Spinal Injury Flashcards
Motor Pathway
Descending; from brain to body, (Efferent)
Sensory Pathway
Ascending, from body to brain, (Afferent)
Monoplegia
paralysis on one limb
Hemiplegia
paralysis in both limbs of same side (half vertical)
Paraplegia
paralysis of both upper or both lower extremities (half horizontal)
Quadriplegia
paralysis all 4 extremities
Paresis
Weakness
Plegia
Paralysis
Ipsilateral
same side as damage occured
Contralateral
Opposite side that damage occured
Hypotonia/Hypertonia
less than normal muscle tone; excessive muscle tone
Flaccidity
Absence of muscle tone
Spasticity
causes still awkward muscle movement
Rigidity
immovable stiffness
Tetany
intermittent tonic spasms
Fracture
fragmentation of the bone
Dislocation
complete displacement of bone
Sublaxation
Partial dislocation, did not come all of the way out
Types of Spinal Cord Injuries (4)
Flexion (head down), Extension (head up), Compression (pushing down on spine ie jumping/diving), Axial Rotation (twisting)
Incomplete Transection
partial preservation of function
Complete Transection
absense of motor and sensory function; lost from site of injury and below (higher up the injury –> the more damaging the effects)
above T1= quadriplegic
below T1= paraplegic
Causes of Spinal Cord Injury
Primary- initial injury
Secondary- progressive neurologic damage (vascular damage, release of enzymes, lack of function)
Central Cord Damage Syndrome
what is it: damage to central grey/white matter of cord; affects upper extremities more
Cause: lesions, trauma, tumors
S/S: paresis, lose pain and temperature sensation
Anterior Cord Syndrome
what is it: infarction of anterior spinal artery; affects anterior 2/3 of cord; POOR RECOVERY
Cause: occlusion of anterior spinal artery
S/S: all malfunction except position and vibratory sensation
Brown-Sequard Syndrome
what is it: damage to half section of anterior/posterior cord; affects loss of voluntary motor function
Cause: unilaeral spinal cord lesions, penetrating trauma
S/S: Ipsilateral paresis, loss of touch, position, vibratory sensation; contralateral loss of pain/temperature sensation
Conus Medullaris
what is it: damage to sacral cord and lumbar nerve roots; affects lower body motor function
Cause: Lesion at L1
S/S: Distal leg paresis,
Perianal and perineal loss of sensation (saddle anesthesia), Erectile dysfunction, Urinary retention, frequency, or incontinence, Fecal incontinence, Hypotonic anal sphincter, Abnormal bulbocavernosus and anal wink reflexes
Cauda Equina
what is it: damage to lumosacral nerve roots w/in canal
S/S: asymetric flaccid paralysis, sensory impairment, and pain
Autonomic Dysreflexia
what is it: acute episode of axaggerated sympathetic reflex response; MEDICAL EMERGENCY
Cause: Visceral distention (full bladder), pain (ulcers, ingrown nail), visceral contractions (ejaculation, spasms)
S/S: extremely high BP, bradycardia, headache, sweating
Upper Motor Neuron Lesions (UMN)
injury at T12 or above; spastic paralysis
Lower Motor Neuron Lesions (LMN)
Injury below T12;
Flaccid Paralysis
Ventilation Function
injury at C1-C3= can’t breathe
injury at C3-C5= need nighttime ventilator
injury below C5= can breathe
Computed Tomography (CT)
cross section imagining of body, can identify larger herniation
with Myelogram- dye lights up nerve roots
Magnetic Resonance Imaging (MRI)
most useful for spine surgery, detail of disc and nerve roots, highly detailed
Electromyography
looks at electrical activity of nerve root, distinguish neuropathy from radiculopathy
Somatosensory evoked potentials
speed of electrical conduction, monitor spinal cord function during surgery
Poikilothermy
assume external temperature
Types of Pain (4)
- Mechanical/fracture pain (dull)
- Radicular/spinal nerve root (shooting)
- Visceral (not localized)
- Central (burning below site of injury, worse with movement/touch)
Herniated Discs (2)
Caused by trauma, aging, degenerative disorder
- Lumbar- lower extremities
- Cervial- upper extremities (pain travels down arm as C# increases)
