Spinal Cord Injury - Part 1

Question 1

Spinal Cord Injury - Definition

Answer 1

Damage to spinal cord which blocks communication between brain and body.
The higher the injury, the more alterations in function.
Affects sensory, motor and reflex messages.

Question 2

Tetraplegia - Definition

Answer 2

Impairment or loss of motor and/or sensory function.
Cervical damage.
Upper, lower limbs and trunk affected.

Question 3

Paraplegia - Definition

Answer 3

Impairment or loss of motor OR sensory function.
Damage to thoracic, lumbar or sacral.
Lower limbs and/or trunk affected.
Can be used to refer to cauda equina, conus medullaris injuries.

Question 4

Complete Spinal Cord Lesion

Answer 4

Sensory and motor function in the lowest sacral segments (S5/S5) absent.
ASIA scale: AIS A

Question 5

Discomplete Spinal Cord Lesion

Answer 5

New term in research.
Clinically complete but accompanied by neurophysiological evidence of residual brain influence on spinal cord function below the level of the lesion.

Question 6

Incomplete Spinal Cord Lesion

Answer 6

Detectable residual sensory OR motor function below the neurological level and specifically in the lowest sacral segment.
ASIA scale: AIS B, C, D, E

Question 7

Types of Spinal Cord Injuries (3): Pathophysiology

Answer 7

Contusion: bruising, usually from trauma.
Laceration: severing or tearing, usually from fire weapons and knife wounds.
Solid: Axonal damage, through injury or demyelination (whiplash injury).

Question 8

ASIA Scale vs Frankel Level

Answer 8

Asia scale is the assessment used to determine the Frankel level.
Frankel level is the completeness of the lesion.

Question 9

Frankel Level A - Completeness of Lesion

Answer 9

Complete
No motor or sensory function preserved in the lowest segments.

Question 10

Frankel Level B - Completeness of Lesion

Answer 10

Sensory incomplete.
Minor sensory deficit, but no motor function preserved, including the lowest segments.

Question 11

Frankel Level C - Completeness of Lesion

Answer 11

Motor incomplete.
Sensory deficit. Motor function present below the injury, but the strengths of more than half of the key muscles are graded < 3 out of 5.

Question 12

Frankel Level D - Completeness of Lesion

Answer 12

Sensory deficit. Motor function present below the injury, but the strengths of more than half of the key muscles are graded more or equal to 3 out of 5.

Question 13

Frankel Level E - Completeness of Lesion

Answer 13

Motor and sensory function in key muscles and dermatomes are normal. Minor sensory and motor deficit. Not normal! Lesions never normal.

Question 14

Spinal Shock - Definition, length and out of shock phase

Answer 14

Loss of neurological activity below the injury level, due to a sudden loss of conduction in the spinal cord.
length: 1 month to 1 year after acute injury.
Out of shock phase: return of spinal reflexes, hyperreflexia.

Question 15

Neurogenic Shock

Answer 15

Hemodynamic consequence of SCI.
Vasodilation and increased perfusion of lower extremities.
Hypotension or bradycardia -> wrong medication.