pressure relief
C7 functional Recovery ?
1) Have major part of Latissimus dorsi (C6, C7. C8)
2) Elbow extension strength present
3) Can perform wheelchair push ups for pressure relief
Able to assist more in transfer without transfer board
C8 - T1 functional status?
C8 => Have the flexor digitorum profundus.
T1 => Have the abductor digiti minimi.
Patient have better finger use
Can live independently, feeding, grooming, oral and fascial hygiene, transferring, bladder and bowel management.
C8 - T1 functional status?
C8 => Have the flexor digitorum profundus.
T1 => Have the abductor digiti minimi.
Patient have better finger use
Can live independently, feeding, grooming, oral and fascial hygiene, transferring, bladder and bowel management.
C8 - T1 functional status?
C8 => Have the flexor digitorum profundus.
T1 => Have the abductor digiti minimi.
Patient have better finger use
Can live independently, feeding, grooming, oral and fascial hygiene, transferring, bladder and bowel management.
T2- T6 functional status?
1) Have better trunk control than highr lesions
T7 - T12 functional status?
1) Better abdominal control, thus better cough effort.
2) Able to perform unsupported seated activates.
L1 - L5 functional status?
L1-L2 : backslaps or callipers with crutches for
therapeutic walking
L4-L5: independent walking with crutches and
AFO
L4 lesion patellar tendon reflex present or absent.
Present
L4 - L5 functional status patient will be able to independently walk without assistive mobility devices
False, need Crutches and AFO’ Gait; Wheelchair not required.
S1 - S5 functional status?
Independent walking, possible loss for bladder and bowel as well as sexual function
S1 - S5 functional status?
Independent walking, possible loss for bladder and bowel as well as sexual function
L4 Myotome ?
Dorsiflexion
L5 myotome?
Big toe extension
S1 Myotome ?
Plantar felxion
S2 Myotome ?
Knee flexion.
Expected Respiratory Function for C1 or C2
5-10 % of normal Vital Capacity, No cough
Expected respiratory function of C3-C6 vital capacity is 20% of normal with weak and ineffective cough
True
Expected respiratory function of T2-T4 is 50-60 =% of normal VC with weak cough
False, VC is 30-50% of normal with weak cough.
Expected respiratory function @ T11 have normal VC and cough is moderate.
False, VC is normal but cough is strong.
Functional Gait recovery L2 - L4 need walking aid with below knee clippers.
True
T10 - L2 gait pattern ?
4 point gait and swing through
Is the recommended gait pattern for T8 - T10 lesions, swing to and swing through gait ?
True
Is T8 - T10 walking is functional?
False
Is T10 - L2 waling functional.
False may be functional though wheelchair is needed during part of the day.
