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OTHY103 > Spinal Cord Injury > Flashcards

Spinal Cord Injury Flashcards

1
Q

What is a spinal cord injury?

A

SCI is damage to the spinal cord that results in a loss of function

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2
Q

Tetraplegia/Quadriplegia

A

injury to the spinal cord between the spinal cord segments C1 and T1

this causes paralysis and loss of feeling involving 4 limbs as well as the bladder, bowel and sexual organs

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3
Q

Paraplegia

A

injury to the spinal cord below the neck

below T1 cord segment

causes weakness and loss of feeling in the trunk, legs and bladder, bowel and sex organs

arms and hands are normal

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4
Q

Percentages of spinal cord injury

A

46% Land transport crashes

32% High or Low fall

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5
Q

Function of the vertebral column

A
  1. support and carry the weight and trunk and limbs
  2. provide movement and flexibility
  3. protect and encase the spinal cord
  4. provide attachment for other structures
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6
Q

where are the 33 Vertebrae located

A 
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccygeal (fused)
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7
Q

what are the four curvatures

A

cervical - concave

thoracic - convex

lumbar - concave

sacral - convex

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8
Q

C1 and C2

A

C1 - atlas
C2 - axis

allow for us to rotate our head, look up, to the side, look down, mobility

delicate and susceptible to injury if placed under force

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9
Q

Which is the longest part of the vertebrae

A

thoracic

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10
Q

Which part of the vertebrae articulates with and attaches to the ribs

A

thoracic

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11
Q

lumbar

A

lower back

receives the most stress and is the weight bearing component of the spine

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12
Q

caudia equina

A

tail of nerves exiting through the sacrum/ base of vertebral column

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13
Q

what matter protects the spinal cord

A

dura mater

arachnoid matter

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14
Q

epidural space

A

made up of fat, contains blood vessels that supply the cord and other structures

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15
Q

dorsal root

A

within the dorsal root there is a spinal ganglion where motor neurons communicate

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16
Q

blood supply of spinal cord

A

anterior spinal artery and its branches supply the antero-lateral half of the spinal cord

paired posterior spinal arteries and branches supply the postero-lateral half of the spinal cord

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17
Q

spinothalamic tract

A

simple touch,, pain and temperature on opposite side of body

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18
Q

dorsal (posterior) columns

A

sensations from same side of body

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19
Q

what are the 3 main ascending (afferent) pathways

A

non-specific ascending pathway
specific ascending pathway
spinocerebellar tracts

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20
Q

non-specific ascending pathway

A

formed by the lateral and anterior spinothalamic tract

transmits pain, temperature, and coarse touch

21
Q

specific ascending pathway

A

formed by the dorsal white column

transmits discriminative touch and vibrations

22
Q

spinocerebellar tracts

A

fromed by the anterior and posterior spinocerebellar tracts
transmits information about muscle and tendon stretch to the cerebellum which utilises this information to coordinate skeletal muscle movement

23
Q

what are the descending pathways

A

direct (pyramidal) system

indirect (Extrapyramidal) system

24
Q

Direct (pyramidal) system

A

transmit information down the large corticospinal (pyramidal tract). axons descend from the brain without synapsing with any other until they reach the level they need and communication with neurons in the ventral horn

regulate fast and fine movements e.g. writing

25
Q

Indirect (Extrapyramidal) system

A

includes all other descending (efferent) pathways
complex with multisynapses, regulate
-muscles used in balance and posture
-coarse limb movement
-head, neck and eye movement that follows moving objects

26
Q

what is the somatic nervous system involved in

A

voluntary movement
sensory input
reflex arc

27
Q

autonomic nervous system

A

divided into sympathetic and parasympathetic
involuntary and automatically
innervates all of the internal organs

28
Q

Sympathetic nervous system

A

arises from the thoracolumbar region of the spine. the SNS is responsible for our ‘fight or flight’ response

when stimulated it causes:

  • increase heartbeat
  • dilation of airways
  • reduced digestion
  • pupil dilation
  • inhibits urination
29
Q

Parasympathetic nervous system

A

arises from cranial nerves and sacral nerves and promotes all internal responses in a relaxed state

when stimulated it causes:

  • promotion of digestion
  • constriction of pupils
  • slowing of heart rate
  • stimulation of urination
30
Q

blunt injury

A 
forced flexion or flexion with rotation
forced extension (hyperextension)
vertical compression (axial loading)
31
Q

penetrating injury

A

commonly caused by a knife or gunshot

spinal cord is rarely severed

32
Q

fractures in vertebral column

A

can occur anywhere in the vertebrae
may not result in spinal cord injury
can result in incomplete or complete SCI

33
Q

secondary mechanisms of injury to the spinal cord

A
  • systemic hemodynamic changes
  • microvascular changes in the cord
  • spinal cord oedema (swelling)
  • electrolyte shifts
  • free radical release
  • excitotoxic amino acid release (vasospasm)
34
Q

ASIA impairment scale

A

international standards for neurological clasification of spinal cord injury

determines the neurological level of the impairment on both a motor and sensory scale

determines if the injury is complete or incomplete or if there are any zones of partial preservation

35
Q

central cord syndrome

A

damage only to the central portion of the cord

arm movement can be affected but leg movement intact

36
Q

Anterior artery syndrome

A

caused by an infarction of the main anterior artery affects the anterior two thirds of the cord
loss of motor and major sensory tracts but preservation of proprioception, vibration and touch sensation

37
Q

brown-sequard syndrome

A

damage is to one side of the cord only

loss of motor on one side of the body and loss of pain and temperature on the other side

38
Q

conus and cauda equina injuries

A

loss of motor function
variable patterns with some recovery potential
lower motor bowel, bladder and sexual function effected

39
Q

sacral sparing

A

sensation of sacral area preserved in otherwise paralysed person

40
Q

upper motor neurons

A

originate in the brain and travel within spinal cord

injury results in spasticity of limbs and bladder and bowel function

41
Q

lower motor neurons

A

originate in spinal cord and travel outside the cord forming the spinal nerves
damage causes disruption of the reflex arc and pathway to communication with upper motor neurons eg flaccid limbs and bladder/bowel function

42
Q

SCI complications

A

spinal shock
autonomic dysreflexia
spasticity
heterotopic ossification

43
Q

spinal shock

A

immediately after injury and up to approx 6 weeks

temporary depression of all reflex activity

  • hypotension
  • bradycardia
  • hypothermia
44
Q

autonomic dysreflexia (AD)

A

potentially life threatening above the lvel of the T6 spinal injury
starts to occur after initial phase of spinal shock, when spinal reflexes return
irritation of the ski, bowel or bladder cause a highly exaggerated response from autonomic nerves caused by the hormone, norepinephrine
this elevates blood pressure, slows heart and causes headaches, nausea, anxiety goose bumps etc which can then cause seizures, cerebral hemmorage and death
inability to sense the irritants is a major cause of this dysreflexia - common caused by an overful bladder, skin irritation, feaces

45
Q

spasticity

A

spinal cord injury prevents the brain from telling the muscle to relax
tendons remodel causing permanent muscle shortening or contracture

46
Q

heterotopic ossification

A

abnormal deposit of bone in muscles and tendons that may occur after injury
causes localised swelling, warmth, redness, and stiffness of the muscle
begins one to four months after the injury and is rare of one year

47
Q

assessment and diagnosis of spinal cord injury

A

CT scan or MRI of the spine
myelogram (xray of the spine after injecting dye)
somatosensory evoked potential (SSEP) testing ot magnetic stimulation
spine xrays

48
Q

surgery

A

halo-thoracic brace

stops heads from turning, looking up/down

49
Q

corticosteroids..

A

reduce swelling that may damage the spinal cord

OTHY103 (1 decks)

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