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neuroscience > spinal cord injury- CC4 > Flashcards

spinal cord injury- CC4 Flashcards

1
Q

what are the immediate (acute) consequences of a SCI in the neck?

A

quadriparesis/plegia
sensory loss (touch, proprioception, pain, temp) and sensory abnormalities (parasthesia, pain)
hypotension, urinary retention, orthopedic pain

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2
Q

what are the immediate (acute) consequences of a SCI below T1?

A

paraparesis/plegia
sensory loss (touch, proprioception, pain, temp) and sensory abnormalities (parasthesia, pain)
hypotension, urinary retention, orthopedic pain

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3
Q

what does paraparesis mean?

A

partial paralysis of lower limbs

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4
Q

what does plegia mean?

A

total paralysis

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5
Q

what type of bladder will someone have in an injury at or above T10

A

spastic bladder

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6
Q

what type of bladder will someone have in an injury below T12

A

flaccid bladder

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7
Q

what does it mean if someone has a spastic bladder?

A

unable to voluntary relax the urethral sphincter

the detrussor muscle will continue to contract

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8
Q

explain what the term “autonomic dysreflexia” means

A
  • Episodes of crazy high BP (ex. 240/160 mmHg)
  • HR might drop to 40 bpm (called paradoxical hypertension)
  • *Occurs in response to strong afferent input
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9
Q

what are some examples of things that could trigger an autonomic dysreflexic response?

A

“nervous system overstimulation”

  • Nociceptor (ex. Overly full bladder)
  • Bladder-emptying (if neurogenic bladder)
  • Strong cutaneous inputs can also trigger
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10
Q

what does an A mean on the ASIA scale?

A

COMPLETE

no motor or sensory function below injury

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11
Q

what does a B mean on the ASIA scale?

A

INCOMPLETE
sensory (only) below injury
including S4-S5 segment (anal sensation

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12
Q

what does a C mean on the ASIA scale?

A

IMCOMPLETE

sensation + limited motor function below injury level

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13
Q

what does a D mean on the ASIA scale?

A

INCOMPLETE

sensation + significant motor function below the injury level

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14
Q

what does an E mean on the ASIA scale?

A

NORMAL

sensory & motor function is normal

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15
Q

can the nerve cell bodies that were crushed by the initial traumatic injury be treated?

A

NO. there is no hope for these neurons

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16
Q

what are the 3 broad approaches to SCI treatment?

A
  • neuroprotection
  • neurorestoration
  • neurorehabilitation
17
Q

what does neuroprotection mean?

A

protect surviving cells/axons so they don’t succumb to toxic environment caused by the injury

18
Q

what does neurorestoration mean?

A

replace cells, provide neurotrophins, establish a growth permissive environment to promote regeneration & re establishment of neural circuitry

19
Q

what does neurorehabilitation mean?

A

strength exisiting (atrophied?) systems, retain circuits or develop alternative strategies to accomplish desired tasks

20
Q

the finding that CPG output can be modified through training in a cat has what type of implications?

A

that there is spinal cord plasticity and that is is activity dependent

21
Q

what were the consequences for the “stepping” in CPG modification in humans?

A

terrible fatigue because of keeping person up at night

much better voluntary walking ability though!

22
Q

of the 4 cases presented in class of people with stepping onset, what were some common factors that these patient’s neurologically complete injury had?

A
  • sensitivity to the hip joint angle
  • rhythmic but NOT reciprocal between agonists & antagonists
  • significant pathology
  • pressure ulcer to the bone present
  • severe hip problems
  • herniated disc at L4/L5
23
Q

in what type of injuries can the “interlimb” reflex be seen

A

it is observed in all persons with chronic cervical SCI
most of them occur in distal upper limb muscles
note: it is rare to see in proximal limb muscles

24
Q

where do you see the interlimb reflex

A

most of them occur in distal upper limb muscles

it is rare to see in proximal limb muscles

25
Q

is the interlimb reflex more likely to be excitatory or inhibitory?

A

almost always excitatory

26
Q

what does the fact that there is minimal latency in the interlimb reflex suggest?

A

that there is a near/direct pathway between sensory afferent & cervical motoneuron

27
Q

once the interlimb reflex appears in a person, how long does it usually exist in that person?

A

forever!

28
Q

after initial onset of the interneuron reflexes, do they get stronger or weaker?

A

they continue to strengthen over about 1-2 years

29
Q

what are the interlimb reflexes likely due to?

A

likely due to new growth within the spinal cord below the lesion

30
Q

are the more likely to see autonomic dysreflexia after a complete or incomplete SCI?

A

complete SCI

31
Q

why do you see a drop in HR even though there is an increase in BP?

A

because the vagal innervation to the heart is still intact

neuroscience (33 decks)

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