Spinal cord injury Flashcards
Name as many SCI injury facts as possible?
- 42 (average age at injury)
- predominately males (80% of SCI cases)
- 282,000 number of people in the US living with an SCI
- Pneumonia and septiciaemia (common cause of death of SCI patient)
- 12,500/ year (US); 1,000-2,000/ year (UK)
what are common causes of SCI?
- motor vehicle accidents
- falls
- sports injuries
- violence
Describe the anatomy of the spinal cord
31 spinal nerves
Cervical 1- Cervical 8
Thoracic 1- Thoracic 12
Lumbar 1- Lumbar 5
Sacral 1- Sacral 5
Coccygeal 1
what information is carried by the posterior columns tract?
vibration, light touch, proprioception
what information is carried by the anterior spinothalamic tract ?
Pain and temperature
what information is carried in the lateral corticospinal tract?
motor control
what are the important motor (descending) tracts in the SC?
lateral corticospinal tract
rubrospinal tract
medial reticulospinal tracat
lateral reticulospinal tract
cestibulospinal tract
tectospinal tract
what is the motor tract also known as?
desccending tract
what is the sensory tract also known as?
ascending
what does a C4 injury cause?
Quadriplegia/ Tetraplegia, results in complete paralysis below the neck
what does a C6 injury result in?
Partial paralysis of hands and arms as well as lower body
what does a T6 injury result in?
Paraplegia, results in paralysis below the chest
what does an L1 injury result in?
Paraplegia, results in paralysis below the waist
what are the priorities for SCI patients?
- Motor function
- Arm/ hand function (for individuals with tetraplegia)
- Mobility (individuals with paraplegia)
- Bowel and bladder function
- Sexual function
what happens in central cord syndrome?
- lesion interrupts fibers crossing to enter the spinothalamic tracts and fibers mediating the tendon stretch reflex
- as the lesion enlarges it affects the intermediolatral columns (autonomic function) and the lateral corticospinal tracts
Name two SCI causing partial lesion syndromes?
1) Brown-sequard syndrome of spinal coord hemisection
2) central cord syndrome
What is ASIA?
The ASIA scale is an indicator of severity of SCI used clinically (A-E)
what does ASIA determine?
Determines:
- sensory levels for right and left sides
- motor levelsfor right and left sides
- single neurological level - lowest spinal level that is normal on both sides
- whether injury is complete or incomplete
what is spinal shock?
a state of temporary loss of function in the spinal cord - often lasts 1 day, but can persist up to 1 month post-injury
what are the symptoms of spinal shock?
- flaccid paralysis below the lesion (due to removal of descending/ motor input) this is replaced by spastic paralysis following spinal shock
- loss of tendon reflexes
- impaired sympathetic outflow to vascular smooth muscle can cause decreased blood pressure (high cervical injury)
- absent sphincter reflexes and tone
what happens to the astrocytes after traumatic injury ?
astrocytes become reactive
what do reactive astrocytes do?
- become hypertrophic
- secrete chondroitin sulfate proteoglycans (CSPGs)
- increase expression of normal molecules (Ex: Glial fibrillary acidic protein (GFAP))
what do reactive astrocytes result in after traumatic injury?
formation of a glial scar
In CNS injury what happens when Glial scar + myelin debris?
Area which growing axons cannot pass through
