Traumatic SCI Flashcards
Disabilities Ass. with C1-C5 Tretraplegia
C1-C3
-breathing support
-communication support
C1-C5
-dressing, bathing, comminication
-assistive devices
Disabilities Ass. with C6-C8 Tretraplegia
Dressing:
-minimal assistance for UE
-moderate assistance for LE
-C8 able to independently
Bathing:
-moderate assistance for LE
-minimal for UE
Communication:
-independent verbal communication
-set up required for C6
Disabilities Ass. with T1-below Paraplegia
independent
Autonomic Dysreflexia
-SNS response to noxious stimuli below lesion
-in T5 and above lesions
-risk increases after spinal shock
S/s:
-HTN (>300)
-sweating above injury
-redness above injury
-Bradycardia
Autonomic Dysreflexia Triggers
-full bladder
-impacted bowel
-kidney stones
-scrotal compression
-gastritis
-DVT
-period
-ulcers
-change in temp
-irritation below lesion
SCI Sexual Function Complications
Men
-libido, potency, fertility
Women:
-libido, sexual response
-fertility remained
Anterior Cord Syndrome
-A. Spinal Artery stroke
-Paralysis, analgesia, loss of discriminative sensation, loss of temp below lesion
-Keep proprioception and light touch (DCML)
Central Cord Syndrome
-trauma induced
-tumors
-Nueromyelitis optica
-hyperextension
-syringomyelia
Small Lesion: pain and nociception impaired at level of lesion
Large Lesion: pain and nociception impaired at level of lesion AND UE motor issues
S/s: UMNL
Brown-Sequard (Hemicord) Syndrome
Ipsilateral segment:
-pareplegia and analgesia of everything
Ipsilateral Below:
-Paralysis and loss of proprioception and light touch
-maintain nociception and temp
-ipaired sweating and nerve root pain
Contralateral Below:
-nociceptive and temp impaired (1-2 levels below)
-maintain motor and light touch/proprioception
Cause:
-penetrating trauma
-MS
-epidural abscess
Cauda Equina Syndrome
-sensation impaired, pain, LE paralysis, bowel/bladder
-no hyperreflexia (LMNL)
Causes:
-disc herniation
-vascular
-infections
-radiation
-neoplastic
-inflammatory
Posterior Column Syndrome
-cause of nuerosyphilis
-early cervical spondylotic myelopathy
-radiation induced myelopathy
S/s:
-inpaired vibration and proprioception
-sensory ataxia
-gait imbalance
Grey Matter Fibers: Brain
-Motor
-cortex filled with cell bodies, folded in 6 layers
-Pyramidal cell: primary output
White Matter Fibers: Brain
Projection fibers, commissural fibers, Association fibers
Flexor-Extensor Rule
-MNs that innervate flexors are located posteriorly to MNs that innervate extensors
Proximal-Distal Rule
-MNs that innervate distal muscles are located laterally to MNs that innervate proximal muscles
Medial Corticospinal Tracts
-uncrossed
-postural movements
-originates from premotor cortex
-descends in venttral funiculus
Dorsal Column Medial Leminiscus
-Ascending tract
-Light touch, proprioception, sterognosis
1st: Dorsal horn ganglion to FG or FC
2nd: Nucleus Gracilis or Cuneatus in Medulla
CROSS with Internal Arcuate Fibers
3rd: Thalamus to PSSC
Anterolateral System
-ascending tract
-crude touch
Anterior: crude touch
Lateral: Fast nociception and temp
1st: Dorsal root ganglion to DH
CROSS at Anterior Commissure
2nd: Anterior commisure and travels up LST to thalamus
3rd: Thalamus to PSSC
Lateral Corticospinal Tract
-voluntary limb mmts
-pyramidal
Primary Motor Cortex> internal capsule> Cerebral peduncles (midbrain)>crosses at decussation of medulla>FC>lateral horn
