Spinal Cord Injury - Part 1 Flashcards
What is a spinal cord injury?
An injury to the spinal cord resulting in a change in its normal sensory, motor, or autonomic function, either temporarily or permanently.
What are the common causes of
- Traumatic spinal cord injuries = ?
- Non-Traumatic spinal cord injuries = ?
Traumatic: Hyperflexion, hyperextension, axial loading, severing, with or without fracture, flexion rotation, and penetration.
Non-Traumatic: Vascular issues, neoplastic conditions, inflammation, and degenerative diseases.
Tetraplegia vs. Paraplegia
Tetraplegia: Impairment of motor or sensory function in the cervical spine, affecting all four limbs, torso, and organs.
Paraplegia: Impairment of motor or sensory function in the thoracic, lumbar, or sacral segments.
What is Anterior Cord Syndrome?
Anterior Cord Syndrome: A syndrome characterized by the
- loss of motor function and pain sensation, while
- preserving light touch and proprioception
- often due to flexion injuries
What is Central Cord Syndrome?
- Expected outcome?
Central Cord Syndrome: A syndrome caused by hyperextension injuries or congenital narrowing, leading to
- UE weakness > LE weakness
- Normal bowel and bladder function
What is Brown-Séquard Syndrome?
Brown-Séquard Syndrome: A condition where one side of the spinal cord is more damaged, causing
- paralysis and loss of light touch on the same side, and
- loss of pain and temperature on the opposite side
What is Posterior Cord Syndrome?
Posterior Cord Syndrome: A rare condition characterized by damage to the dorsal columns, leading to
- loss of proprioception
What are the characteristics of a cauda equina injury?
- low back pain
- radicular pain
- lower extremity paresis
- bowel/bladder dysfunction
- absent patellar and Achilles reflexes
What is sacral sparing?
Preservation of motor or sensory function at the S4-5 dermatome, even in incomplete injuries.
How are the motor and sensory level determined in spinal cord injuries?
Motor: The lowest key muscle with a grade of at least 3/5, provided all muscles above are graded 5/5.
Sensory: The lowest dermatome with intact sensation, graded 2/2.
What is the neurological level of injury ?
The highest of the intact motor or sensory levels on both sides of the body.
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What are the key muscle groups for L2, L3, and L4?
- L2: Hip flexors
- L3: Knee extensors
- L4: Ankle dorsiflexors
What are the key muscle groups for L5, S1, and S2?
- L5: Long toe extensors
- S1: Ankle plantarflexors
- S2: Sphincter tone
What are the steps in ASIA classification?
- determine the sensory level
- determine the motor level
- determine the neurological level
- complete/incomplete injury
- ASIA impairment scale classification
What is the ASIA A classification?
““All gone”
Complete injury with no motor or sensory function preserved in the sacral segments.
What is the ASIA B classification?
“Barely moves, but feels.”
Sensory incomplete injury with sensory function preserved below the neurological level, including sacral segments.
What is the ASIA C classification?
“Can move, but weak”
Motor incomplete injury with more than half the key muscles below the neurological level having a muscle grade < 3.
What is the ASIA D classification?
“Dominant function.”
Motor incomplete injury with at least half the muscles below the neurological level having a muscle grade greater than or equal to 3.
What is the ASIA E classification?
“Everything works!”
Normal motor and sensory function.
What is sacral sparing in spinal cord injury?
Preservation of sensory or motor function in the sacral segments S4-S5.
What are the 3 point scale values for sensory examination?
- 0 = absent
- 1 = impaired/altered
- 2 = normal/intact
What is zone of partial preservation?
Zone of Partial Preservation: Area of motor or sensory function below the neurological level of injury in the absence of sacral sparing.
- Only ASIA A / complete spinal cord injury
What is expected in a complete spinal cord injury?
No sensory or motor function is preserved below the level of injury, including sacral segments.
What happens in an incomplete spinal cord injury?
There is some preservation of motor or sensory function below the neurological level, including sacral segments.
What muscles are assessed to determine C5 motor function?
The biceps brachii.
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