Spinal cord injuries

Question 1

Spinal cord

Answer 1

Direct continuation of the brainstem specificaly the medulla

Question 2

conus medullaris

Answer 2

at L1 level where spinal cord becomes cone shaped

Question 3

cauda equina

Answer 3

mass of spinal nerve roots formed with spinal cord

Question 4

filum terminale

Answer 4

extends from the caudal end of the spinal cord and attaches to the coccyx.

Question 5

Gray matter

Answer 5

refers to areas that contain large numbers of nerve cell bodies and dendrites.
it surrounds the white matter.

Question 6

White matter

Answer 6

composed of axon and associated glia

Question 7

how many pairs of spinal nerves does human have

Answer 7

31 pairs corresponding to segment of spinal cord
C1-C8
T1-T12
L1-L5
S1-S5
Coccygeal 1 pair

Question 8

A spinal cord injury

Answer 8

 A spinal cord injury is damage to the spinal cord that causes temporary or permanent changes in its function.
 Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.

Question 9

causes of spinal cord injury

Answer 9

*Trauma
*Infection
*Benign/malignant tumor
*Vascular disorders

Question 10

Primary Injury

Answer 10

The initial mechanical forces delivered to the spinal cord at the time of injury is known as primary injury where “displaced bone fragments, disc materials, and/or ligaments bruise or tear into the spinal cord tissue.”

Question 11

Secondary injury

Answer 11

In the 15th minute, microhemorrhage occurs in the gray matter and spreads, the spinal cord swells, fills the canal, ischemia begins when venous pressure is exceeded.

Question 12

Spinal Shock

Answer 12

• Spinal shock is manifested by the absence of the
  bulbocavernous reflex, hypotension, bradycardia, and complete
  loss of motor, sensation and reflexes.

Question 13

Upper Motor Neuron Lesion

Answer 13

– Refers to the lesion of the spinal cord.
– Cortical control is lost below the lesion level.

Question 14

Lower Motor neuron lesion

Answer 14

– It is the lesion of the cauda equina and peripheral nerve
roots.

Question 15

Tetraplegia (Quadriplegia)

Answer 15

– They are the lesions above T1
– It is dysfunction of the arms, trunk, legs and pelvic organs.
– The term incomplete tetraplegia is used instead of the previously used term tetraparesis.

Question 16

Lesions below T1
– Depending on the lesion level, the trunk, lower extremities, and pelvic
organs may be affected.
– Includes lesions of cauda equina and conus medullaris.

Answer 16

paraplegia

Question 17

types of spinal injury

Answer 17

complete
incomlete

Question 18

incomplete injuries

Answer 18

there is partial preservation of some motor or sensory function

Question 19

central cord syndrome

Answer 19

prognosis is good
bleeding into central gray matter causes damage to the spinal cord

Question 20

anterior cord syndrome

Answer 20

prognosis is bad
result from flexion injury to cervical spine in which dislocation/fracture of cervical spine occurs

Question 21

posterior cord syndrome

Answer 21

rare incomplete syndrome that results from damage to posterior spinal artery by tumor or vascular infarct

Question 22

Brown-Séquard Syndrome

Answer 22

best prognosis
injury involve half of the spinal cord

Question 23

Damage to the sacral aspect of the spinal
cord and the lumbar nerve roots
– Blow to the back such as gunshot and spinal tumor.

Answer 23

conus medullaris syndrome

Question 24

injury usually occurs after the patient sustains a direct trauma from a fracture-dislocation below the L1 vertebrae

Answer 24

Cauda Equina Syndrome

Question 25

Complete injuries

Answer 25

If an injury is complete, sensory and motor function will be absent below the level of the injury and in the lowest sacral segments of S4 and S5.

Question 26

Factors affecting functional expectation

Answer 26

*Return of sacral sensation
*Neurological level
*Complete-incomplete injury
*Other medical problems
*Age
*Motivation

Question 27

Complications in spinal cord injury

Answer 27

Autonomic Dysfunction
Cardiovascular Dysfunction
Respiratory Dysfunction
Gastrointestinal Dysfunction
Urological Dysfunction
Sexual Dysfunction
Bone Metabolism Dysfunction
Pain
Psychological

Question 28

Spinal shock

Answer 28

temporary loss of all neurological activity including motor, sensory and reflex activity

Question 29

Neurogenic shock

Answer 29

result from damage to the spinal cord above level of T6

Question 30

Autonomic Dysreflexia

Answer 30

Autonomic dysreflexia, also referred to as autonomic hyperreflexia, is a potentially life-threatening condition that can affect people who have had a spinal cord injury at the level of T6 or above, and occurs more frequently in those with a complete injury over those with an incomplete injury, presenting more commonly during the chronic phase of spinal cord injury, around 3 - 6 months.

Question 31

thermoregulatory problems

Answer 31

Thermoregulatory center in the hypothalamus regulates thermogenesis by activating or inhibiting the sympathetic nervous system to maintain core body temperature.

Question 32

Orthostatic hypotension

Answer 32

 Orthostatic Hypotension is defined as a decrease in
 systolic blood pressure of 20 mmHg or more, or
 diastolic blood pressure of 10 mmHg or more,

Question 33

Upper motor neuron bladder

Answer 33

occurring in a suprasacral lesion results in a reflex bladder, characterized by loss of cortical inhibition of sacral reflex arcs due to disturbance of descending spinal tracts, leading to detrusor
hyperactivity often in combination with detrusor sphincter dyssynergia.

Question 34

lower motor neuron bladder

Answer 34

occurring in a Sacral Lesion at S2 - S4 results in an areflexic bladder characterized by diminished motor stimulation of the bladder and reduced or absent contractility of the detrusor, meaning the bladder will not contract no matter how much it fills up.

Question 35

other complications of spinal injury

Answer 35

*Erectile dysfunction
*Infertility
*Heterotrophic ossification
*Osteoporosis
*Spasticity
*Nociceptive pain and
*Neuropathic pain
*Psychological pain