Trauam Flashcards

1
Q

Commonest groups for non trauma spinal cord injury

A

Older patients and females

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2
Q

Distribution of pathology along the cord in non trauma SCI

A

Equally amongst cervical thoracic and lumbar sacral

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3
Q

What proportion of non traumatic injuries are complete?

A

40%

60% are incomplete

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4
Q

What percentage of non trauma SCI result in paraplegia and quadriplegia respectively

A

75% paraplegia

25% quadriplegia

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5
Q

What proportion of SCI are traumatic

A

Two thirds

One third non trauma

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6
Q

Typical population of trauma SCI

A

Younger men

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7
Q

What proportion of trauma SCI is incomplete

A

90% incomplete

10% complete

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8
Q

What percentage of traumatic SCI are paraplegic and quadriplegia respectively

A

Para 50%

Quad 50%

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9
Q

What is the distribution of affected areas in traumatic SCI

A

Cervical 50%
Thoracic 40%
Lumbar sacral 10%

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10
Q

Name the five mechanisms of traumatic SCI

A

Flexion - falls, cars, ligament damage and bilateral dislocation
Rotation - passenger in a car, side impact, unilateral fracture dislocation
Extension - older, OA, spondylitis, central cord syndrome
Compression - burst fractures, usually minor damage
Direct - high energy blow to column

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11
Q

What is the ASIA criteria for SCI

A
A - complete motor and sensory
B - incomplete sensory only
c - incomplete motor grade less than 3
D incomplete motor grade more than 3
E normal function
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12
Q

ASIA class A

A

Complete motor and sensory

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13
Q

Asia class b

A

Incomplete sensory only

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14
Q

Asia grade c

A

Incomplete motor grade less than 3

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15
Q

Asia grade d

A

Incomplete motor more than 3

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16
Q

Asia E

A

Normal

17
Q

Features of anterior cord lesion

A

Damage to anterior spinal artery or vertebral bodies

Loss of motor, loss of pin prick

Touch and proprioception preserved

Muscle recovery poor

18
Q

Features of posterior cord injury

A

Uncommon

Loss of light touch proprioception, vibration, pain and temperature

Some motor preservation

Proprioception loss causes poor functional recovery

19
Q

Features of central cord syndrome

A

Cervical mostly
Weakness with arms worse than legs and sacral sparing

Recovery sequence lower limb, bladder and bowel, proximal upper, distal upper

20
Q

Feature of brown sequard SCI

A

Hemisection so;

Ipsilateral sensation loss above the lesion
Ipsilateral flaccid paralysis
Ipsilateral loss of vibration and proprioception below the lesion
Contralateral loss of pain and temperature below

21
Q

Cauda equine features

A

Lower motor neurone lesion

Flaccid lower limbs
Atomic bladder bowel
No sacral reflexes
Variable sensation loss

22
Q

Conus medullaris SCI features

A

Lies at L1 supplies L4 - S1
Associated with L1-2 injury

Mixed upper (conus) and lower (nerve root) lesion