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Spinal tracts and injury Flashcards

1
Q

anterior cord syndrome

A

Common MOI: cervical flexion
Impairment: loss of pain, temp and motor fxn
Affected tract: corticospinal and spinothalamic tracts

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2
Q

Brown Sequard’s syndrome

A

Common MOI: stab wound that produces hemisection of SC

Impairment: loss of vibration and postion sense as the SAME side of the lesion (corticospinal and dorsal columns), loss pf pain and temp on OPP side (lateral spinothalamic tract)

Affected tract: corticospinal tract, dorsal columns, lateral spinothalamic tract

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3
Q

Cauda equina injury

A

injury below L1 where nerve roots transcend. Frequently non complete. considered a peripheral nerve root injury. Characterisitics: flaccid, areflexia, B&B dysfxn

full recovery not expected 2/2 slow axonal degeneration

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4
Q

Central cord syndrome

A

UE is more affected then LE and greater motor defcits than sensory
Common MOI: compression to central region of SC
Impairment: Cervical hyperextension
Affected tract: spinothalamic tract, corticospinal and dorsal columns

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5
Q

Posterior cord syndrome

A

rare
compression of posterior spinal artery
- characterized by loss of proprioception, 2 point discrimination, sterognosis
- motor fxn is perserved

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6
Q

ASIA Level A

A

Complete: no sensory or motor function is perserved in sacral segments S4-S5

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7
Q

ASIA level B

A

Sensory incomplete: Sensory but not motor fxn is perserved below neuro level and extends thro S4/S5

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8
Q

ASIA level C

A

motor incomplete: motor fxn is preserved below neuro level and most key muscles below level have are lower than MMT 3/5

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9
Q

ASIA level D

A

motor incomplete: motor fxn is preserved lower than nuero level and key muscles have MMT higher than 3/5

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10
Q

ASIA level E

A

Normal; senosry and motor fxns are normal

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11
Q

How is motor level assigned in in ASIA

A

determined by the most caudal keey muscle that has strength of 3/5 or greater and superior segment 5/5 or normal

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12
Q

How is sensory level assigned in in ASIA

A

determined by the most caudal dermatome with normal score of 2/2 for pin prick and light touch

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13
Q

What is motor index scoring

A

testing each key muscle using the 0-5 scoring.
25 max for each extremity
100 total possible points

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14
Q

According to ASIA, what key muscles are tested for C5

A

elbow flexors (biceps and brachialis)

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15
Q

According to ASIA, what key muscles are tested for C6

A

wrist extensors (extensor carpi radialis longus and brevis)

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16
Q

According to ASIA, what key muscles are tested for C7

A

elbow extensors (triceps)

17
Q

According to ASIA, what key muscles are tested for C8

A

finger flexors (flexor digitorum profundus )

18
Q

According to ASIA, what key muscles are tested for T1

A

small finger ABDs (abductor digiti minimi)

19
Q

According to ASIA, what key muscles are tested for L2

A

Hip flexor (illiopsoas)

20
Q

According to ASIA, what key muscles are tested for L3

A

knee extensor (quad)

21
Q

According to ASIA, what key muscles are tested for L4

A

ankle DF tibialis anterior

22
Q

According to ASIA, what key muscles are tested for L5

A

Long toe extensors (extensor hallicus longus)

23
Q

According to ASIA, what key muscles are tested for S1

A

ankle plantar flexors (gastroc soleus)

24
Q

What are the sights for pin prick sensation for the cervical region

A 
C2 Occipital protruberance 
C3supraclavicular fossa
C4 top of AC joint 
C5 lateral side of anticubital fossa 
C6 thumb 
C7 middle finger
C8 little finger
25
What are the sights for pin prick sensation for the thoracic region
``` T1 medial side of anticubital fossa T2 apex of axilla T3- T9: intercostal space (IS) btwn vertebrae above and below (T5 = btwn T4 and T6 VB) T4 - nipple line T6- level of xiphisternum T10 belly button or 10th intercostal spoace T11 11th IS T12 mid point of inguinal ligament ```
26
What are the sights for pin prick sensation for the lumbar AND Sacral region
``` L1 half the distance btwn t12 and L2 L2 midanterior thigh L3 medial femoral condyle L4 medial malleolus L5 dorsum of foot at 3rd MTP S1 lateral heel S2 popliteal fossa in the midline S3 ischial tuberosity S4-5 perianal area (taken as 1 level) ```
27
Are pts with SC injury more at risk for a DVT?
Yes - loss of motor fxn and sensory; decreased normal pumping actions of active muscles in LE - Homans signs - Prevention includes prophylactic use of anticoagulant, maintaining positioning schedule, ROM, proper positioning to avoid venous stasis and elastic stockings
28
What level of assistance and functional skills to someone with high tetraplegia (C1-5) have with bed mobility, transfers, wait shifts, wheelchair management, gait, range of motion, feeding, grooming, dressing, bathing, bowel and bladder?
Bed mobility: Dependent C-5 requires moderate to max assist Transfers:Dependent C-5 requires moderate to max assist Wait shifts: Modified independent with power recline dependent with manual recline Wheelchair management: Dependent with WC management, Modified independent on smooth, ramps and rough terrain with power wheelchair. Manual wheelchair requires max asst unless on smooth surfaces and forward direction, then modified independence Gait:N/A Range of motion/positioning: Dependent Feeding: Dependent. C-5 minimal assistance with adaptive equipment Grooming: Dependant, C5 will need min-max Dressing:Dependant Bathing:Dependant Bowel and bladder:Dependant
29
What level of assistance and functional skills to someone with mid level tetraplegia (C6) have with bed mobility, transfers, wait shifts, wheelchair management, gait, range of motion, feeding, grooming, dressing, bathing, bowel and bladder?
Bed mobility: Min assist to modified independent with equipment Transfers:Min assist to modified independent for slide board, dependant for all other Wait shifts: Modified IND with side to side, floor forward or depression Wheelchair management: Modified independent in smooth, ramps and rough terrain with power WC. dependent with asst up and down curbs in power WC but max-mod asst with manual WC. Gait:N/A Range of motion/positioning: Mod asst to mod-Indpendent Feeding: Modified independent with adaptive equipment Grooming: modified independent Dressing: modified independent for UE, min asst for LE dressing and mod-for undressing Bathing: Min for UE mod for LE. USe shower or tub chair Bowel and bladder:min to mod
30
What level of assistance and functional skills to someone with low level tetraplegia (C7-8) have with bed mobility, transfers, wait shifts, wheelchair management, gait, range of motion, feeding, grooming, dressing, bathing, bowel and bladder?
Bed mobility: IND Transfers: Mod asst with car transfer, max-mod floor transfer, Mod-I with level surface transfer Wait shifts: Mod-I Wheelchair management: may need cushion, Mod-I with smooth, ramp, rough terrian with power WC. Dependant with going down curbs with power but mod-min with maunal. Dependant going up and down steps in WC Gait:N/A Range of motion/positioning: min-mod-asst Feeding: Modified independent with adaptive equipment Grooming: Mod- I Dressing: Mod I for in bed dressing Bathing: Mod- I Bowel and bladder: Mod- I for peeing Min asst for poop
31
What level of assistance and functional skills to someone with paraplegia have with bed mobility, transfers, wait shifts, wheelchair management, gait, range of motion, feeding, grooming, dressing, bathing, bowel and bladder?
Bed mobility: IND Transfers: Min asst w floor transfer, IND with level surface transfer and car transfer Wait shifts: Mod-I Wheelchair management: mod-I With going up and down 6 inch curb descending steps with manual WC. Max-min asst with going up steps with manual WC Gait: use of othoses ``` Range of motion/positioning:IND Feeding:IND Grooming: IND Dressing: Mod-I Bathing:Mod-I Bowel and bladder:Mod-I ```

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