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CONDITIONS 2 > Unit 5 Spinal Cord Injury > Flashcards

Unit 5 Spinal Cord Injury Flashcards

1
Q

The 2 main results of spinal cord injury are __A)___ and __B)___ of __C)___ and __D)___.

A

a. paralysis
b. sensory loss
c. limbs
d. trunk

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2
Q

The extent of the results depends on the __A)___ and ___B)__ of injury

A

a. level

b. severity

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3
Q

Spinal cord extends from ___A)__ to ___B)__

A

a. C1

b. T12-L3

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4
Q

There are __A)___ pairs of spinal nerves, which consist of ___B)__ pairs of cervical nerves, ___C)__ lumbar nerves and ___D)__ thoracic spinal nerves.

A

a. 31
b. 8
c. 5
d. 12

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5
Q

Which cervical nerves exit above the vertebra and which exits below the vertebra?

A
  • Above: C1

- Below: C2-C8

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6
Q

Thoracic spinal nerves exit _____ the vetebra

A

below

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7
Q

What is the spinal cord below the T12 vetebra called?

A

Cauda equina

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8
Q

What is a lesion below L1 called? Would you say it was a central or peripheral nerve lesion? Why?

A
  • Cauda equina lesion

- Peripheral nerve lesion because it affects the nerve roots

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9
Q

How would you define tetraplegia and what is another name for tetraplegia?

A
  • Tetraplegia: injuries in four limb paralysis (loss ability to move). (Above T1)
  • Also known as quadriplegia
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10
Q

Describe how different spinal cord injuries are classified?

A

SCI are classified by vertebral level and severity of neurologic deficit

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11
Q

Define “zone of preservation”

A
  • At 1-2 level below lesion where there is some motor or sensory sparring
  • Applies to complete injuries
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12
Q

What is the significance of myotomes and dermatomes when naming the level of spinal cord injury?

A

Motor level:
-Strength of key muscles based on myotomes

Sensory level:
-Most caudal dermatome for pinprick and light touch

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13
Q

Define complete and incomplete SCI?

A

Complete:

  • No motor/sensory function below lesion, nor in sacral segments S4-S5, in anal and perineal areas
  • Can have “zone of preservation” of injury

Incomplete:

  • Preservation of sensory/motor function below lesion
  • Including sacral sparing
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14
Q

Explain the 3 main types of incomplete SCI

A

Anterior cord syndrome:

  • Head forward –> hyperflexion
  • Loss of movement, pain, temperature below injury

Brown-sequard syndrome:

  • Gunshot/stabbing –> penetrating
  • Loss of motor on one side

Central cord syndrome:

  • Fall forward so chin hits (elderly), Stenosis –> hyperextension
  • UE > LE
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15
Q

What types of physical forces may be exerted against the spinal cord?

A
  • Hyperflexion
  • Hyperextensioin
  • Flexion-rotation
  • Compression
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16
Q

Describe 2 ways that complete SCI could happen?

A

Flexion-rotation:

  • Causes vertebral body dislocation
  • Eg. rear-enders

Compression:

  • Causes burst fracture
  • Eg. Diving accidents
17
Q

Primary and secondary damage occurs during the period of _____

A

-Period of Spinal Shock

18
Q

Pathophysiology: Primary Damage

A
  • Spinal cord is bruised, crushed or torn
  • Bleeding into gray matter
  • Neurons destroyed
  • Increased cell membrane permeability
19
Q

Pathophysiology: Secondary Damage

A
  • Neurons in gray matter die
  • Swelling and increased pressure on nerve tracts in white matter
  • Small blood vessels destroyed
  • ->Hypoxia (deficiency in the amount of oxygen reaching the tissues)
  • ->Ischemia (inadequate blood supply to an organ or part of the body, especially the heart muscles)
  • ->Demylination (any disease of the nervous system in which the myelin sheath of neurons is damaged)
  • ->Axons shirk
20
Q

Pathophysiology: Chronic Changes

A
  • Swelling decreases
  • Blood reabsorbed
  • Scaring (or fibrosis) around lesion
  • Cavitation (or loss of central gray matter) within spinal cord
21
Q

What is spinal shock?

A
  • Temporary loss of function of spinal cord
  • No neurological function below level of lesion
  • Occurs immediately following SCI
  • Lasts for 24-48 hrs
22
Q

How do patients present clinically during the period of spinal shock?

A
  • Arreflexia: loss of deep tendon reflexes (DTR)
  • Flaccid paralysis
  • Low blood pressure (hypotension)
  • Low pulse rate (bradycardia)
23
Q

What motor impairments would you expect following spinal cord injury after the period of spinal shock?

A
  • Paralysis/paresis
  • Flaccidity
  • Abnormal tone
24
Q

List 5 other impairments after the period of spinal shock?

A
  • Respiratory dysfunction
  • Orthostatic hypotension
  • Pain
  • Impaired temp. regulation (cervical)
  • Bladder and bowel dysfunction
  • Reproductive and sexual dysfunction
25
Q

What are 2 ways to stabilise the spine?

A

External immobilisation:

  • To prevent further injury
  • Traction to assist with spinal alignment (cervical)
  • Braces/external fixation (lumbar)

Surgery:

  • Restores alignment of vertebra
  • Stabilises spine via fusion
  • Decompress neural tissue
26
Q

What are 4 traumatic causes of SCI?

A
  • road traffic
  • sports
  • domestic/industrial
  • self-care/criminal
27
Q

What are 4 non-traumatic causes of SCI?

A
  • developmental
  • congenital
  • inflammatory
  • ischaemia
  • pressure/expanding lesions (abscess or tumour)
28
Q

What is paraplegia and what veterbral level does it affects?

A
  • paralysis of the legs and lower body

- Below C8

29
Q

What is the most common level of injury? And common level of paraplegia?

A
  • C4, C5 (most common) and C6

- T12, thoracolumbar junction

30
Q

What are the medical and surgical management for SCI?

A

Manage or treat acute problems:
-First 8 hours

Treat associated damage:

Decrease secondary damage:

  • Steroid treatments
  • Surgery: decompress neutral tissue

Stabilise spine:

  • By immobilising or providing traction
  • Either stabilising externally or with surgery
31
Q

What does C6 complete SCI mean?

A
  • Have function at C6 and above.
  • No sensory/motor function below C6 except for some function at 1-2 below levels of C6. Eg. zone of preservation.
  • No function in S4-S5
32
Q

What does C7 incomplete SCI mean?

A
  • Some neurological function below C6, and in S4-S5.

- Including sacral sparing

33
Q

Explain the following terms:

a. C5 Quad
b. C7 Quad
c. T12 Para

A

a. Have muscles innervated by C5 and above
- C6 and below: No movement

b. Have muscles innervated by C7 and above
- C8 and below: No movement

c. Have muscles innervated by T12 and above
- T12 and below: No movement

CONDITIONS 2 (12 decks)

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