Spinal cord injury Flashcards

1
Q

After injury to the spine weekday is released and how does it make the injury worse?

A

Glutamate is released and triggers disrupting normal processes and killing neurons and axon protectors

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2
Q

sensory information comes in through what root?

A

Dorsal root

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3
Q

motor information goes out through which root?

A

Ventral root

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4
Q

If a patient has a brain stem injury, which cervical area is affected

A

C 2-3

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5
Q

Injury above C4 can cause?

A

Respiratory difficulty and paralysis of all for extremities

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6
Q

If a patient has an injury to T11, what might you expect?

A

The patient can walk

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7
Q

Quadriplegic is also known as? What area of the body is affected? How?

A

Tetraplegia; there is motor an sensory loss below the neck.

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8
Q

Paralegal effects what parts of the body?

A

The lower limbs

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9
Q

This type of spinal injury includes a posterior rupture of ligaments and anterior dislocation of the discs? What activity might have caused this?

A

Hyper flexion injury; whiplash from an MBA or diving

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10
Q

What spinal injury includes an anterior rupture of ligaments? What might this patient have done to have this injury?

A

Hyper extension injury; chin to table impact

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11
Q

Which spinal injury results in compression of the spinal column and bone shattering? What activity could lead to this injury?

A

Axial loading injury; falling from a ladder or diving

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12
Q

What type of spinal injury results in a fractured vertebral body and posterior rupture of ligaments? What activity might cause this?

A

Rotational injury; skiing

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13
Q

Procedure where a balloon is inserted and inflated inside fractured vertebrae and a cement-like material is inserted

A

Kyphoplasty

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14
Q

What is the goal of kyphoplasty?

A

To restore height to the bone reducing deformity of the spine. Aiding the patient to return to ads and daily activities

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15
Q

On the impairment scale, what is an A?

A

Complete with no motor or sensory in sacral segment

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16
Q

On the impairment scale, what is a B?

A

Incomplete. Sensory but no motor below injury

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17
Q

On the impairment scale, what is a C?

A

Incomplete. Motor present below injury with weakness in more than 1/2 of key muscles

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18
Q

On the impairment scale, what is a D?

A

Incomplete. Motor is present below injury with weakness in at least 1/2 of key muscles

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19
Q

On the impairment scale, what is an E?

A

Normal motor and sensory

20
Q

Bowel, bladder, and reproductive system is innerased by?

A

Parasympathetic nervous system

21
Q

Thoracic organs and abdominal organs are innervated by?

A

Parasympathetic nervous system

22
Q

What is immediate response to spinal injury with an interruption of sympathetic pathways?

A

Spinal shock

23
Q

What does spinal shock look like in a patient?

A

Loss of skeletal muscle function, bowel and bladder tone, reflex function, sensory function, flaccid paralysis, loss of temperature control, and loss of the ability to perspire

24
Q

Aside from spinal shock, what type of shock can occur with patients suffering from a spinal cord injury?

A

Neutrogenic shock which is the interference with the nervous system control of blood pressure is causing severe vasodilation

25
Q

What would you expect in neurogenic shock? How would you treat it?

A

Severe vasodilation, loss of venous return leading to decrease in O2 sats, clots, blood pooling, bradycardia, hypertension - orthostatic. Vasoconstrictors, fluid, compression stockings, air mattress, turn schedule

26
Q

The two main interventions when you find a patient who you suspect has suffered a spinal cord injury

A

Immobilization and airway

27
Q

What drug therapy can be prescribed for spinal cord inury patient? What does it do?

A

Solu-medrol. It decreases inflammation and decreases glutamate

28
Q

What are you thinking if you’re patient has absent bowel sounds?

A

With absent bowel sounds we are concerned is a paralytic ileus due to internal hemorrhage. The blood collects and fills the cavity causing no bowel sounds

29
Q

In this type of cord damage there is a loss of voluntary motor control on the same side as the cord damage and the loss of pain and temperature sensation on the opposite side

A

Brown-square syndrome aka lateral cord syndrome

30
Q

In this type of cord damage there is a loss of pain, temperature, and motor function below the level of the Legion. Lite Touch, position and vibration sinsation remain intact due to acute disc herniation or hyperflexion injuries

A

Anterior cord syndrome

31
Q

This type of cord injury result in the loss of motor power and sensation and incomplete laws of the bowel and bladder. Caused by injury or edema usually in the cervical area

A

Central cord syndrome

32
Q

What is the longest a soft collar should stay on and why?

A

3 to 4 days only. Prolonged use can lead to weaken the neck muscles and the need for physical therapy

33
Q

This can be used if the patient experiences a sore neck from whiplash and does not need a physician’s order

A

Soft collar

34
Q

This is used for surgery or for patients just out of a halo and needs a prescription from a physician

A

Cervical collar aka hard collar

35
Q

Contains rods to lengthen the spine to remove compression. These are surgically implanted

A

Internal fixator devices

36
Q

Name 8 tips to educate a patient who is using a halo traction

A

Use a fleece liner under vest, keep shirt on under it, keep liner dry, wash skin under vest with warm water, avoid soap, lotion, or powder, clean pins QD usually with soap and water, keep a wrench available for emergency removal, have a screwdriver available to tighten screws occasionally

37
Q

Sensory nerves detect stimuli and transmit impulses up the cord, but the impulses cannot reach the brain which increases sympathetic responses of autonomic nervous system

A

Autonomic dysreflexia

38
Q

Hyper reflexive or exaggerated sympathetic response to noxious stimulus leading to severe vasoconstriction

A

Autonomic dysreflexia

39
Q

Name some causes of autonomic dysreflexia

A

Full bladder, UTI, fecal impaction, decubitus ulcer, invasive testing, hemorrhoids, gallstones, kidney stones, draft on skin

40
Q

Name the symptoms of autonomic dysreflexia

A

Severe hypertension, flushing, pounding headache, profuse diaphoresis, piloerection, nasal congestion, bradycardia

41
Q

How is autonomic dysreflexia managed

A

Have the patience it up right to decrease the blood pressure, administer antihypertensive like nifedipine/ procardia, nitroglycerine/nitropaste, cath as needed, assess for fecal impaction

42
Q

In an injury above t12 what would you expect a patient’s bladder control to be?

A

This patient has a reflexive bladder aka spastic bladder where no sensation or motor control is present however the bladder empties on reflex. This patient is incontinent

43
Q

For a patient with injury below t12 what would you expect for bladder control?

A

This patient has a flaccid bladder where once it overflows the patient has incontinence due to an overextended bladder

44
Q

Patients who have injuries above the sacral region lead to what type of BAL control?

A

This patient has a reflex bowel pattern which means of the bowels work on reflex

45
Q

For patients who have injuries at the sacral region they result in what type of bowel pattern?

A

These patients have a flaccid bowel pattern which means that they defecate due to overflow. It results in a leaking that can be constant

46
Q

What does rehab focus on for spinal cord injury patients?

A

Maintaining skin integrity, avoiding DVTs, decreased infection, controlling spastic legs with meds, promoting self care, Council on sexual changes