SCI, Scoliosis, CP Flashcards
What is a spinal cord injury?
A spinal cord injury is caused by a complete or partial rupture of the spinal cord
What is paraplegia and how is it caused?
- Paraplegia is loss of motor and sensory functions from arms and down
- Can be complete - legs, abnomen, and chest
- Incomplete - just legs
- Caused by injury of thoracic level (complete) or lumbar level (complete or incomplete)
Symptoms of upper motor neuron lesion (in SCI)
- No muscle atrophy
- Positive Babinski
- Hyperactive deep tendon reflexes
- Hypertonia
- Arm weakness
- Spasticity, pain, sensory impairment, and autonomic impairment (ex. Bladder)
What are the different grades of SCI?
- Complete which is no sensory or motor functions
- Sensory incomplete where sensory functions still present but no motor functions
- Motor incomplete where motor functions are still present but decreased
- Normal which is normal functions but may have abnormalities of reflexes
What are the key points of assessments?
Sensory:
- injury of C7 affects sensation of little finger dorsal surface
- injury of L4 = medial melleoulus
Motor:
- injury of C5 affects bicep brachii
- injury of L4 affects dorsiflexion
- injury of S1 plantarflexion
It is not black and white since multiple muscles and nerves work together
How is scoliosis defined?
It is a three-dimensional lateral deformity of the spine and trunk meaning that it is both curve and torque deformities
What are the types of scoliosis?
Functional = caused by factors outside spine
- Different length of legs
- Different pain in sides from ex. Lumbago sciatica
Structural = changes of the spine during development and growth
- Congenital scoliosis = asymmetrical bone growth in in formation of spine
- Degenerative scoliosis = degenerative changes of spine
- Neuromuscular scoliosis = secondary to a neuromuscular condition (CP, SCI, atrophy)
- Traumatic scoliosis (rare) = deformation may also be due to trauma
- Idiopathic scoliosis = without any further explanation, most common and may be due to hormones affecting bone metabolism and is more common in females
How is the progression of scoliosis?
- Youths are at highest risk of rapid progression especially for idiopathic
- Adults with complete spinal growth will progress slower
- The condition will get worse if you go untreated
Explain treatment options
Physiotherapy - self correction
- Passive = correction driving positions of body with help of tools
- Active = correction driving exercises without tools
Bracings - for curves over 25-45 Cobb
- More you wear the better
- Goal is to avoid surgical treatment and reach curve below 30 Cobb
Srugery - for curves over 45 Cobb
- Maintain trunk balance
- Prevent progression and deformities
What are the consequences of scoliosis?
- Lung and heart problems in severe cases since ribcage is pushed against heart and lungs which may cause pain, nerve compression, and leakage of spinal fluid
- There are also psychological consequences like low self-esteem and depression or anxiety due to physical limitations and abnormal appearance
- Difficulties sleeping due to bracing
Name some tests that is used to diagnose scoliosis
- Adam’s test: bend forward to measure torque of thorax with coliometer
- Cobb’s test: determines severity of spinal curvature
Symptoms of scoliosis is…
- Back pain going down to legs, shoulder pain
- Uneven hips or shoulders
- Fatigue in spine after sitting or standing
- Trouble breathing
How is CP defined and what causes it?
A group of permanent neurological disorders that affects the motor functions.
Caused by a lesion of the brain before the age of 2 years old, and affects the brains plasticity (ability to form new neuron connections):
- Intraventricular hemorrhage – bleeding into brain’s ventricles
- Hypoxic injury/ischemic injury – restricted/complete disruption of oxygen supply to the brain
What are the classifications of CP?
- Spastic (hypotonia first in babies) = most common and is defined as unbalanced/increase muscle tone causing stiff muscles
- Dyskinetic:
1. Dystonia = presented as sustained muscle contractions causing abnormal posture
2. Dyskinesia = involuntary movements - Ataxic = disturbances in balance, coordination, and depth perception
Can be bi- or unilateral and is classified by dominant presentation of symptoms
Name some factors increasing risk of CP
- Prenatal - before birth:
1. High maternal age increase risk of thrombosis
2. First time pregnancy increase risk of stroke - Maternal disease:
1. Diabetes
2. Anemia
3. Hypertension - Trauma to brain as child (under 2 y/o)
- Exposure to infectious disease at birth - urinary tract, STD
