Spinal injury Flashcards
describe the life expectancies for different spinal cord injuries
Severe tetraplegia - life expectancy reduced by 1/3
Otherwise normal
What is the incidence of different spinal cord injuries
was 50:50 between paraplegic and tetraplegic but now 75:50 tetra:para
Which diagnostic test is best used for spinal cord injury
MRI
What is a halo brace?
A brace used on a patient with multiple cervical fractures
Which region of the spinal cord is most commonly injured?
Cervical region
Which spinal tracts cross over at the medula oblongata?
- posterior column and lateral corticospinal tracts
Which spinal tracts cross in the spinal cord?
- spinothalamic tract
What is quadriplegia?
injury in the cervical region in which all 4 extemities are affected
What is paraplegia?
Injury in the thoracic, lumbar or sacral segments in which 2 extremities are affected
What is tetraplegia?
AKA - quadriplegia
patients have paralysis in the cervical region from C1-7
What is a complete spinal cord injury?
Lesion at a specific site from the injury and no information can pass
What is an incomplete spinal cord injury?
Variable amount of movement and sensation below the site of injury
What are the different types of incomplete injuries?
- central cord syndrome
- anterior cord syndrome
- posterior cord syndrome
- brown-sequard syndrome
- cauda equina syndrome
What is central cord syndrome?
type of incomplete spinal injury
- most common
- typicall elderly patients (degenerative changes)
- hyperextension injury
centre of the cord is affected by compression anteriorly by osteophytes and posteriorly by ligamentum flavum
What are the symptoms of central cord syndrome?
Preservation of light touch proprioception and some retainment of sharp/blunt discrimination and hot/cold sensation.
Weak upper limbs but strong lower limbs
What is brown-sequard syndrome?
a type of incomplete spinal injury
- hemi-section of the cord due to penetrating injuries (stab/gunshot)
What are the symptoms of brown-sequard syndrome?
- paralysis on the affected side (corticospinal)
- loss of proprioception and fine discrimination (dorsal columns)
- pain and temperature loss on the opposite side below the lesion (spinothalamic
What is cauda equina syndrome?
a type of incomplete spinal cord injury that is due to bony compression or disc protrusions in the lumbar or sacral region
What are the symptoms of cauda equina syndrome?
non specific symptoms = back pain
- bowel and bladder dysfunction
- leg weakness and numbness
- saddle parasthesia
creates lower motor neuron problems
How do you assess spinal cord injuries?
Clinical examination to determine the extent of the injury and prognosis for recovery
Examines patients power by assessing the myotomes. And voluntary anal contraction.
ASIA scale
Above which spinal segment will an injury cause autonomic dysfunction?
T5
What is spinal shock?
temporary supression of all reflex activity below the level of the injury
occurs immediately after injury at varying intensity and duration
Which reflex sign is the first to appear as spinal shock wears off?
babinski sign
What are the stages of spinal shock?
1- Areflexia/Hyporeflexia
2- Initial reflex return
3- Hyperreflexia (initial)
4- Hyperreflexia, Spasticity
