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otsem2: physdys 1 > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

Involves damage to the spinal nerves through compression, bruising or severing of the spinal cord

A

Spinal cord injury

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2
Q

Differentiate complete SCI vs incomplete SCI

A

Complete: complete interruption of nerve tracts leading to TOTAL paralysis and loss of sensation

Incomplete: there is partial preservation between sensory and motor pathways below the level of lesion

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3
Q

Epidemiology for SCI

A

Males > Females
Young adults (16-30 years old)

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4
Q

Etiology of SCI

A

Traumatic
- MVA, sports, Falls

Non-traumatic
- Osteoporosis, Myelitis, Arthritis, Multiple Sclerosis

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5
Q

Pathophysiology:
mc MOI that may lead to anterior cord syndrome.
Identify which cord is most susceptible

A

Flexion
c4 to c7
t12 to l2

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6
Q

Pathophysiology:
Excessive axial loading force
Closely associated with flexion injuries

A

Compression

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7
Q

Pathophysiology:
MC MOI in elderly (falls)
May lead to Central Cord Syndrome

A

Hyperextension

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8
Q

Pathophysiology:
Flexion injury directed at a rotated Vertebral Column

A

Flexion rotation

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9
Q

Pathophysiology:
Horizontal force is applied to adjacent V.C. segment

A

Shearing

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10
Q

Pathophysiology:
LC MOI
Usually applied as a traction force w/c is common in whiplash injuries

A

Distraction

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11
Q

Indication whether there is incomplete or complete lesion

A

Incomplete lesions: (+) sacral sparing
Complete lesions: (-) sacral sparing

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12
Q

Identify and briefly explain 3 tests for sacral sparing

A

Perianal sensation: through light touch
Anal wink: insertion of finger in the anus
Big toe flexion = (+) anal sphincter

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13
Q

Dorsal column conveys the following sensation:

A

proprioception, vibration, 2 pt discrimination, kinesthesia

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14
Q

tract for motor pathway

A

Corticospinal tract

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15
Q

Lateral spinothalamic tract is responsible for transmitting __ and __

A

Pain and temperature

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16
Q

Anterior spinothalamic tract is responsible for transmitting __ and __

A

light touch and pressure

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17
Q

Identify which syndrome is being defined:
- Incomplete injury that mostly affects UE
- “Walking SCI”

A

Central cord syndrome

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18
Q

Identify which syndrome is being defined:
-(CST) Motor function is partially affected
-(LST) Pain and temperature is affected
-(AST) light touch and pressure is affected

A

Anterior spinal cord syndrome

19
Q

type of syndrome where only 1 side of the cord is damaged d/t stabbing or gunshot injury

*below level of injury:
(paralysis) i/L side = (+) paralysis and loss of proprio
(sensation) c/L side = loss of pain and temperature

A

Brown-Sequard syndrome

20
Q

known as “collection of spinal nerves”
- syndrome that affects the peripheral nerves of SC d/t fractures around the pelvic region.
- Has better prognosis and higher chance to recover from sensory and motor deficit

A

Cauda Equina Syndrome

21
Q

known as a tapered region of the SC
Sacral cord of the spinal roots
areflexic bladder and bowel control

A

Conus Medullaris syndrome

22
Q

clinical manifestation wherein there is loss of all neurological activity below the level of lesion (motor, sensory, reflexes, autonomic)

A

Spinal shock

23
Q

presence of this reflex indicates the end of spinal shock

A

bulbocavernosus reflex/ osinski reflex

24
Q

How to assess Bulbocavernosus Reflex?

A

Male: squeeze glans penis
Female: stimulate clitoris

= (+) contraction of anal sphincter

25
Q

Ascending nerve tracts are in charge of ___

A

Sensory

26
Q

Descending nerve tracts are in charge of __

A

Motor

27
Q

Nerve that supplies the diaphragm

A

Phrenic Nerve

28
Q

known as the inability to regulate core body temperature

A

Poi kilo thermic

Poikilothermic

29
Q

presence of this reflex is the first indication of spinal cord injury

A

Babinski reflex

30
Q

Lesion of UMN is ___ while LMN is __

A

above L2; L2 and below

31
Q

Which motor neuron is spastic and which one is flaccid?

A

UMN - spastic
LMN - flaccid

32
Q

reflex arc for UMN and management provided to help trigger urination

A

reflex arc: small amount of urine can trigger contraction

mgmt: hair pulling, suprapubic tapping

33
Q

reflex arc for LMN and management provided

A

reflex arc: bladder overflow d/t excessive filling pressure

mgmt: timed voiding, Valsalva maneuver, crede’s maneuver

34
Q

Management for bowel dysfunction for UMN (reflexive)

A

Suppositories, digital stimulation

35
Q

Management for bowel dysfunction for LMN (non-reflexive)

A

straining and manual excavation

36
Q

Differentiate (LMN) psychogenic and (UMN) reflexogenic erection

A

Psychogenic Erection: This kind of erection occurs as a result of the brain thinking about something sexual.

Reflexogenic Erection: This kind of erection is the result of direct stimulation of the penis.

37
Q

Complete or Incomplete SCI?

Difficulty in erection
reduced ejaculation

A

Complete SCI

38
Q

Complete or Incomplete SCI?

increased erection
increased ejaculation

A

Incomplete SCI

39
Q

What to expect during INITIAL stage of SCI mgmt?

A

> 1 - 10 days
- maintain life support fxn
- OT start to intervene

40
Q

What to expect during ACUTE stage of SCI mgmt?

A

> 11 days to 3 months
- early mobilization and training for independence

41
Q

What to expect during INTERMEDIATE stage of SCI mgmt?

A

> 3 months to 3 years
- community adaptation and return to work

42
Q

What to expect during LONG TERM stage of SCI mgmt?

A

> 3 years
- health maintenance

43
Q

Identify the degree of independence for:
- Above c6: __
- c6- t6: __
- below t6: __

A
  • Above c6: complete dependence
  • c6- t6: c assistance
  • below t6: marked degree of independence

otsem2: physdys 1 (10 decks)

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