spinal cord injuries Flashcards
what percentage of people with a fracture or dislocation will have SCI
15%
spinal cord injuries are most common in
Male > female
peak 20-29
most common cause of spinal cord injury
fall
Presentation of Complete Spinal cord Injury (5)
- No motor/sensory function distal to lesion
- No anal squeeze
- no sacral sensation
- Asia Grade A
- No chance recovery
Incomplete spinal cord injury presentation (2)
- Some function below site of injury
2. Not able to determine acutely as patient may be in spinal shock
Asia Classification of Spinal cord Injury Grade A
Complete
No sensory or motor function preserved in S4-S5
Asia Classification of Spinal cord Injury Grade B
Incomplete
Sensory but not motor preserved below level and extend through S4-S5
Asia Classification of Spinal cord Injury Grade C
Incomplete
Motor function preserved below near level
Asia Classification of Spinal cord Injury Grade D
Incomplete
Motor function preserved below neurologic level
majority of key muscles grade >3
Asia Classification of Spinal cord Injury Grade E
normal motor and sensory function
What is Tetraplegia (2)
Partial or total loss of all four limbs and trunk
Loss of motor/sensory function in cervical segments of the spinal cord
Tetraplegia cause
Cervical Fracture
Results of Tetraplegia
Resp failure due to loss of innervation of diaphragm
Which nerve affected in loss of innervation to diaphragm in tetraplegia
C3-5 Phrenic Nerve
Spasticity affects what type of Spinal cord injury
spasticity
Spasticity Features Presentation (4)
Increased Muscle Tone
UMN Lesion
Spinal Cord and Above
Injury above L1
What is Paraplegia (4)
- Partial or total loss of use of the lower-limbs
- Impairment or loss of motor/sensory function in thoracic, lumbar or sacral segments of the spinal cord
- Arm function spared
- Possible impairment of function in trunk,
Paraplegia is caused by (2)
Thoracic/Lumbar fractures
Associated chest or abdominal Injuries
Paraplegia what is affected (2)
Spasticity if injury of spinal cord (i.e. above L1)
Bladder/ Bowel function affected
Central Cord Syndrome affects who
Older Patients
Hyperextension Injury
Central Cord syndrome presentation (2)
Weakness of arms > legs
Perianal sensation & lower extremity power persevered
Anterior cord syndrome is what type of injury (3)
Hyperflexion injury
Anterior Compression Fracture
Damaged Ant Spinal Artery
Anterior Cord Syndrome Presentation
Fine touch and proprioception preserved
Profound weakness
Brown Sequard Syndrome is what (3)
Hemi-section of the cord
Penetrating injuries
Paralysis on affected side (corticospinal)
Brown Squared Syndrome Presentation
Paralysis on affected side (corticospinal)
Loss of proprioception and fine discrimination (dorsal columns)
Pain and temperature loss on the opposite side below the lesion (spinothalamic)
How do Spinal Cord injuries typically present in circulation (5)
IV fluids Consider Neurogenic Shock - low BP and HR - Loss of sympathetic tone - Vasopressors
How does spinal shock present (4)
Transient depression of cord function below level of injury
Flaccid paralysis
Areflexia
Last several hours to days after injury
How does neurogenic shock present (5)
Hypotension Bradycardia Hypothermia Injuries above T6 Secondary to disruption of sympathetic outflow
What is preferred for spinal surgery surgical fixation
pedicle screws