spinal cord injury

Question 1

define spinal cord injury

Answer 1

disruption to the spinal cord

Question 2

define cauda equina injury

Answer 2

disruption to the nerve roots that lie with in the spinal column

Question 3

define upper motor neurone injury

Answer 3

comes form the brainstem, Cerebella hemispheres, and cerebellum.

Question 4

define lower motor neurone injury

Answer 4

come from the brainstem of from below the brainstem.

Question 5

what is the age specific distribution of spinal cord injuries

Answer 5

bimodal
20-29- road traffic accident
50-59.- trips and falls.

Question 6

what 2 factors about a lesion causing spinal cord injury must be determines

Answer 6

What is the lesion?
Idiopathic, vascular, inflammatory, traumatic, autoimmune, metabolic, infective, neoplastic, degenerative.
Where is the lesion
functional neuroanatomy.

Question 7

Causes of spinal cord injury include

Answer 7

• Acquirred
• Congenital- may not be present at birth.
– Spina bifida, birth trauma, spinal muscular atrophy and congenital spinal anomaly.

Question 8

what are the subtypes of different spinal injury

Answer 8

Tumour- inflammatory
infection- bacterial
vascular
degenerative
Iatrogenic
Idiopathic
Trauma- RTA, falls

Question 9

how is the level of spinal cord injury determines

Answer 9

dermatomes and myotomes

Question 10

If lesion in cerveical region (c1-t1) what limbs lose function

Answer 10

all

Tetraplegia/paraplegia-

Question 11

If lesion in thoracic region (T1-L5) what limbs lose function

Answer 11

lower limb loss

Paraplegia- loss of sensation in the lower extremities.

Question 12

how is spinal cord injury examined

Answer 12

Manual muscle testing

Sensory testing for light touch and pinprick sensations

Question 13

What is the AISA impairment scale and what do the 4 categories within it represent.

Answer 13

A (Complete)
• No motor or sensory function is preserved in S5
B (Incomplete)
• Sensory but not motor function is preserved below the neurological level to S5
C (Incomplete)
• Motor function preserved, and more than half of key muscles below the neurological level have a muscle grade less than 3
D (Incomplete)
• Motor function preserved, and at least half of key muscles below the neurological level have a muscle grade of 3 or more
• If your power score is less than 3 then you have no power against gravity.

Question 14

what spinal tract may be affected by spinal cord injury

Answer 14

descending
lateral corticospinal tract, anterior corticospinal tract.

Ascending sensory tract
dorsal column
anterolateral spinothalamic pathway.

Question 15

lesions above what level often result in excess vagal stimulation

Answer 15

above T6 and spinal shock.

Question 16

what are the consequences of excess vagal stimulation

Answer 16

loss of parasympathetic control

bradycardia

Question 17

which drug prevents vagal stimulation

Answer 17

atropirne

Question 18

what does excessive bagel stimulation affect- parasympathetic or sympathetic nervous system

Answer 18

parasympathethic.

Question 19

lesions above what level cause autonomic dysreflexia

Answer 19

T6

Question 20

what causes autonomic dysreflexia

Answer 20

bladder distention and constipation

skin, soft tissue and bone injuries.

Question 21

what do patients with autonomic dysreflexia present with

Answer 21

headache, hypertension, facial flushing

Question 22

what is autonomic dysreflexia

Answer 22

unable to control BP- become hypertensive.

Question 23

what are acute symptoms of spinal injury

Answer 23

Urinary tract infections- urinary tract stones, progressing to renal failure.

Respiratory infection- progressing to respiratory failure.

Pressure sores- Osteomyelitis (inflammation of the bone marrow), amyloid, neoplastic change.

Question 24

How is acute spinal injuries treated

Answer 24

bed rest/ positioning/ skull traction
Prevent further damage to spinal cord
Skin care
bladder and bowel care
Prevention of thromboembolic and GI complications

Question 25

how is chronic spinal cord injury treated

Answer 25

Appropriate skin care
Bladder and bowel care
Prevention of thromboembolic complications
Different presentations e.g. acute abdomen

Question 26

what are the chronic complications os spinal cord injury

Answer 26

Progressive neurological decline
Syringomyelia- a chronic progressive disease in which longitudinal cavities forms in the cervical region of the spinal cord. This characteristically results in wasting of the muscles in the hands and a loss of sensation.
Neuronal “drop-out”
Pain and spasticity

Rheumatological complications
Degenerative joint disease
Hetertopic ossification- bone in soft tissue.

Question 27

what are multi-channel stimulators, and what is there use in future treatment for spinal cord injuries

Answer 27

Electrical stimulation- electodes are attached to the surface of the skin. They produce field between them, and a flow of ions through the body. If the action potential is reached in the neurone, a nerve impulse is produced.