Spinal Cord Injury - Part 2 Flashcards
What is…
- spinal shock = ?
- signs = ?
- Spinal shock: A period of areflexia immediately following SCI with loss of reflexes below the level of lesion.
- Usually lasts about 24 hours, with gradual return of reflexes within 1-3 days.
- Signs:
- Absence of reflex activity, autonomic reflexes like bladder and bowel control, and hypotension.
- Autonomic Dysreflexia (AD) = ?
- Symptoms = ?
Autonomic Dysreflexia: A life-threatening emergency due to an uncoordinated autonomic response to a noxious stimulus below the lesion in SCI above T6.
Symptoms: Pale skin below lesion, flushing and sweating above lesion, reduced heart rate, and increased blood pressure.
What triggers Autonomic Dysreflexia?
- Triggers:
- bladder retention
- rectal distention
- pressure sores
- bladder infections, and other noxious stimuli.
- Anoxious stimuli below the level of lesion elicits sympathetic over activity thatconstricts blood vessels (of viscera and skeletal muscles) below the level of lesion –abrupt increase in blood pressure
- Normally, sympathetic facilitation (through neurons conveying signals regardingnoxious stimuli) is balanced by inhibitory signals descending from the brain –normal blood pressure is maintained; lesion above T6 level prevent most of thespinal cord to receiving signals from the brain that inhibit sympathetic activity
What is the treatment for Autonomic Dysreflexia?
Bring patient upright, loosen clothing, drain the bladder, and call for emergency assistance.
What is….
- Spasticity = ?
- Common triggers = ?
- How is it managed = ?
a) Increased muscle tone and hyperactive reflexes occurring below the level of the lesion after spinal shock.
b) Common triggers: Tight clothing, kidney stones, UTI, emotional stress, and fecal impaction.
c) Managment: Medications like Baclofen, selective stretching, weight-bearing, and ROM exercises.
What is the main method of bladder management after SCI?
Intermittent catheterization, performed every 4 hours.
What is the difference between a spastic and flaccid bladder in SCI?
- Spastic bladder empties in response to filling pressure (UMN).
- Flaccid bladder has difficulty emptying (LMN).
What is the leading cause of death in SCI patients?
Pulmonary complications such as pneumonia.
Injuries occurring at which cervical levels require ventilator support?
- C1-C2 injuries require ventilator support
- C3-C4 injuries may require partial ventilator support
What is the management goal for pulmonary impairments in SCI?
Improved ventilation, effective coughing, and prevention of chest tightness.
What are common exercises for pulmonary function in SCI?
- diaphragmatic breathing
- assisted cough
- respiratory muscle training
What are pressure ulcers?
Lesions of the skin and underlying tissue caused by prolonged immobilization.
What is the main prevention strategy for pressure ulcers?
Frequent repositioning, proper wheelchair and bed positioning, and skin inspections.
What is orthostatic hypotension?
A sudden drop in blood pressure when moving to an upright position, common in SCI above T6.
What are the symptoms of orthostatic hypotension?
Lightheadedness, low blood pressure, and fainting.