Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PRM Board Exam > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

Two most common causes of non-traumatic spinal cord injury?

A

Tumor, inflammatory/autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common level of injury for children and adolescents suffering SCI?

A

Cervical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percentage of pediatric SCIs are incomplete?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common cause of traumatic SCI in children?

A

MVC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

At what age is the ASIA exam thought to be reliable

A

6 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of injury typically causes central cord syndrome?

A

Hyperextension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of bladder impairment is typically seen in central cord syndrome?

A

Urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is pain/temp affected in Brown-Sequard syndrome?

A

Contralateral loss starting two levels below the lesion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the typical mechanism of injury for anterior cord syndrome?

A

Hyperflexion injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

At what level does the spinal cord terminate?

A

L1/L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are four anatomic vulnerabilities that increase children’s susceptibility to SCIWORA?

A

Underdeveloped neck muscles, ligament laxity, horizontal facet joints, large head to trunk ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What age group has a higher incidence of SCIWORA?

A

9 and under

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In what age group are cervical SCIWORA injuries more common?

A

3 and under

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common cause of SCIWORA in the 11 to 17 age group?

A

Sports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the standard treatment for SCIWORA with MRI findings?

A

Hard collar bracing for 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for self-resolving SCI symptoms with normal MRI?

A

Hard collar brace for 1-2 weeks with close follow-up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the three criteria for a spinal cord concussion?

A
  1. Spinal trauma with immediate neurological deficit
  2. Deficit corresponds to level of spinal injury
  3. Complete recovery within 72 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What spinal abnormality are patients who suffer a spinal cord concussion at risk for developing?

A

Syringomyelia (up to 15% at 2 year follow-up)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

At what age do cervical vertebrae reach adult size?

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A Minerva body jacket is as effective as a halo in stabilizing what level cervical injuries?

A

Mid to lower portion of cervical spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When do most VTE’s after SCI occur?

A

Within in 90 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the greatest independent risk factor for VTE in the setting of pediatric trauma?

A

Central venous catheter (CVC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Under what age does risk of a VTE significantly decrease?

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Recommended length for chemoprophylaxis in an adult with SCI without additional risk factors?

A

At least 8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What risk factors argue for VTE chemprophylaxis longer than 8 weeks in an adult with SCI? (6)

A

Older, obesity, cancer, complete injury, lower extremity fracture, history of VTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Length of anticoagulation treatment for first provoked VTE?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ASIA examination at what time after injury allows for best prognostication?

A

72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Recovery of pinprick or light touch associated with more motor recovery?

A

Pinprick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When does most recovery from SCI occur?

A

first 6 months, plateau reached around one year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What percentage of ASIA A level SCI patients will be functional ambulators at one year?

A

Up to 5 percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What percentage of patients with ASIA B will be functionally ambulating at 1 year?

A

33%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What physical exam finding significantly increases the odds of an ASIA B SCI patient being able to ambulate at 1 year post-injury?

A

Intact sacral pin prick sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the odds of ASIA C and D SCI patients being able to functionally ambulate at one-year post injury?

A

About 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What level injury is able to use their extremities for feeding/upper body dressing and complete lower body dressing with an assistive device?

A

C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What level ASIA injury can drive and self-catheterize?

A

C5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What level can self-feed and complete upper body dressing with assistive devices?

A

C5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What level ASIA injury can be fully independent needing only an assistive device for lower body dressing?

A

C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What medication has the best evidence to treat orthostasis in SCI patients?

A

Midodrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How can FES help treat orthostasis?

A

It can increase venous return to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What age are typical children normally independent with a majority of self-care activities with supervision?

A

5 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When teaching self-care to a child with an SCI injury, which activity is usually first?

A

Self-feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

At what age should a child with an SCI injury be introduced to self-catheterization?

A

3 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the goal age range for self-catheterization in a child with an SCI injury?

A

5 to 7 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the usually timing for urodynamic testing after an SCI? Why?

A

3 months to allow for resolution of spinal shock

45
Q

Are antibiotics typically recommended for UTI prophylaxis in SCI patients?

A

No

46
Q

What is the Mitrofanoff procedure?

A

Using the appendix to create a conduit from the bladder to abdominal wall with formation of a stoma in order to allow for easier self-catheterization.

47
Q

What are the benefits of bladder augmentation surgery in an SCI patient?

A

Increases the volume of the bladder, reduces frequency of catheterization, and reduces the risk of renal damage

48
Q

What can patients with bladder augmentation be at increased risk for?

A

Urolithiasis

49
Q

Where is the electrode typical implanted with sacral neuromodulation to treat overactive bladder?

A

S3 foramen

50
Q

What is the Malone Antegrade Continence Enema (MACE) procedure?

A

The appendix is used to create a induct from the cecum to the abdominal wall with creation of a stoma to allow for antegrade enema

51
Q

When monitoring pulmonary status in SCI patients, what are signs and symptoms to watch for? (5)

A

snoring, secretions,, headache, cough, change in mental status

52
Q

How long does senna and bisacodyl typically take to work?

A

6 - 12 hours

53
Q

What are two side effects of metoclopramide?

A

Cardiac arrhythmia, extrapyramidal effects

54
Q

How do most bowl medications work (magnesium, lactulose, PEG)?

A

By drawing water into the gut to stimulate colonic motility

55
Q

How does mechanical ventilation in an SCI patient differ from a patient with ARDS?

A

Ventilation in an SCI patient requires HIGH tidal volumes (12-20ml/kg of ideal body weight)

56
Q

In an SCI patient on mechanical ventilation, how are high tidal volumes of benefit?

A

They facilitate early weaning

57
Q

When should parenteral feeds be considered in an SCI patient?

A

If nutrition needs are not otherwise met in 5 days

58
Q

What presents with nausea, vomiting, abdominal pain, bloating, AD, and increased spasticity in an SCI patient?

A

Superior mesenteric artery syndrome (SMA)

59
Q

How is superior mesenteric artery syndrome diagnosed?

A

CT of abdomen with contrast

60
Q

What is the treatment for superior mesenteric artery syndrome?

A

Left side-lying, abdominal decompression with an NG, high-calorie feeding with a NJ or TPN

61
Q

What grade pressure injury is consistent with full-thickness skin loss?

A

III

62
Q

What is a grade one pressure injury?

A

Non-blanchable erythema

63
Q

What is the standard for repositioning a SCI patient in bed?

A

Every 2 hours

64
Q

How often and for how long should a patient in a wheelchair preform a weight shift (independent and dependent)?

A

Independent: every 15 minutes for at least 15 seconds
Dependent: every 30 minutes for at least 30 seconds

65
Q

How does autonomic dysreflexia typically present?

A

With hypertension, bradycardia and vasodilation above the level of the injury.

66
Q

When after an SCI injury does AD typically present?

A

Majority of cases do not occur until 3 to 6 months post injury

67
Q

What are the two most common causes for AD in a child with SCI?

A

Urologic (75%) followed by bowel impaction (18%)

68
Q

How often should blood pressure be monitored when treating AD?

A

Every 2-5 minutes

69
Q

What class of medications can be helpful for prophylactic treatment of AD in SCI patients?

A

Alpha-1 blockers (prazosin, terazosin)

70
Q

When after injury is hypercalcemia typically seen?

A

1 to 4 months after injury

71
Q

What are two treatments for hypercalcemia?

A

Fluids, diuretics (furosemide)

72
Q

What is the most common site for HO in SCI patients?

A

Hip

73
Q

How does timing of development of HO differ in the pediatric SCI population?

A

It is more delayed (4 months on average and up to about 12 months) than in adults (2 months on average and up to about 6 months)

74
Q

What are 3 risk factors for HO in the SCI population (among others)?

A

ASIA A or B, pelvic trauma, spasticity

75
Q

What is the prophylactic treatment for HO in ASIA A and B patients?

A

NSAIDs (indomethacin) for at least 15 days

76
Q

Besides NSAIDs, what is another prophylactic treatment for HO?

A

Low-dose radiation

77
Q

Do you have to wait for HO to mature before surgical removal?

A

No

78
Q

What level pediatric SCI patients are at risk for difficulty with temperature regulation?

A

T8 and above

79
Q

What are three classes of medications that can reduce heat dissipation?

A

Anticholinergics, antihistamines, and serotoninergic drugs

80
Q

What are two types of medications that can reduce ability to conserve heat?

A

Opioids, sedatives

81
Q

What are two risk factors for development of a latex allergy in a pediatric SCI patient?

A

Younger age at time of exposure, repeated exposures

82
Q

When does spinal shock typically resolve?

A

Within weeks

83
Q

When does spasticity typically develop after SCI?

A

In weeks to months

84
Q

Can SDR be done in children with SCI?

A

Yes

85
Q

What is the most common orthopedic complication in children with SCI?

A

Neuromuscular scoliosis

86
Q

What age children with SCI are at higher risk of needing surgery for scoliosis?

A

Those under 12

87
Q

What is the benefit of using a TLSO bracing in children with neuromuscular scoliosis after SCI?

A

It can delay rate of curve progression and delay need for surgery

88
Q

At what angle is surgery for neuromuscular scoliosis in a child with SCI typically recommended?

A

Over 40 degrees

89
Q

At what age of SCI are children at a significantly higher risk of hip subluxation?

A

Children who sustain SCI before age 10 are at much higher risk (about 90% vs 10%)

90
Q

What type of SCI injury is most at risk for a pathologic fracture?

A

Complete paraplegic

91
Q

What is the timing of decrease in bone mineral density after SCI?

A

Between 6 months to 2 years

92
Q

At what level injury is the parasympathetic reflexogenic erection maintained?

A

Below L2

93
Q

How is sperm affected in an SCI patient?

A

Low motility and viability

94
Q

At what level injury can penile vibratory stimulation (PVS) be expected to be effective?

A

At or below T10

95
Q

What spinal levels mediate a psychogenic erection?

A

T11-L2

96
Q

When does fertility typically normalize in women with a SCI?

A

After 6 months to one year

97
Q

When do nerve transfer surgeries for peripheral nerve injuries need to take place? Why?

A

Within 6 to 12 months before development of muscle fibrosis

98
Q

How long might a patient with an UMN injury wait before pursing nerve transfer?

A

Up to 2 years to allow for natural recovery

99
Q

What age group in children is most at risk for SCI?

A

Adolescents (6 times more likely than in children)

100
Q

When does HO show up on XR?

A

About 3 - 6 weeks after symptom onset

101
Q

Other than medication, what can halt progression of HO?

A

low-dose radiation

102
Q

Can a patient with C5 injury roll in bed?

A

no, requires mod to max assist

103
Q

What activity does a C6 patient need assistance with?

A

bathing

104
Q

What are two activities that a C6 patient may be independent with but it is not expected?

A

level surface transfers, rolling

105
Q

What activity may a C7 patient be independent with but it is not expected?

A

bathing

106
Q

What is the one activity besides bathing that a C7 patient may need assistive devices to complete?

A

lower body dressing

107
Q

Besides lower body dressing, what are two ADLs a C6 can complete independent with assistive devices?

A

bladder and bowel care

108
Q

Can a C5 preform bowel care?

A

no

109
Q

Can a C5 preform bladder care?

A

yes, with assistive devices but not expected

PRM Board Exam (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions