Unit 2: CONCEPTS of Spinal Cord Injuries

Question 1

Force is applied to the spinal cord causing damage

Answer 1

Spinal Cord Injury (SCI)

Question 2

Damage that eliminates all innervation below the injury

Answer 2

Complete Spinal Cord Injury

Question 3

Injuries that allow some function (mobility, sensory perception, bowel and bladder control) below the level of the injury

Answer 3

Incomplete Spinal Cord Injury

Question 4

Primary cause of a Spinal Cord Injury (SCI)

Answer 4

Initial injury

Question 5

Secondary cause of a Spinal Cord Injury (SCI)

Answer 5

Effects after the initial injury that worsen the primary injury

Question 6

6 Primary causes that result in Spinal Cord Injuries (SCI)

Answer 6

1. Hyperflexion
2. Hyperextension
3. Axial Loading/Vertical Compression
4. Excessive Rotation
5. Penetrating trauma
6. Distraction

Question 7

Term:
A sudden forceful acceleration (movement) of the head forward, causing extreme flexion of the neck.

Answer 7

Hyperflexion
(head-on MVCs, diving accidents, fall on butt causing lower thoracic and lumbar spine flexion)

Question 8

Term:
A sudden forceful acceleration (movement) and then deceleration of the head and neck that can stretch or tear the anterior longitudinal ligament, fracture or subluxate the vertebrae, and possibly rupture an intervertebral disc.

Answer 8

Hyperextension

(rear-ended MVC, falls when the chin is struck)

Question 9

Term:
A force is directed through the top of the head (or through the butt) and through the spine that causes spinal compression that can result in the shattering of vertebrae.

Answer 9

Axial Loading/Vertical Compression

(Diving accidents, falls on the butt, or a jump in which a person lands on the feet)

Question 10

Term:
Results from injuries that are caused by turning the head beyond the normal range.

Answer 10

Excessive rotation

Question 11

Term:
Results from the speed of the object’s (knife, nail, bullet) impact causing the injury.

Answer 11

Penetrating trauma
Low-speed impact injury → damage directly to site of spinal cord or spinal nerves
High-speed/impact injury → both direct and indirect damage

Question 12

Term:
A spinal cord injury that results in separation of the vertebrae or spinal nerves

Answer 12

Distraction
(kyphosis?)

Question 13

5 Secondary Spinal Cord Injuries (SCI)

Answer 13

1. Hemorrhage
2. Ischemia
3. Hypovolemia
4. Impaired tissue perfusion
5. Edema

Question 14

A Secondary Spinal Cord Injury causing impaired tissue perfusion results from _______ shock and is considered an _______.

Answer 14

Neurogenic shock - loss of blood vessel tone (dilation) resulting in hypoperfusion
EMERGENCY!

Question 15

Major causes of death r/t Spinal Cord Injuries (SCI)

Answer 15

1. Pneumonia
2. Septicemia
   (pg. 879)

Question 16

The higher up the SCI →

Answer 16

the more severe the Sxs!

Question 17

What body functions or body systems may be affected by an SCI?

Answer 17

1. Mobility
2. Sensory perception
3. DTRs
4. CV system
5. Respiratory system
6. Bowel control
7. Bladder control

Question 18

Portion of the spinal cord associated with respiratory control.

Answer 18

C3-C5 (innervate the phrenic nerve controlling the diaphragm)

Question 19

Portion of the spinal cord associated with CV control. What S/S would you expect?

Answer 19

Above T6 (disruption of SNS input)
1. Bradycardia
2. Hypotension
3. Dysrhythmias
4. Hypothermia

Question 20

Term:
Zones of Sensory and Motor function are called

Answer 20

Dermatomes

Question 21

Term:
Complete paralysis of all four extremities

Answer 21

Tetraplegia/Quadriplegia

Question 22

Term:
Lower extremity paralysis

Answer 22

Paraplegia

Question 23

Term:
Weakness of all four extremities

Answer 23

Quadriparesis

Question 24

Term:
Lower extremity weakness

Answer 24

Paraparesis

Question 25

Term:
Decreased sensory perception

Answer 25

Hypoesthesia

Question 26

Term:
Increased sensory perception

Answer 26

Hyperesthesia

Question 27

Injury to what portion of the spinal cord is associated with Quadriplegia + Quadriparesis

Answer 27

Cervical and Upper thoracic

Question 28

Injury to what portion of the spinal cord is associated with Paraplegia + Paraparesis

Answer 28

Lower Thoracic and Lumbosacral

Question 29

Term:
A complete but temporary loss of motor, sensory, reflex, and autonomic function that occurs immediately after an acute SCI as a response to the injury and usually lasts <48 hrs but can last for several weeks.

Answer 29

Spinal Shock (aka Spinal Shock Syndrome)

Altered Motor function + sensory perception
Abnormal body temp., perspiration, HTN

Question 30

Term:
A potentially life-threatening condition in which noxious visceral or cutaneous stimuli cause a sudden, massive, uninhibited reflex of the SNS

Answer 30

Autonomic Dysreflexia (AD) aka Autonomic Hyperreflexia

Question 31

Causes of Autonomic Dysreflexia (AD) are typically GI, GU, and Vascular stimulation.
Name some specific risk factors

Answer 31

GI: bowel distention/fecal impaction, hemorrhoid irritation

GU: bladder distention, UTI, epididymitis, or scrotal compression

Vascular: tight clothing (constriction), extreme room temperatures (increased usually), pain, contact w/ hard or sharp objects

Question 32

SCI Complications r/t Immobility

Answer 32

1. DVT/SVT
2. Pressure injuries
3. Fractures secondary to osteoporosis/osteopenia

Question 33

SCI Complications:
Types of Shock r/t SCIs

Answer 33

1. Hypovolemic Shock (hemorrhage)
2. Neurogenic Shock (w/in 24 hrs + injury above T6)

Question 34

EXTRA:
How to assess Dermatomes

Answer 34

Start with the area of reported loss of sensory perception and end where it becomes normal
- the level of injury is the lowest neurologic segment with intact or normal motor + sensory function
- Ex. sensation at level of umbilicus is T10
(pg. 879)