Spinal Cord Injury Flashcards
How is SCI (spinal cord injury) the same as TBI?
There is a primary and secondary component
What three spinal cord injuries may cause ischemia/infarction?
Compression
Hemorrhage
Traumatic vasospasm
How soon after primary injury does secondary injury occur in SCI?
Within minutes following initial trauma
___________ mechanisms induce cord edema and due to the rigid confines of the vertebral canal, increased pressures within that canal that reaches maximum pressure within ___-___ days - high risk of ischemia
Pathologic mechanisms
4-6 days
What are the 5 pathologic consequences of cord injury?
Induction of nitric oxide synthase
Release of excitotoxic amino acid
Cellular influx of calcium
Oxidative stress
Lipid peroxidation
What causes hypotension that exacerbates secondary SCI?
Hypotension causes hemorrhage or neurogenic shock
What does nitric oxide (NO) modulate?
vascular tone
insulin secretion
airway tone
peristalsis, angiogenesis
neural development
retrograde neurotransmitter
What is the proximate cause of septic shock?
Nitric oxide (NO) which is a free radical with an unpaired electron and may function in autoimmune disease
Disruption of afferent and efferent signals is caused by what type of cord transection? (complete loss of motor and sensory function below the spinal cord injury).
Complete cord transection
A partial cord transection does what to the spinal cord?
Damages only a portion of the spinal cord. Partial or random preservation of motor or sensory function below the spinal cord injury.
What syndromes are classic partial spinal cord disruption?
Central cord syndrome
Anterior cord syndrome
Brown-Sequard syndrome
Cauda-equina syndrome
What is this type of incomplete (partial) spinal cord injury:
Below injury level, motor weakness or paralysis on one side of the body (hemiparaplegia). Loss of sensation on the opposite side (hemianesthesia). Results from penetrating injuries that cause hemisection that affect half the cord.
Brown-Sequard Syndrome
What is this type of incomplete (partial) spinal cord injury:
Below injury level, motor paralysis and loss of pain and temperature sensation. Proprioception (position sense), touch and vibratory sensation preserved. Caused by damage to the anterior portion of the gray and white matter of the spinal cord.
Anterior cord syndrome
What is this type of incomplete (partial) spinal cord injury:
Below injury level, motor function preserved. Loss of sensory function: pressure, stretch, and proprioception (position sense). Caused by damage to the posterior portion of the gray and white matter.
Posterior cord syndrome
What is this type of incomplete (partial) spinal cord injury:
Results from cervical spinal injuries. Greater motor impairment in upper body compared to lower body. Variable sensory loss below the level of injury. Occurs from a lesion in the central portion of the spinal cord.
Central cord syndrome
What is this type of spinal cord injury is this?:
Follows damage to the lumbar nerve roots and conus medullaris. Bowel and bladder are flexia. Loss of motor sensory function
Conus medullaris syndrome
What is this type of spinal cord injury is this?:
Occurs from injury to the lumbosacral nerve roots below the conus medullaris. Areflexia of the bowel, bladder and lower reflexes.
Cauda equina syndrome
What are the main categories of impairment in the ASIA impairment scale?
A (complete)
B (incomplete)
C (incomplete)
D (incomplete)
E (normal)
What category of the ASIA impairment scale is this:
No motor or sensory function is preserved in the sacral segments S4-S5
A (complete)
What category of the ASIA impairment scale is this:
Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5
B (incomplete)
What category of the ASIA impairment scale is this:
Motor function is preserved below the neurological level, and more than a half of key muscles below the neurological level have a muscle grade of <3
C (incomplete)
What category of the ASIA impairment scale is this:
Motor function is preserved below the neurological level and at least a half of key muscles below the neurological level have a muscle grade of >/=3
D (incomplete)