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711: Neurological Rehabilitation > Spinal Cord Injury & Disease > Flashcards

Spinal Cord Injury & Disease Flashcards

1
Q

What is the difference between a complete SCI and an incomplete SCI?

A

With a complete there is total absence of sensory and motor function below lesion level.
Whereas in an incomplete SCI there is partial preservation of sensory and motor functions below the lesion level.

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2
Q

The return of function of the last preserved sensory level in a complete and incomplete SCI is enhanced by the administration of what drug?

A

the corticosteroid methylprednisone

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3
Q

Methylprednisone must be administered - hours after SCI in order to be effective

A

3-8

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4
Q

Which occurs more frequently, complete or incomplete SCIs?

A

incomplete

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5
Q

What are 4 common causes of SCI?

A
  • Transection
  • Compression
  • Infection
  • Degenerative Disorders
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6
Q

What are the symptoms if the cause of a SCI is transection?

A

All sensory & motor information is interrupted at or below the lesion level

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7
Q

What is an example of an infection that can compromise the integrity of the spinal cord?

A

Polio

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8
Q

What is an example of an degenerative disorder that can compromise the integrity of the spinal cord?

A

ALS

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9
Q

What are the 5 most important tracts to clinically evaluate?

A
  • Lateral Corticospinal Tracts
  • Dorsal Columns
  • Lateral Spinothalamic Tracts
  • Spinocerebellar Tracts
  • Vestibulospinal Tracts
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10
Q

What type of information do the lateral corticospinal tract carry?

A

Voluntary motor control on the contralateral side

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11
Q

What type of information do the dorsal columns carry?

A

Conscious discriminative touch, pressure, vibration, and proprioception on the contralateral side

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12
Q

What type of information do the lateral spinothalamic tract carry?

A

Conscious pain & temperature on the contralateral side

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13
Q

What type of information do the spinocerebellar tract carry?

A

Unconscious proprioception

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14
Q

What type of information do the vestibulospinal tract carry?

A

Facilitation of extensor tone

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15
Q

CN nuclei are part of the ____ motor neuron system, whereas CN ____ are part of the ____ motor neuron system

A

upper

lower

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16
Q

Are the conus medullaris and the cauda equina consider UMN or LMN?

A

LMNs

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17
Q

Cord lesions at the __ vertebra area and lower are considered LMN injuries

A

L1

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18
Q

What are the 3 UMN lesion signs that occur below the level of the lesion?

A
  • Spasticity
  • Hyperactive reflexes
  • Clonus
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19
Q

True or False

People with spasticity have difficulty actively and passively moving the muscle on one side of the joint, not both sides.

A

True

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20
Q

What is it called if both flexors and extensors display increased tone?

A

rigidity

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21
Q

What is the 1 UMN lesion signs that occur at the level of the lesion?

A

flaccidity

22
Q

Muscles that undergo atrophy following LMN lesion may display what 2 types of dysfunction?

A

Fibrillations and/or Fasciculations

23
Q

What are Fibrillations?

A

Fine twitches of single muscle fibers that usually cannot be detected on clinical exam but can be identified on an EMG

24
Q

What are Fasciculations?

A

Brief contractions of motor units, which can be observed in skeletal muscle and detected on clinical exam

25
Q

Which type of spinal cord disease is caused by neurosyphilis?

A

Dorsal Column Disease

26
Q

Dorsal Column Disease results in what symptoms?

A

Bilateral Loss of:

- Tactile discrimination
- Vibration
- Pressure
- Proprioception
27
Q

Describe the pathology of Brown-Séquard Syndrome

A

spinal cord hemisection

28
Q

Brown-Séquard Syndrome results in what symptoms?

A 
Ipsilateral Loss of:
    - motor control
    - discriminative touch
    - pressure
    - vibration
    - proprioception
Contralateral Loss of:
    - Pain & Temperature (below the level of the lesion)
Bilateral Loss of:
    - Pain & Temperature (at the level of the lesion)
29
Q

What 3 things can cause anterior cord syndrome?

A
  • Infarct
  • Ischemia
  • Trauma
30
Q

Describe the pathology of Anterior Cord Syndrome

A

Occurs when 2/3 of the anterior cord is lost

31
Q

Anterior Cord Syndrome results in what symptoms?

A 
Bilateral Loss of:
    - Pain & Temperature 
    - voluntary motor control
Spasticity
Flaccidity at and below the level of the lesion
32
Q

Describe the pathology of Central Cord Syndrome

A

Involves a cavitation of the central cord in the cervical segments

33
Q

Central Cord Syndrome results in what symptoms?

A
  • bilateral loss of pain and temperature

- flaccidity of the UEs

34
Q

What are 3 possible causes of posterolateral cord syndrome?

A
  • Severe vitamin B12 deficiency
  • Pernicious anemia
  • AIDS
35
Q

Describe the pathology of Posterolateral Cord Syndrome

A

Affects the posterior and posterolateral white funiculi of the SC

36
Q

Posterolateral Cord Syndrome results in what symptoms?

A

Bilateral:

  • loss of discriminative touch, pressure, vibration, and proprioception
    - spastic paralysis
    - ataxia
37
Q

Describe the pathology of Anterior Horn Cell Syndrome

A

Caused by disease process that destroys the MNs in the ventral horn resulting in LMN damage

38
Q

Anterior Horn Cell Syndrome results in what symptoms?

A

Bilateral flaccidity (LMN symptom)

39
Q

What is described as a state of areflexia that occurs immediately after SCI in which there is a complete loss of all spinal reflexes below the level of the lesion?

A

Spinal Shock (aka Neurogenic Shock)

40
Q

What are the 3 signs of spinal shock?

A
  • Flaccid paralysis
  • Loss of tendon reflexes
  • Loss of autonomic function
41
Q

What can be defined as an acute episode of exaggerated sympathetic reflex responses in SCI that occurs because higher center reflex regulation is lost.

A

Autonomic Dysreflexia

42
Q

Autonomic Dysreflexia is associated with SCIs at __ or above

A

T6

43
Q

What other condition tends to develop in patients with injuries at T6 or above in which BP drops precipitously when a patient is in an upright position?

A

Orthostatic Hypotension

44
Q

Why does body temperature dysregulation occur following SCI?

A

Because communication between hypothalamic temperature regulators and sympathetic function below the lesion level become disrupted

45
Q

What is Poikilothermy?

A

A condition in which the body takes on the temperature of its external environment

46
Q

Poikilothermy is associated with SCIs at __ or above

A

T6

47
Q

What are 3 other considerations to take into consideration following SCI?

A
  • edema
  • skin breakdown
  • DVTs
48
Q

Patients with _MN lesions have a spastic bladder

Patients with _MN lesions have a flaccid bladder

A

UMN

LMN

49
Q

Patients with SCI above __-__ lose voluntary control of the external anal sphincter

A

S2-S4

50
Q

How are T12/L1 or higher SCI patients sexually aroused?

A

Through touch only

51
Q

How are L2-S1 SCI patients sexually aroused?

A

Through touch or mental stimulation

711: Neurological Rehabilitation (10 decks)

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