Spinal Cord Injury Flashcards
What is the pathopys of Spinal Cord Injury?
Primary - Compression or contusion on SC damage nerunal and glial cell.
Secondary - Cascade,
Acute - Vascular damage, haemorrhage and disruption of (BSCP). Bleeding causes additional damage to surrounding tissues, releasing pro-iflammatory cytokines due to neutrophils.
Sub-Acute: Arter damage compromises vascular supply -> ischaemic damage to surviving neuronal cells due to no nutrients.
Inflammatory cytokines are releasing from resident cells. Glutamate is released from damaged neuronal cells leading to demyelination.
Chronic phase:
Loss of cell volume causes cyst to form, blocking migration of cells and axon regrowth, glial scar formation also causes this.
What is autonomic dysreflexia?
Occurs from T6 and above. Increases risk of stroke by 300%
Signs:
Severe headache, bradycardia, facial flushing, sweating, increased Bp, Decreased HR.
What is affected in C1-C3? Using the Movement, breathing, communication, ADL, mobility template?
Movement - Limited movement of head and neck
Breathing - Ventilator dependent
Communication - talking limited or impossible
ADL - Physically dependent, 24-hour care and hoist
What is affected in C4 injury?
Movement - breathing, head and neck control, shoulder shrug
Breathing - vemtilator assistance, assised cough
Communication - talking can be compromised
ADL - physically dependent, 24-hour care and hoist transfers, Assistive technology, Using mouth to help with function
Mobility - Electric wheelchair
What is affected in C5?
Movement - partial innervation of all shoulder muscles except Lats + CB, elbow flexion, supination, can achieve elbow ext via gravity.
Breathing - idependent breathing (assitive coughing)
ADL - Adaptive splints for hand function eating, texting, some dressing, maybe tendon transfer surgery.
Mobility - Bed; rolling, unsupported sitting, assistance in vertical lift. Transfers ; full hoist, Max Ao2 with slide board
Long sitting
Wheelchair bound electric/ manual.
What is affected in C6?
Movement - elbow flexion and wrist extension
Breathing - independent breathing. Cough through pec accessory muscles.
ADL - Can be independent, feeding, grooming.
Mobility - Rolling, unsupported sitting, vertical lift on edge of bed.
What is affected C7?
Movement - Elbow extension, strong wrist extension, thumb ext & ab.
Breathing - independent breathing, cough through pec.
ADL - independent
Mobility - bed independent
Wheelchair bound - self propel.
What is affected in C8?
Movement - finger flexion, improves grasp and release, everything before
Breathing - Same
ADL - Same
Mobility - life in and out transfer
wheelchair - self propel, drive car.
What is affected in T2-T6?
Movement - All muscles of the upper limb, partial innervation of intercostal muscles
Movement - all arm, partial trunk, endurance increased.
What is affected in T7-T12?
Movement - Intercostal muscles fully, abs partially.
Good trunk stability.
What is affected in L1-2?
Muscles - Psoas Major and minor, ileus
Movement - hip flexion
Function - wheelchair, standing frame.
What is affected in L3-4?
Muscles - Quads, tibialis anterior, obturator externus
Movement - Knee ext, dorsiflexion, hip external rotation.
Function - push up to stand, actvities in standing
What is affected in L5?
Muscles - Peroni, gluteus medium & minimus
Movement - Ankle eversion, hip abduction.
Can walk with minimal aids
What is affected in S1-2?
Muscles - gluteus maximus, hamstrings, posteior tibialis, gastrocnemius and soleus.
Movement - hip ext, knee flexion, plantar flexion
function - normal gait, stand, do any activity in stand.
