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PTRS 852 - Neuro PT I Midterm > Spinal Cord Injury (Guest Lecture) > Flashcards

Spinal Cord Injury (Guest Lecture) Flashcards

1
Q

Term: Temporary or permanent change in the spinal cords normal sensory, motor, or autonomic function

A

Spinal Cord Injury (SCI)

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2
Q

3 Atraumatic MOI of SCI

A
  1. Vascular
  2. Neoplastic/Cancer
  3. Degenerative (OA, compression)
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3
Q

Term: Blood compressing the spinal cord

A

Spinal Hemorrhage

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4
Q

4 Traumatic MOI in SCI

A
  1. MVA (39%)
  2. Falls (28%)
  3. GSW/Violence (15%)
  4. Sports–Diving/Contact (8%)
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5
Q

4 Common Comorbidities with SCI

A
  1. Brain Injury (affects pt. ability to understand tx.)
  2. Fractures (WB restrictions)
  3. Penumothorax (Slows progress)
  4. Peripheral Nerve Injury (can affect ability to transfer)
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6
Q

Term: SCI between C2-T1

A

Tetraplegia or Quadraplegia

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7
Q

2 Ways to Classify Tetraplegia

A
  1. High/Low
  2. Complete (14%)/Incomplete (45%)
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8
Q

Term: SCI from T1/T2 down

A

Paraplegia

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9
Q

Way to Classify Paraplegia

A

Complete (20%)/Incomplete (21%)

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10
Q

Describe how medical advances has changed the proportion of SCI seen

A

Have gone from more tetra to paraplegics

Have gone from more complete to incomplete SCIs

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11
Q

Describe what happens when an injury to the spinal cord occurs

A
  • Changes in BF cause ongiong damage
  • Excessive NT release kills nerve cells
  • Inflammatory response occurs
  • Free radicals attack nerve cells
  • Nerve cells self destruct
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12
Q

Describe what occurs at the primary injury vs. the surrounding areas

A

Primary injury = all cells die

Surrounding area = cells closes tend to die due to inflammation, cells farther out typically live but could die depending on extent of inflammatory response

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13
Q

6 Pieces of Critical Information for a SCI

A
  1. MOI
  2. Co-morbidities
  3. PMH
  4. Precautions
  5. Level of Injury
  6. ASIA level
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14
Q

KU C-Spine Precautions (3)

A
  1. Spine unstable = Bedrest
  2. C-spine pending clearance, no fx/dislocation id’ed = up with collar
  3. Post fixation = use of collar
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15
Q

KU T/L Spine Precautions (5)

A
  1. Bedrest
  2. Limit extremity movement
  3. DO NOT elevate HOB
  4. Reverse Trendelenburg to prevent aspiration
  5. Log roll
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16
Q

Describe how the cord compares to the vertebral level

A

C1-T1 cord and vertebrae level very similar

T12 exits at the T8 vertebra

Lumbar cord exits between T9-T11

Sacral cord exits between T12-L1

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17
Q

Key Muscle Group: C1-C4

A

Diaphragm and sensory

This level is determined by sensory function/lack of function

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18
Q

Key Muscle Group: C5

A

Biceps

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19
Q

Key Muscle Group: C6

A

Wrist Extension

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20
Q

Key Muscle Group: C7

A

Triceps

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21
Q

Key Muscle Group: C8

A

Finger Extensors

22
Q

Key Muscle Group: T1

A

Small finger ABD

23
Q

Key Muscle Group: T2-L1

A

Sensory level

24
Q

Key Muscle Group: L2

A

Hip flexors

25
Q

Key Muscle Group: L3

A

Knee extensors

26
Q

Key Muscle Group: L4

A

Ankle DF

27
Q

Key Muscle Group: L5

A

Big toe extensors

28
Q

Key Muscle Group: S2-S5

A

Sensory level

Sphincter tone

29
Q

ASIA Level of Injury: The lowest key muscle with at least 3/5, provided ALL key muscles above are grade 5/5

A

Motor Level

30
Q

ASIA Level of Injury: The lowest normal dermatome

A

Sensory Level

31
Q

ASIA Level of Injury: The most caudal level with normal sensory and motor function bilaterally

A

Neurological Level

32
Q

Term: Presence of rectal tone or sensation

A

Incomplete SCI

33
Q

Term: Absence of rectal tone or sensation

A

Complete SCI

34
Q

ASIA Level: A

A

Complete

NO motor or sensory function preserved from S4-S5

35
Q

ASIA Level: B

A

Sensory Incomplete

Sensory, but NO motor funciton below neurological level of injury

S4-S5 INTACT

36
Q

ASIA Level: C

A

Motor Incomplete

Motor function preserved below neurological level of injury

> 1/2 of key mm below neurolgoical level of injury are < 3/5

37
Q

ASIA Level: D

A

Motor Incomplete

Motor function preserved below neurological level of injury

at least 1/2 of key mm below neurolgoical level of injury are 3/5 or greater

38
Q

ASIA Level: E

A

Normal

Used in FU of pts. with SCI with initial deficits

39
Q

3 Types of Incomplete Lesions

A
  1. Anterior Cord Syndrome
  2. Central Cord Syndrome
  3. Brown-Sequard Syndrome
40
Q

Type of Lesion: Characterized by loss of funciton of the ventral pathway and the conservation of the dorsal column

A

Anterior Cord Syndrome

41
Q

Type of Lesion: Characterized by preservation of light touch, proprioception, deep pressure and absence of pain and motor function

A

Anterior Cord Syndrome

42
Q

Type of Lesion: Less functional recovery compaired to other incomplete lesions

A

Anterior Cord Syndrome

43
Q

Type of Lesion: Charaterized by a central area of injury

A

Central Cord Syndrome

44
Q

Type of Lesion: Affects nwdially located motor fibers that control distal UE function. Also characterized by greater UE weakness compared to LE weakness and sacral sparing

A

Central Cord Syndrome

45
Q

Type of Lesion: Characterized by damage that affects one half of the spinal cord significantly greater than the other half

A

Brow Sequard Syndrome

46
Q

Type of Lesion: Characterized by spastic paresis, loss of light touch and vibration on the damaged side. Loss of pain and temperature sensation on the contralateral side two levels down

A

Brown Sequard Syndrome

47
Q

Type of Lesion: Characterized by LBP, radicular pain, LE paresis/paralysis, sensory deficit in the perineal area, bowel/bladder dysfunction, diminished/absent patellar and achilles reflexes

A

Cauda Equina Injury

48
Q

9 Common Secondary Conditions Associated with SCI

A
  1. Autonomic dysreflexia
  2. DVT
  3. Pressure ulcers
  4. Heterotopic ossifications
  5. UTI/Renal complications
  6. Bone Fx
  7. Syringomyelia
  8. Spasticity
  9. Pain
49
Q

Secondary Condition Sx:

  • Headache
  • Sweating
  • Nasal congestion
  • Goosebumps
  • Paresthesias
A

Autonomic Dysreflexia

50
Q

Term: A tapered fluid filled cavity within the SC that may extend for multiple levels

A

Syringomyelia

51
Q

Secondary Condition Sx:

  • Reduction in functional capacity
  • Decrease in motor function
  • Pain
A

Syringomyelia

PTRS 852 - Neuro PT I Midterm (15 decks)

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