traumatic SCI

Question 1

what is traumatic SCI

Answer 1

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

Question 2

as per asian scale, what is a complete lesion

Answer 2

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

Question 3

what is an incomplete SCI

Answer 3

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

Question 4

when do u get spinal shock

Answer 4

0-1 day

Question 5

what is spinal shock

Answer 5

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

Question 6

what is long term effect of SCI

Answer 6

paralysis and loss of sensation below the level of the lesion

Question 7

what happens after spinal shosk

Answer 7

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

Question 8

is SCI associated with hyperrefflxia or hypo

Answer 8

hyper

Question 9

are traumatic SCI more in males or females

Answer 9

males

Question 10

what is mean age of SCI

Answer 10

52

Question 11

what is mean age for SCI from falls

Answer 11

61 (but 64 in notes)

Question 12

what is mean age for motor vehicle SCI injuries

Answer 12

43

Question 13

what is the trend about age and SCI

Answer 13

• Median age getting older (increased elderly people)

Question 14

is incomplete or complete more frequent and why

Answer 14

incomplete, most likely due to better acute care

Question 15

is there any gender difference emerging in sci

Answer 15

yes
gender diffidence is getting smaller

Question 16

what are the most common causes of SCI

Answer 16

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

Question 17

what is most common cause of SCI traumatic

Answer 17

falls

Question 18

what are the most common symptoms of SCI

Answer 18

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

Question 19

spasticity is associated with upper or lower motor injury

Answer 19

upper

Question 20

flaccidity is associated with upper or lower motor injury

Answer 20

lower

Question 21

explain why imaging has limitation for SCI

Answer 21

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

Question 22

what is key for SCI diagnosis

Answer 22

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.

Question 23

what are the associated conditions with SCI

Answer 23

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

Question 24

true or false, there is high suicide risk in SCI

Answer 24

true, whole life changes suddenly

Question 25

what are the fuNctional impairments associated with SCI

Answer 25

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.

Question 26

what are the activity limitations in SCI

Answer 26

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.

Question 27

what are the participation restrictions for SCI

Answer 27

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.

Question 28

what is medical treatment for SCI

Answer 28

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

Question 29

what is treatment for OT PT with SCI

Answer 29

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.

Question 30

why would u need a nurse with SCI

Answer 30

bladder and bowerl training

Question 31

Any probability of neurological recovery decreases with time true or false

Answer 31

true

Question 32

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

Answer 32

first 3-6 months