Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NeuroRehab > SCI review > Flashcards

SCI review Flashcards

1
Q

What is the general function of the spinal cord?

A
  • To convey messages between the brain and the body

- Role in visceral function through the autonomic nervous system: HR, BP, Temp regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SCI classified as concussions mean…

A
  • a temporary loss of function
  • transient disturbance of function of the spinal cord that shows initial signs of either complete or partial interruption of the function of the SC or cauda equine
  • usually results in full recovery w/in a few hours after injury if the cause is rapidly relieved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

SCI classified as contusions mean…

A
  • injury to the glial tissue and spinal cord surface remain intact
  • Subarachnoid hemorrhages are frequent and can cause further compression on the cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

SCI classified as lacerations mean…

A

-Glial tissue and spinal cord is may be torn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of Nontraumatic SCI

A
  • Circulatory: AV malformation, thrombus
  • Compression: vertebral sublaxation from ligament laxity in RA or down syndrome
  • Demyelinating disease: MS
  • Inflammatory disease: transverse myelitis
  • congenital malformations
  • hysterical paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of Traumatic SCI

A
  • MVA
  • Violent crimes
  • sports:diving,football,cycling,hunting
  • falls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the areas most commonly affected in a SCI

A

Transition areas

  • C1-C2
  • C5-C7
  • T12- L2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In a flexion injury

What part of the cord would be the most affected?

A
  • most commonly occur in the cervical spine and thoracolumbar junction
  • associated with wedge frcatures and fractures of the anterior vertebral body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

extension injury

What part of the cord is most likely involved?

A

-usually results in rupture of the anterior longitudinal ligament and fracture of the posterior elements of the cervical vertebra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the primary damage that affects the spinal cord?

A
  • Possible fracture of the spine
  • destruction of the neurons at the level of the injury
  • destruction of the neurons at the level of the injury
  • disruption of the membrane
  • hemorrhage and vascular damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Secondary damage

A
  • hypoxia and ischemia due to damage to the actual blood vessels
  • Vasoconstriction from compression on the remaining blood vessels from the accumulated swelling in the area
  • macrophages digest necrotic tissue
  • astrocytes form scar tissue in the SC and overlying dura
  • demyelination
  • wallerian degeneration in the ascending posterior columns above the lesion and in the descending CST
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Quadriplegia

A
  • complete paralysis of all four extremities and trunk

- results from injuries to the cervical area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Quadriparesis

A
  • Partial paralysis of all four extremities and trunk

- results from injury to the cervical area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Paraplegia

A
  • Complete paralysis of all or part of the trunk and both lower extremities. the upper extremities are not involved
  • results from injuries to the thoracic or lumbar area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Paraparesis

A
  • partial paralysis of part of the trunk and both lower extremities
  • results from injuries to the thoracic or lumbar area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is a complete injury?

A

-no movement or sensation below the level of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is an Incomplete injury?

A
  • some movement and/or sensation below the level of injury

- function may not be oresent through S4-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Syringomyelia

A
  • Pathologic condition that can appear over time in the spinal cord related to trauma
  • posttraumatic syringomyelia may develop up to 30 yrs after the initial injury, but most commonly 4-9 yrs after injury
  • cystic cavitation and gliosis of the SC
  • Thoracic spine is the most common site for the syrinx to develop
  • the cavity may occupy the entire cross sectional area of the cord compression the cord and the root entry zone
  • compression of the posterior columns, resulting in loss of sensation, compression of the spinothalamic tracts resulting in sharp pain that is often the first symptom followed by stiffness and weakness in the neck, upper back, shoulders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Brown-Sequard Syndrome

A
  • hemisection of the cord
  • Damage to one side of the SC is caused by stabbing or GSW
  • ipsi involvement: - motor loss: altered selective movements, hyperreflexia, spasticity, Babinski, clonus. loss of proprioception

-contra involvement: pain and temp loss starting a few levels below the injury site secondary to the lateral spinothalamic tract ascending on the same side several segments before crossing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anterior Cord syndrome

A
  • frequently associated with flexion injuries
  • often a result of loss of supply from the anterior spinal artery
  • damage to the anterior and anterolateral aspect of the cord results in bilateral loss of motor function and pain and temperature sensation due to interruption of the anterior and lateral spinothalamic tracts and corticospinal tract

-Proprioception, kinesthesia, vibration is spared secondary to the unaffected posterior columns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Central cord syndrome

A
  • results of damage to the central aspect of the spinal cord often caused by hyperextension injuries in the cervical region
  • more severe involvement in the upper extremities than in the lower extremities
  • Peripherally located fibers of the cord are not affected therefore, function is retained in the thoracic, lumbar , and sacral regions including bowel, bladder and sexual function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Posterior Cord syndrome

A
  • very rare
  • preservation of motor function, pain and light touch sensation
  • loss of proprioception, kinesthesia, vibration below the level of the lesion
  • tabes Dorsalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cauda Equina Syndrome

A
  • damage at the base of the vertebral column
  • peripheral nerve injury, potential for regeneration
  • areflexive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

acute stages of SCI: Spinal Shock

A
  • period of generalized loss of neurological function and areflexia immediately following the SCI
  • Characterized by: flaccidity, loss of al reflexive activity, loss of sensation below the level of injury
  • duration varies from several hours to several weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

bulbocavernous reflex

A
  • utilized as a prognostic indicator
  • involves monitoring anal sphincter contraction in response to squeezing the glans penis or pulling on the foley catheter

–pos reflex w/o sensory or motor return indicates a complete injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Autonomic Dysreflexia

A

-ANS dysfunction which causes uninhibited reflex response to a noxious stimulus

  • -noxious stimuli initiates a reflex reaction if the ANS of total body vasoconstriction
  • the body’ normal compensatory mechanisms to vasodilate are non-functional dur to the inability of messages to pass the level of injury
  • occurs with complete or incomplete SC injuries at or above T5
  • in the non-spinal cord injured person, the descending sympathetic output compensates for the incr in BP by causing vasodilation to bring the BP back to normal
  • following an SCI the nerves below the level of injury cont to transmit excitatory impulses causing vasoconstriction and incr BP
  • With the lack os sympathetic inhibitory output below the level f the lesion, the BP keeps rising unchecked
27
Q

symptoms of Autonomic Dysreflexia

A
  • Pounding, severe headaches
  • sudden and significant incr in both systolic and diastolic BP above normal
  • flushing at the level of injury with pallor below the level of injury
  • shivering with goose pimples followed by profuse sweating above the level of injury
  • nasal congestion
  • blurred vision, visual field changes
  • fast pounding pulse followed by a progressively slowing pulse
  • incr anxiety and apprehension
28
Q

Spasticity

A
  • occurs with T11 injuries and above (L1-2 cauda equine)
  • characterized by hypertonicity in combination with hyperreflexia and clonus
  • due to lack of inhibition of reflex activity caused by interruption of nerve signals along the SC
29
Q

Stages I of Pressure Sores

A
  • Reactive Hyperemia

- Marked by reddened area of skin which lasts for 15 mins or longer after teg oressure has been relieved

30
Q

Stage II of Pressure Sores

A
  • Ischemia

- marked blisters or small breaks through the dermis

31
Q

Stage III of Pressure Sores

A
  • Necrosis

- Marked opening in deeper subcutaneous fatty tissue layer beneath the dermis

32
Q

Stage IV of Pressure Sores

A
  • Ulceration
  • ulceration penetrates through all soft tissue layers between the skin and bone
  • destruction of dermis, subcutaneous tissue, muscle an dbone
33
Q

Primary causes of pressure sores

A
  • impaired sensation
  • DEcr blood flow
  • decr muscle bulk
  • decr ability to make positional changes
  • poor nutrition
  • constant moisture from incontinence
  • cigarette smoking
  • poor self care
34
Q

postural hypotension

A
  • sudden onset of low BP caused by peripheral venous pooling

- S/S: drop in BP, dizziness, pale color, fainting, fast pulse

35
Q

treatment of postural hypotension

A
  • Elastic stockings

- abdominal binders

36
Q

Heterotopic ossification

A
  • abnormal bone growth in the soft tissue below the level of injury
  • etiology is unknown other than a neurological insult is the predisposing factor
  • always extraarticular: adjacent to large joints, Develops in connective tissue b/w muscles planes, in aponeurotic tissue and in tendons
37
Q

stage I of Heterotopic Ossification

A
  • soft tissue swelling, pain local warmth, erythema, serum and alkaline, phosphatase levels are elevated. no evidence is present on radiographs. Possible limitations of joint ROM
38
Q

stage II of Heterotopic Ossification

A

-Swelling remains, cont high alkaline phosphatase levels. formation is present on radiographs

39
Q

stage III of Heterotopic Ossification

A
  • initial swelling and erythema subsiding
40
Q

Stage IV of of Heterotopic Ossification

A
  • extensive calcification has developed. may be initial signs of ankylosing of adjacent joint
41
Q

Complications of Heterotopic Ossification

A
  • functional limitation due to ankylosing joint

- pressure sore development

42
Q

treatment of Heterotopic Ossification

A
  • drug therapy can prevent the crystallization of calcium phosphate, preventing ectopic bone formation
  • aggressive ROM
  • surgical intervention
43
Q

Contractures

A
  • connective tissue and muscle tissues progressively shorten when not stretched regularly
  • occur mostly in flexor muscle groups because of the incr sitting time in wheelchairs
44
Q

treatment of contractures

A
  • PROM and self stretching exercises
  • Positioning programs
  • splinting/serial casting
  • surgical interventions
45
Q

Nerve root pain

A
  • nerve roots b/w the uninjured cord and injured cord, which has been stabilized surgically, create an area of irritation
  • occurs at the level if injury
  • follows a dermatomal pattern
46
Q

Dysethesias pain

A

-possible causes include sparing of sensory fibers which become irritated and scarring

47
Q

musculoskeletal pain

A
  • occurs above the level of injury

- excessive work load

48
Q

Respiratory complications of SCI

A
  • high risk of aspiration exists
  • “quad cough”
  • pneumonia is a frequent complication associated with high level injuries and is the most common cause of death immediately after the injury
  • lesions above C4 result in paralysis of muscles of inspiration and generally require artificial ventilation
  • loss of respiratory function from C5-T12 arise from loss of innervation of the abdominal and intercostal muscles
  • alternate breathing pattern develops where the accessory muscles are used for inspiration
49
Q

Osteoporosis

A
  • abnormal loss of bone substance as a result of an incr resorption rate relative to the rate of new bone formation
  • lack of stress on bone from decr axial compression and decr muscle pull on the bone
  • Primary complications can include kidney stones, spont fractures, marginal rib erosion
50
Q

Spastic Bladder

A
  • UMN
  • T11 injuries and above
  • Spont voiding if sphincter not spastic
  • no voiding if sphincter is spastic
  • management- intermittent catheterization (ICP)
  • time void or external collection device (leg bag)
51
Q

Flaccid bladder

A
  • LMN
  • T12 injuries and below
  • no voiding
  • constant dribbling
  • requires leg bag
  • managed with triggering techniques
  • needs intermittent catheterization to remove residual volume
52
Q

SCI Prognosis

A
  • most motor recovery will occur within the first 6 months
  • strength can cont to incr with appropriate facilitation
  • muscles graded in the 1-3 zone have potential to recovery motor function
  • compression fractures have the most favorable prognosis, crush fractures have to least potential for return
53
Q

SCI Prognosis for incomplete lesions

A
  • improvement begins almost immediately
  • motor and sensory function below the level of injury and good prognostic indicators for recovery
  • recovery can be minimal to dramatic depending on the factors discussed above. In time the rate of recovery will decr and a plateau will be reached
54
Q

Percentage for an Asia grade A to progress to higher level

A
  • 10%
55
Q

percentage for an ASia B or C to progress to higher level

A
  • B to higher: 45%

- C to higher: 55%

56
Q

Level C1-3 functional capabilities

A
  • Bed mobility: total assist
  • transfers: total assist
  • Power w/c: independent driving using head, mouth or chin controls. independent pressure relief with tilt in space or eecline
  • manual w/c: total assist
  • no ambulation
57
Q

Level C4 functional capabilities

A
  • Bed mobility: total assist
  • transfers: total assist
  • power w/c: independent driving using head, mouth or chin controls. independent pressure relief with tilt in space or recline
  • manual w/c: total assist
  • no ambulation
58
Q

Level C5 functional capabilities

A
  • Bed monility: some assist
  • transfers : total assist
  • Power w/c: independent driving using hand controls. independent pressure relief with tilt in space or recline
  • manual w/c: independent to some assist indoors on uncarpeted level floors. some assist to total assist outdoors
  • no ambulation
59
Q

Level C6 functional capabilities

A
  • Bed mobility: SOme assist
  • transfers: even surfaces some assist. uneven surfaces, some assist to total assist
  • Power w/c: independent driving using hand controls. independent pressure relief with or w/o tilt in space or recline
  • manual w/c: independent to some assist indoors on uncarpeted level floors. SOme assist to total assist outdoors
  • no ambulation
60
Q

Level C7-8 functional capabilities

A
  • Bed mobility: independent to some assist
  • transfers: even surfaces independent. uneven surfaces, independent to some assist
  • manual w/c : independent indoors on level surfaces. some assist outdoors
  • no ambulation
61
Q

Level T1-9 functional capabilities

A
  • Bed mobuility: Independent
  • transfers: independent
  • Manual w/c: independent indoors and outdoors-ambulation: standing with RGOs/KAFOs, functional ambulation not typical
62
Q

Level T10-L1 functional capabilities

A
  • Bed mobility: independent
  • transfers: independent
  • manual w/c: independent indoors and outdoors
  • ambulation: some assist to independent in functional ambulation with RGOs/KAFOs using Loftsrand crutches or a walker
63
Q

Level L2-S5 functional capabilities

A
  • Bed mobility: independent
  • transfers: independent
  • Manual w/c: independent indoors and outdoors
  • ambulation: some assist to independent in functional ambulation with RGOs/KAFOs using Loftstrand crutches or a walker

NeuroRehab (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions