Spinal Cord Injury Flashcards
ASIA A
Complete impairment (no sacral sparing)
ASIA B
Incomplete: Sn preserved but no Motor fx including S4 & S5
ASIA C
Incomplete: Motor preserved + >1/2 of key muscles have grade <3
ASIA D
Incomplete: Motor preserved + >1/2 of key muscles have grade >3
ASIA E
Motor and Sn normal
Motor grade 3
Movt against gravity
Descending motor pathway (cortex -> internal capsule & crus cerebri)
Corticospinal tracts
Corticospinal tract damage
IPSILAT muscle weakness, spasticity, DTR, babinski
Dorsal gray matter
Spinothalamic tracts
Spinothalamic tract damage
Loss of pain & temp sn in CONTRALAT
Ascending pathway
Dorsal posterior columns
Dorsal (posterior) column
IPSILAT loss of vibration and proprioception
3 incomplete spinal cord syndromes
- Anterior cord syndrome
- Central cord syndrome
- Cauda equina syndrome
Damage to corticospinal and spinothalamic pathways with preservation of posterior column fx (poor prog)
Anterior cord syndrome
Usually seen on patients wth cervical spondylosis who sustain a hyperextension injury; dec strength, pain & temp sn in UE>LE
Central cord syndrome
Not a true spinal cord syndrome, more of peripheral nerve injuries; sciatica, sadle anesthesia, variable motor and sn loss in LE, dec LE reflexes
Cauda equina syndrome
Distributive shock -> warm vasodilated, dec BP, relative bradycardia, loss of SY tone
Neurogenic shock
temp loss/ depression of spinal reflex activity -> flaccidity, loss of reflexes/ voluntary movt
Spinal shock
Intubate patients with spinal injury C_ and above
C5 (C3-C5 affect phrenic nerve)
Maintain MAP >__ mm Hg for 7 days
85
Spinal-dose steroid
Methylprednisione 30 mg/kg IV bolus over 15 mins ff by 45-min pause then continuous infusion at 5.4 mg/kg/h for 23 hours (within 8 h of injury)
Rigid external orthotic devices
Philadelphia, miami-J collars
Cervicothoracic orthoses
Minerva braces
External cervical stabilization
Halo vest assemblies
Provides lumbar stabilization
Thoracolumbosacral orthoses
