spinal cord injury Flashcards
initial injury caused by
- cord compression
- interruption of blood supply
- traction
- penetrating trauma (GSW or stab wounds)
primary injury
initial disruption of axons
secondary injury
ongoing damage progressive damage after initial injury
- ischemia
- hypoxia
- microhemorrhage
- edema
spinal shock
- a temporary neurologic syndrome
- occurs at the time of injury
- all cord function below the level of the lesion ceases
neurogenic shock
- d/t loss of vasomotor tone caused by the injury
- hypotension, bradycardia, warm extremities
- associated with cervical or high thoracic injuries T6 or higher
classification of injury
- mechanism
- level
- degree (complete vs incomplete)
C1-C3 injury remaining movements
- movement in neck and above
- loss of innervation to diaphragm
- absence of respiratory function
C4 injury remaining movements
- sensation and mvmt in neck and above
- may be able to breath without a ventilator
C5 injury remaining movements
- full neck, partial shoulder, back, biceps
- gross elobw
- inability to roll over or use hands
- decreased respiratory reserve
C6 injury remaining movements
- shoulder and upper back abduction and rotation at shoulder
- full biceps to elbow flexion
- wrist extension
- weak grasp of thumb
- decreased respiratory reserve
C7-C8 injury remaining movements
- all triceps to elbow extension
- finger extensors and flexors
- good grasp with some decreased strength
- decreased respiratory reserve
T1-T6 injury remaining movements
- full use of upper extremities, back, intrinsic muscles of the hand
- full dexterity of grasp with some decreased strength
- decreased respiratory reserve
T6-T12 injury remaining movements
- full, stable thoracic muscles and upper back
- functional intercostals resulting in increased respiratory reserve
L1-L2 injury remaining movements
- varying control of legs and pelvis
- instability of lower back
L3-L4 injury remaining movements
- quadriceps and hip flexors
- absence of hamstring function
- flail ankles
incomplete cord injury - central cord
- caused by dmg to the central spinal cord
- motor weakness and sensory loss in BUE and BLE
- BUE affected more than lower ones
incomplete cord injury - anterior cord
- caused by dmg to anterior spinal artery -> compromised blood flow to the anterior spinal cord
- typically from flexion injury
- motor paralysis
- loss of pain and temp sensation below level or injury
incomplete cord injury - Brown Sequard
- results from dmg to one half of spinal cord
- from a penetrating injury
- ipsilateral: loss of motor function and position, and vibratory sense
- contralateral: loss of pain and temp below level of injury
incomplete cord injury - posterior cord syndrome
- results from compression or dmg to posterior spinal artery
- loss of proprioception
complete cord injury
total loss of sensory and motor function
