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OT 7 Finals > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

cervical injury and involves any degree of paralysis of the
four limbs and trunk musculature

A

Quadriplegia

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2
Q

paralysis caused by a thoracic, lumbar or sacral injury and
involves any degree of paralysis of the lower extremity with involvement of
the trunk, legs, feet and toes, depending on the level of the lesion

A

Paraplegia

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3
Q

most caudal level of the spinal cord with normal motor
and sensory function on both the left and right sides of the body

A

Neurological Level

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4
Q

all segments above must be 5/5

A

Motor Level

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5
Q

all segments above must be 2/2

A

Sensory Level

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6
Q

No motor or sensory function is preserved in S4-S5 (Asia Scale)

A

A - Complete

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7
Q

SENSORY BUT NOT MOTOR fxn is preserved below the neurological level and includes S4-S5 (ASIA Scale)

A

B - Incomplete

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8
Q

Motor function is preserved below the neurological elevel and MORE THAN HALF of key muscles below the neuro level have a muscle grade less than 3

A

C - Incomplete

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9
Q

Motor function is preserved below neuro level, and AT LEAST HALF OF KEY MUSCLES have a muscle grade of 3 or more (ASIA Scale)

A

D - Incomplete

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10
Q

Motor and sensory function is normal (ASIA Scale)

A

E - Normal

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11
Q

describe the areas of intact motor and/or sensory
function below the neurological level if an individual has motor and/or sensory function below the neurological level but does not have
function at S4 and S5

A

Zone of Partial Preservation

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12
Q

complete transection of the spinal cord; no motor or sensory
preserved at S4-S5; may have preservation of strength or sensation below the neurological level

A

COMPLETE

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13
Q

injury to the spinal cord that does not cause a total transection with some degree of voluntary movement or sensation preserved
at S4-S5

A

INCOMPLETE

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14
Q

Incomplete Injury CLINICAL SYNDROMES

A
  1. Anterior cord
  2. Brown-Sequard
  3. Central cord
  4. Posterior cord
  5. Cauda equina Injuries
  6. Conus medullaris injuries
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15
Q
  • damage to the anterior portion of the cord and/or its vascular supply from the ASA
  • d/t FLEXION INJURIES
  • proprioception is preserved
A

Anterior Cord Syndrome

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16
Q
  • HEMISECTION of the spinal cord
  • d/t PENETRATING WOUNDS, GSW, STAB WOUNDS
A

Brown-Sequard Syndrome

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17
Q
  • MC
  • d/t HYPEREXTENSION/WHIPLASH INJURIES to the cervical region, congenital or degenerative narrowing of the spinal canal
  • Most prevalent in aging populations due to arthritic changes
  • UE > LE, potential flaccid paralysis
A

Central Cord Syndrome

18
Q
  • damage to the DCML
  • d/t STDs such as syphilis
  • involvement: gait dev
A

Posterior Cord Syndrome

19
Q
  • do not involve damage to the spinal cord itself but rather to the spinal
    nerves that extend below the end of the spinal cord
  • anatomically incomplete d/t the great number of nerve roots involved
  • considered as peripheral nerve injuries
  • usually occurs with fractures below the L2
  • areflexic bowel and bladder; LMN motor paralysis
A

Cauda Equina Injuries

20
Q
  • injury of the sacral cord and lumbar nerve roots
  • bowel and bladder incontinence and sexual dysfunction are typically
    more severe than cauda equina injuries*
  • Involvement: loss of motor and sensory function below the level of injury
    (not severe); absence of reflex arc, LMN motor paralysis
A

Conus Medullaris Injuries

21
Q
  • immediately after SCI
  • period of AREFLEXIA and flaccid paralysis below level of injur
  • 1 week to 3 months
A

Spinal Shock

22
Q
  • MC cause of death
  • T12 and below - normal respiratory status
A

Respiratory Complications

23
Q
  • occurs in lesions above T6
  • Sx: pounding headache,
    diaphoresis, flushing,
    goosebumps, tachycardia
    followed by bradycardia
  • Mx: find the cause and alleviate
    (e.g. emptying the bladder)
A

Autonomic Dysreflexia

24
Q
  • blood tends to POOL DISTALLY in the LE as a result of reduced
    muscle tone in the trunks and legs
  • Sx: light-headedness, dizziness, pallor, sudden weakness,
    unresponsiveness
  • Mx: antiembolism socks, abdominal binders, assuming an
    upright position slowly
A

Postural Hypotension

25
Q

➢ a serious complication after SCI
caused by the following main
reasons:
a. reduced circulation due to
decreased tone
b. frequency of direct trauma
to legs causing vascular
damage
c. prolonged bed rest
➢ Signs: LE swelling, localized redness,
low-grade fever

A

Deep Vein Thrombosis

26
Q
  • maintaining appropriate body temperature is often a problem
    for SCI patients above T6.
    ➢ poikilothermia - during the 1st year after injury
    ➢ cold weather causes discomfort
    ➢ excessive sweating may occur above the level of injury in
    warmer weather
A

Thermal Regulation

27
Q

➢ appears after spinal shock subsides
➢ increase in spasticity can be triggered by:
a. infections
b. positioning
c. pressure sores
d. UTIs
e. heightened emotional states
➢ beneficial

A

Spasticity

28
Q

➢ abnormal formation of bone deposits on muscles, joints, and tendons
➢ MC areas: hip and knee
➢ happens in 20% of SCI patients
➢ Signs: heat, pain, swelling, decrease in AROM/PROM

A

Heterotopic Ossification

29
Q

➢ kidney failure as a result of chronic UTI - one of the MC
causes of death
➢ Warning signs: cloudy urine or has excessive particles, dark or foul-smelling urine, fever, chills, increase in
spasticity
➢ Tx: PREVENTION

A

Genitourinary Complications

30
Q

➢ can become either spastic or flaccid
➢ usually flaccid during the state of spinal shock

A

Complications Associated with the Bowel

31
Q

major reason for hospital admission in SCI patients

A

Decubitus Ulcer

32
Q

availability of a caregiver 24hrs is the most appropriate safety option

A

C4 and above

33
Q

may use a phone independently with possible adaptations but may be limited in other emergency responses

A

C5 and below

34
Q

rely on wheelchair for household and
community mobility

A

Thoracic level and above

35
Q

able to ambulate in short distances with an AD (e.g. lofstrand crutches) and orthosis but practicality during
household and communitysettings must be considered.

A

Lower level thoracic injury

36
Q

requires assistance and some personal attendance care

A

C6 and above

37
Q

can often live independently; but may require
assistance with heavier maintenance tasks

A

C7 and below

38
Q

Wheelchair Prescriptions

A

C4 and above - power wheelchair
C5 - highest level - power wheelchair (community mobility)
manual wheelchair with handrim projections
C6 - manual wheelchair with handrim projections
C7 - manual wheelchair with handrim projects (friction)
C8 - standard handrims; wheelie for community ambulation

39
Q

Orthosis

A

C4/C5 - balance forearm orthosis
C6 - tenodesis splint
T1-T8 - KAFO + // bars or walker
T9-T12 - KAFO + walker
T12-L3 - KAFO + loftstrand crutches
L4 - L5 - AFO + loftstrand
L5-S1 - rocker bar

40
Q

Transfers

A

C3 (obese) - hydraulic lift
C5 - dependent sliding transfer
C6 - independent sliding board transfer
C7 - independent transfer s̅ sliding board on all level surfaces
T1 - floor to wheelchair
T4 - sitting pivot
L3 - standing pivot

41
Q
A

OT 7 Finals (1 decks)

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