Spinal cord injury

Question 1

How determine complete or incomplete spinal cord injury?

Answer 1

Sacral testing- rectal motor and sensory test

Complete- both absent

Question 2

Brown sequard syndrome

Answer 2

Hemi- cordectomy
Usually due to blunt trauma (stab)
Sx: ipsilateral motor weakness, contralateral pain and temperature loss

Question 3

Anterior cord syndrome

Answer 3

Happen after AAA surgical repair
Flaccid paralysis
Sx: loss pain and temperature below Lesion
-light touch, proprioception, and vibration sense intact

Question 4

What score of motor function is normal?

Answer 4

Greater than or equal to 3

Question 5

How grade spinal cord injury?

Answer 5

Lowest motor level intact and rectal exam

Question 6

autonomic dysreflexia (AD) symptoms

Answer 6

Pounding HA, flushing above injury, sweating above injury
Increased BP, 100/60 bp is normal for T6 injury aor above
Triggered by pain or stress response

Question 7

Treatment autonomic dysreflexia

Answer 7

1. Sit pt upright and loosen clothes
2. Look for trigger, overfull bladder most common, followed by Bowels
3. Anti-HTN medication

Question 8

Innervation of sacral Bowel innervation and bladder?

Answer 8

S2, 3, 4 keep the poop off the floor

S2,3,4 keep the pee off the floor

Question 9

Neurogenic shock

Answer 9

Hemodynamics symptoms ( loss sympathetic to one):
Hypotension, bradycardia, hypothermia

Question 10

Spinal shock

Answer 10

Limp flaccid paralysis, DTR absent

High risk thrombosis

Question 11

Central cord syndrome

Answer 11

Arms weak, legs normal and bowel intact

Barrelman

Question 12

Syrinx

Answer 12

• Following spinal cord injury cyst form within cord
• Can cause new weakness or sensory loss, pain, or respiratory problems
• can happen months- years after injury

Question 13

Common complication after spinal cord injury

Answer 13

Fractures due to osteoporosis (common)
Heterotopic ossification (rare, but usual always happens in hip for spinal cord injury)

Question 14

True or false: spinal fracture level = spinal injury level

Answer 14

False, usually cord injury is higher than fracture

Question 15

Hematologic Effects of SCI?

Answer 15

DVT, so put on blood thinners

Question 16

Respiratory effect with SCI?

Answer 16

Atelectsis, because shallow breathes
Pneumonia 
Can't cough
SCI level problems:
*T1-T8 intercostal muscles (cough, breath in and out)
*T7-T12 abdominal muscles (cough)

Question 17

Skin effect SCI?

Answer 17

Burns, injuries, pressure sores (sacral >heel>ischium)

Question 18

What spinal cord injury level can patients be off a ventilator?

Answer 18

C4 and below

Question 19

What spinal cord injury level can patients walk with long leg braces and forearm crutchs?

Answer 19

L2 and below

Question 20

C1-3 injury mobility

Answer 20

Power Wheelchair with head and chin control

Question 21

C4 injury mibility

Answer 21

Power Wheelchair with mouth control (sip/puff)

Question 22

Mobility c5 injury

Answer 22

Drive power wheelchair with hand

Question 23

C6-C7 injury mobility

Answer 23

Manual wheelchair