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cases for neurophysiology > traumatic SCI > Flashcards

traumatic SCI Flashcards

1
Q

what is traumatic SCI

A

A trauma that causes damage to any part of the spinal cord, leading to nerve cell death and surrounding secondary cell death.

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1
Q
A
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2
Q

as per asian scale, what is a complete lesion

A

means absence of motor and sensory input at the lowest segment (S4-S5, bowel or bladder dysfunctions).

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3
Q

what is an incomplete SCI

A

Incomplete is any motor/sensory impairment that does not have absence of motor and sensory at S4-S5.

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4
Q

when do u get spinal shock

A

0-1 day

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5
Q

what is spinal shock

A

A sudden loss of sensation accompanied by motor paralysis and loss of reflexes at/below the lesion (Inflammatory reaction).

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6
Q

what is long term effect of SCI

A

paralysis and loss of sensation below the level of the lesion

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7
Q

what happens after spinal shosk

A

there is a slow return of reflexes, followed by hyperreflexia and spasticity.

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8
Q

is SCI associated with hyperrefflxia or hypo

A

hyper

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9
Q

are traumatic SCI more in males or females

A

males

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10
Q

what is mean age of SCI

A

52

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11
Q

what is mean age for SCI from falls

A

61 (but 64 in notes)

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12
Q

what is mean age for motor vehicle SCI injuries

A

43

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13
Q

what is the trend about age and SCI

A
  • Median age getting older (increased elderly people)
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14
Q

is incomplete or complete more frequent and why

A

incomplete, most likely due to better acute care

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15
Q

is there any gender difference emerging in sci

A

yes
gender diffidence is getting smaller

16
Q

what are the most common causes of SCI

A
  • Fall (51%), transport (26%), sports (15%) assault (4%) are the most common causesw
17
Q

what is most common cause of SCI traumatic

A

falls

18
Q

what are the most common symptoms of SCI

A

Loss of motor and/or sensory function, Loss of bladder/bowel function, Loss of sexual function, Spasticity (subacute phase) or flaccidity (depending on upper motor or lower motor injury),
neuropathic pain

19
Q

spasticity is associated with upper or lower motor injury

A

upper

20
Q

flaccidity is associated with upper or lower motor injury

A

lower

21
Q

explain why imaging has limitation for SCI

A

you might see swelling and no associated symptoms, or you might see symptoms that aren’t explained by imagery

22
Q

what is key for SCI diagnosis

A

Neurological exam is done before arrival to rehabilitation center. Imagery tests such as X-rays, CT scans, MRI…are done,

Patient history, functional evaluation, and ongoing evaluation are key.

23
Q

what are the associated conditions with SCI

A

TBI, Fractures, Pressure sores, depression (high suicide risk), pneumonia, UTIs, septicemia, and heart disease.

24
Q

true or false, there is high suicide risk in SCI

A

true, whole life changes suddenly

25
Q

what are the fuNctional impairments associated with SCI

A

paralysis in LE, trunk, hands, triceps, grabbing objects is challenging, neuropathic pain, spasticity trunk and lower limbs, some sensory loss C6-C7-C8 and full loss of sensory below T2, decreased balance when seated, impaired bowel and bladder control, Non-weight bearing L wrist.

26
Q

what are the activity limitations in SCI

A

loss of functional ambulation, wheelchair bound, Unable to do stairs, decr. bed mobility, ability to transfer, ADLs (dressing, bathing, grooming…), must rely on self-catheterization due to urinary incontinence. Assistance required to empty bowel, loss of sexual function.

27
Q

what are the participation restrictions for SCI

A

Home access + access to basement (stairs), Unable to return to work as a carpenter, IADLs (cooking, cleaning, driving…). Couple life with girlfriend and possibly other friends/family.

28
Q

what is medical treatment for SCI

A

Anti-inflammatory medication, Botox, neuropathic pain meds.
In the long term, UL surgery, tendon and nerve transfers.

29
Q

what is treatment for OT PT with SCI

A

ADL/IADL retaining. Often involves adaptation of the environment and adaptive aids/wheelchair. Exercises to maintain current muscle function and even improve UE function. Stretches to assist with pain/spasticity.

30
Q

why would u need a nurse with SCI

A

bladder and bowerl training

31
Q

Any probability of neurological recovery decreases with time true or false

A

true

32
Q

Any probability of neurological recovery decreases with time true or false (statistically, when is recovery most possible

A

first 3-6 months

33
Q
A

cases for neurophysiology (14 decks)

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