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PTRS 852 - Neuro Exam 1 > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

Spinal Cord Injury

A

Injury to the spinal cord resulting in a change, either temporary or permanent, in its normal sensory, motor or autonomic function

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2
Q

SCI Causes

A 
Hyperflexion/extension
Axial loading
Bruising
Severing
With or without spinal fracture or dislocation
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3
Q

SCI Causes - Atraumatic

A

Vascular
Neoplastic
Degenerative

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4
Q

Traumatic SCI %

A 
MVC - 39%
Falls - 28%
Gun-related - 15%
Sports - 8%
Other trauma - 10%
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5
Q

Common SCI Co-morbidities

A

Brain injury
Fractures
Pneumothorax
Peripheral nerve injury

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6
Q

Who’s more likely to get SCI?

A

Males

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7
Q

Tetraplegia

A

Between C2 and T1

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8
Q

Paraplegia

A

T1 down

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9
Q

Spinal Cord Injury Manifestation

A 
Traumatic blow to spine
Changes in blood flow cause damage
Excessive release of neurotransmitters kills nerve cells
Immune system cells create inflammation
Free radicals attack nerve cells
Nerve cells self-destruct
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10
Q

Aspen Collar

A

Most common cervical

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11
Q

Miami J Collar

A

Prevents head from developing wound

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12
Q

Philadelphia Collar

A

Preventative if not sure about injury

Can be intubated

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13
Q

SCI Evaluation

A 
MOI
Co-morbidities
Past history
Precautions
ASIA level
Level of injury
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14
Q

Cervical Precautions

A

Unstable, on bed rest
Pending clearance, and no fracture/dislocation identified, may use a collar
Post fixation, to be up, will use a collar

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15
Q

Thoracic and Lumbar Precautions

A 
Bedrest
Limit extremity movement
Don't elevate HOB
Place in reverse trendelenburg (30 deg) to prevent aspiration
Log roll x 2 assist
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16
Q

Level of Injury

A

Determined by last intact muscle group and dermatome, not by fracture

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17
Q

ASIA Sensory Grading

A

0 - absent
1 - altered
2 - normal

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18
Q

ASIA Motor Grading

A

Same as MMT

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19
Q

“Completeness” of Injury

A

Relates to presence or absence of rectal tone or sensation

Takes into consideration if any sensation or motor function is present below level of injury

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20
Q

ASIA “A” Classification

A

Complete - no motor or sensory function is preserved

21
Q

ASIA “B” Classification

A

Sensory Incomplete - sensory, but not motor function is preserved below neurological level

22
Q

ASIA “C” Classification

A

Motor Incomplete - motor function preserved below neurological level and more than half of key muscle functions below NLI have grade less than 3

23
Q

ASIA “D” Classification

A

Motor Incomplete - motor function preserved belos neurological level and at least half of key muscle functions below NLI have grade more than 3

24
Q

ASIA “E” Classification

A

Normal - follow up of patients who initially had deficits

25
Q

Incomplete Lesions

A

Pattern of clinical presentations directly related to cross-sectional anatomy of spinal cord

26
Q

Anterior Cord Syndrome

A

Loss of function of the ventral pathway and the conservation of the dorsal column
Not good prognosis

27
Q

Anterior Cord Syndrome Result

A

Preservation of light touch, proprioception and deep pressure with absences of pain and motor function

28
Q

Anterior Cord Syndrome Causes

A

Anterior spinal artery infarction
Disc herniation
Radiation myelopathy

29
Q

Central Cord Syndrome

A

Central area of injury which affects the medially located motor fibers that control distal upper extremity function
Favorable functional recovery

30
Q

Central Cord Syndrome Result

A

UE weakness greater than LE weakness

Sacral sensory spared

31
Q

Central Cord Syndrome Causes

A

Syringomyelia
Tumor
Spondylotic myelopathy

32
Q

Brown-Sequard Syndrome

A

Damage that affects one-half of the spinal cord significantly greater than the other half

33
Q

Brown-Sequard Syndrome Result

A

Spastic paresis
Loss of light touch and vibration
Sensation on the damaged side
Loss of pain and temperature on the contralateral side

34
Q

Cauda Equina Results

A 
Low back pain
Radicular pain
Lower extremity paresis or paralysis
Sensory deficit in the perineal area
Bowel or bladder dysfunction
Diminished or absent patellar and Achilles reflexes
35
Q

Factors with Improved Outcomes

A

Completeness of injury
Age
So-so early surgical intervention
Zones of partial preservation

36
Q

Secondary Conditions from SCI

A 
Autonomic dysreflexia
DVT
Pressure ulcers
UTI/Renal problems
Fractures
Pain
Spasticity
37
Q

Autonomic Dysreflexia

A

Risk at T6 and higher

Inc blood pressure which increases risk for cerebral hemorrhage or heart failure

38
Q

AD Symptoms

A 
Headache
Sweating
Nasal congestion
Hyperhidrosis
Paresthesias
39
Q

AD Causes

A 
Bowel/bladder distension
Rectal stimulation
Cutaneous lesions
Fractures
Body-positioning
*BLOCKED URINARY CATHETER*
40
Q

DVT

A

Result of coagulation of blood

Highest incidence in first 2 weeks

41
Q

DVT signs

A

Rapid onset of swelling

Increased temperature in limb

42
Q

Pressure Ulcers

A

Due to immobilization or poor handling
Prolonged compression between bony prominence against support surface
Decrease tissue perfusion

43
Q

Heterotrophic Ossification

A

Ectopic bone formation in soft tissue surround joint
Usually caudal to injury
Sudden limitation of ROM

44
Q

Bone Fracture

A

SCI patients see bone demineralization

45
Q

Syringomyelia

A

Fluid filled cavity within spinal cord extending multiple levels
Decrease in motor function is sign of new pathology

46
Q

Spasticity

A

Hypertonicity of muscle below lesion

47
Q

Nociceptive Pain

A

People with spastic paresis or paralysis, reflex is exaggerated

48
Q

Neuropathy Pain

A

Pain or sensory disturbance due to abnormal processing of afferent input

PTRS 852 - Neuro Exam 1 (7 decks)

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