Spinal Injuries Flashcards
why can spinal injury classification not be diagnosed acutely?
due to spinal shock
describe complete spinal injury
> no chance of recovery
no sacral sensation
no sensory function distally
no motor function distally
describe an incomplete spinal injury
some function is present below the site of the injury and it carries a more favourable prognosis
describe grade a classification of spinal injury
complete
describe grade b classification of spinal injury
incomplete
sensory is preserved
describe grade c classification of spinal injury
> incomplete
motor function is preserved
majority key muscles have a grade 3> motor function
describe grade d classification of spinal injury
> incomplete
motor function is preserved
majority of key muscles have grade 3
describe grade e classification of spinal injury
normal motor and sensory function
what can cause a spinal injury?
> thoracoabdominal aortic aneurysm > infarct > tumours > sport > RTA > falls
what is tetraplegia?
partial loss of use of all 4 limbs and the trunk due to loss of function in cervical segments of the spinal cord
what is the presentation of tetraplegia?
> respiratory failure due to loss of innervation of the diaphragm
spasticity (increased muscle tone)
what is paraplegia?
partial/total loss of lower limb use due to loss of function in the thoracic lumber or sacral segments
is the bladder and bowel function affected in paraplegia?
yes
what can cause central cord syndrome?
hyperextension injury (in older patients with an arthritis neck
what is affected in central cord syndrome?
the central cervical tracts
how does central cord syndrome present?
> weakness is in the arms more than the legs
perianal sensation affected
lower extremity power preserved
what can cause an anterior cord syndrome?
hyperflexion injury- anterior compression fracture
what is damaged in anterior cord syndrome?
anterior spinal artery
how does anterior cord syndrome present?
> profound weakness
> preserved proprioception and fine touch
what is a hemi-section of the cord called?
brown-sequard syndrome
what can cause brown-sequard syndrome?
a penetrating injury
how can brown-sequard syndrome present?
> paralysis on the affected side (corticospinal)
loss of proprioception and fine discrimination (dorsal columns)
pain and temperature loss on the opposite side (spinothalamic)
what is spinal shock?
transient depression of cord function below the level of the injury
how does spinal shock present?
> areflexia
flaccid paralysis
lasts several days
how does neurogenic shock present?
> hypotension
bradycardia
hypothermia
what is neurogenic shock?
secondary disruption of the sympathetic flow
what management can be offered in unstable fractures?
surgical fixation
what long term management is available for spinal injuries?
> psychological support
OT
physiotherapy
urological and sex counsellung