Spinal Cord Injury Flashcards
What is hyperextension?
You are hit from behind which causes body to have fast acceleration/deceleration of the head (rock back and forward). Could be caused by being rear ended from a car
What is hyperflexion?
Sudden forceful acceleration of the head forward which causes extreme flexion of the neck. Caused by diving or crashing into something head on
What is compression fracture?
Compression and crushing of vertebrae down and causes them to shatter. The debris from that can enter the spinal canal and damage the spinal cord. Examples- fall off ladder onto butt or diving
Excessive rotation?
Head turned beyond its limits/normal range
Penetrating trauma?
Gun shot or stab wound. Have varying degrees of damage
Primary vs secondary injury?
PI- initial damage to vertebra applies injury to spinal cord
SI- happens hrs to days after an accident where vascular/inflammatory processes causes damage/necrosis. They worsen the primary injury. examples are- hemorrhage, ischemia, local edema, impaired perfusion
Traumatic vs non trauma related injuries that damage the spinal cord?
Trauma- motor vehicle accidents, falls, violence, recreational sporting activities (over 50%)
Non Trauma- osteoarthritis, rheumatoid arthritis, ankylosing spondylitis
Dx of SCI injuries?
Radiography, CT scan (bones), MRI (how does SC look), angiography SEP, assess their ABCs, motor/sensory/reflexes
What is spinal shock?
Response that occurs immediately after injury. Pt has complete loss of sensation/motor (flaccid)/reflex activity. Usually lasts 48 hrs but may last 7-20 days post injury
What is neurogenic shock? S+S
Form of hypovolemia shock caused by massive vasodilation/peripheral pooling of blood. Some S+S are hypotension, bradycardia, hypothermia, decreased CO, and inability to sweat below injury level. Happens in pt with injury T5 and above
Complete spinal injury and S+S?
Loss of all motor/sensory function below level of injury caused by damage to entire spinal cord (quadriplegia). S+S are muscle flaccidity, loss of reflexes/sensory function, B+B atony, spinal shock, and resp impairment above C4
What is paraplegia?
Loss of motor/sensory function of lower extremities. Upper extremities still intact
What is an incomplete spinal cord injury?
Preservation of some sensory/motor function below level of injury because of partial damage to spinal cord.
What do upper motor neuron lesions vs lower motor neuron lesions cause?
UMN- spastic paralysis
LMN- flaccid paralysis
Surgical treatment used for SCI?
It can stabilize, realign, and decompress the spinal column with instruments. Usually done 12-24 hrs post injury (this will improve pt outcomes)
Manual stabilization?
Halo vest (immobilizes cervical spine by connecting to the skull), braces, skull tongs
Complications of SCI?
Cardiac dysfunction, impaired B+B, ineffective temp regulation, malnutrition, inability to care for self, alterations in oxygen/ventilation problems with gas exchange
Can people with SCI be susceptible to pneumonia?
Yes because they can’t cough as well as normal people. They might need a trach if their cervical spine is damaged as well
What does altered mobility caused in SCI?
Skin breakdown, fractures (bones become softer), decreased joint moblity, DVT risk, bone overgrowth into muscle (heterotopic ossification)
What can CNS dysfunction lead to?
Autonomy dysreflexia
What can abnormal perfusion/CVS dysfunction lead to?
Orthostatic hypotension, bradycardia, hypothermia
What is Autonomic dysreflexia? and causes
Massive uncompensated CVS reaction mediated by the SNS and its a life threatening condition. Visceral/subcut stimuli causes sympathetic discharge.
Causes- distension of bladder/rectum, tight clothes, contraction of bladder/rectum, stimulation of pain receptors, impaction from stool, temp fluctuations
S+S of AD?
Severe HTN (300 mmHg), bradycardia (30-40), goosebumps/diaphoresis/flushed skin above lesion level, throbbing headache, nausea, blurry vision, anxiety, nasal congestion
What to do when suspecting AD?
Sit pt upright (elevate HOB at least 45 degrees), assess for/remove causative factor (kinking in catheter tubing, urine retention, fecal impaction…), call HCP, monitor their BP q10-15 min, give antihypertensives if needed , calcium channel blocker/nitrates if S+S persist after removal of causative agent
What is tetraplegia?
Injury involving all 4 extremities- seen with cervical and upper thoracic injuries
Why are people with cervical SCI at risk for breathing problems? and what might they need
B/c of interruption of spinal innervation to respiratory muscles so they might need a trach to help with gas exchange
