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Clinical Medicine - OT > Week 2 - Spinal Cord Disorders > Flashcards

Week 2 - Spinal Cord Disorders Flashcards

1
Q

What is a spinal cord injury?

A

Damage to the spinal cord that results in a loss of function such as mobility or feeling.

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2
Q

What can cause SCI?

A

Fracture
Dislocation
Penetration
Non-traumatic

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3
Q

A tumour is an example of what type of cause of SCI?

A

Non traumatic

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4
Q

What is the mechanism of injury for SCI?

A

Direct trauma
Compression
Ischemia

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5
Q

How long is hypoxia in SCI for injury to occur?

A

1-3 minutes

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6
Q

True or false, hypoxia for longer than 1-3 minutes causes disruption to ascending and descending nerve pathways?

A

True

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7
Q

What 3 types of impairment can SCI cause?

A

Motor
Sensory
Autonomic

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8
Q

What motor impairment can be seen with SCI?

A

Paralysis

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9
Q

What 4 sensory impairments can result from SCI?

A

Temperature
Touch
Pain
Proprioception

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10
Q

What 4 autonomic impairments can result from SCI?

A

Bowel
Bladder
Sexual function
Vasomotor

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11
Q

How many people are affected by spinal injury in Australia?

A

12,000

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12
Q

What is the highest cause of SCI?

A

Transport related injuries

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13
Q

True or false, SCI affects more females than males?

A

False, 84% are male, 16% female

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14
Q

What age group has the most frequent number of spinal cord injuries?

A

15-24 years

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15
Q

How is SCI diagnosed?

A

Imaging

Clinical assessments

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16
Q

What imaging can be used to diagnose SCI?

A

CT
MRI
X-ray

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17
Q

What clinical assessments can be used to diagnose SCI?

A

ASIA impairment scale

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18
Q

What does ASIA stand for?

A

American Spinal Injury Association

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19
Q

What does the ASIA impairment scale diagnose?

A

Neurological level and complete/incomplete injury

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20
Q

True or false: Neurological level of injury is at the same level as the vertebral level or injury/

A

False. Spinal cord segments may not arise at the same level of vertebral segment.

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21
Q

What 3 areas do we assess as practitioners for SCI?

A

Motor function
Sensory Function
Autonomic function

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22
Q

What is a complete class A on the ASIA Impairment Scale?

A

No motor or sensory function is preserved in S4/S5

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23
Q

What is an incomplete class B on the ASIA Impairment Scale?

A

Sensory but not motor function is preserved below the neurological level and includes S4/S5

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24
Q

What is an incomplete class C on the ASIA Impairment Scale?

A

Motor function is preserved below the neurological level and more than half of key muscles below the neurological have a muscle grade less than 3

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25
What is an incomplete class D on the ASIA Impairment Scale?
Motor function is preserved below the neurological level and at least half of key muscles below the neurological level have a muscle grade of 3 or more
26
What is a normal class E on the ASIA Impairment Scale?
Motor and sensory function are normal
27
What is a complete injury?
The spinal cord is completely severed
28
What is an incomplete injury?
There are zones of partial preservation
29
What are zones of partial preservation?
Some functions for several segments below injury, nil below this level.
30
What is lateral preservation?
One side with partial sparing or at a different level
31
What are the 3 points of diagnosis for SCI?
1. Level of injury 2. ASIA classification 3. Completeness
32
What is tetraplegia AKA?
Quadriplegia
33
What segments of the spine are affected in a quadriplegic SCI?
C1-12
34
True or false, Quadriplegia and Paraplegia affect the upper and lower limbs?
False. Paraplegia affects lower limb only
35
What segments of the spine are affected in a paraplegic SCI?
T1 and below
36
Ture or false, bowel, bladder and sexual function are affected in both quadriplegia and paraplegia?
True
37
What are the functional outcomes for injuries above T12/L1?
Upper motor neurone issues and reflex activity
38
What are the functional outcomes of injuries below T12/L1?
Lower motor neurone issues and flaccid paralysis
39
What is central cord syndrome?
Caused by hyperextension injury Impairment greater to upper limbs The majority are incomplete injuries
40
What are the outcomes of central cord syndrome?
Ambulant Bowel and bladder control Poor hand function
41
What is Brown-Sequard syndrome?
A unilateral injury (one side) caused by fracture/dislocation, tumour or penetrating injury
42
What are the signs of Brown-Sequard?
Ipsilateral (Same side) loss of motor function, touch and proprioception Contralateral (opposite side) loss of pain, temperature and touch sensation
43
What is Anterior Cord syndrome?
Caused by flexion injury which compromises the anterior spinal artery, injuring the anterior cord and sparing the lateral and posterior cord.
44
What are the signs of anterior cord syndrome?
Pain, temperature and touch sensation affected, intact proprioception.
45
What is conus medullaris syndrome?
Injury to sacral and lumbar nerve roots.
46
What are the signs of conus medullaris?
Lower limb motor impairment LL sensory impairment areflexic bladder Areflexic bowel and lower extremities.
47
What is Cauda equina syndrome?
Injuries below L2 damage spinal roots.
48
What are the signs of Cauda equina syndrome?
Flaccid paralysis with variable prognosis
49
What is spinal shock?
All nerve cells below the level of lesion do not function Nil reflexes and limbs flaccid The higher the level the more severe and persisting the shock is
50
How long does it take for spinal shock to subside?
24 hours to 6 weeks
51
What causes spinal shock?
Bleeding or oedema within spinal cord Other injuries Neurogenic shock Complications from lying in bed
52
What is early phase spinal injury management trying to achieve?
Avoiding neurological deterioration Enhancing recovery Achieving biomechanical stability
53
Why would surgery be required for SCI?
To remove fluid, tissue, disc, bone or foreign objects pressing on the cord To stabilise vertebra Spinal traction for anatomical realignment
54
What are the treatment goals of respiratory management?
Improve gas exchange and ventilation, and making sure people are getting air in and out of their lungs
55
True or false, people with SCI are at high risk of respiratory infection and sleep apnoea?
True
56
What bladder complications can SCI cause?
UTI, Sepsis and renal impairment
57
What is Autonomic Dysreflexia?
T6 Lesion or above, life threatening condition that is a vascular reflex in response to a noxious stimulus.
58
What are the signs and symptoms of Autonomic Dysreflexia?
Sweating Blotchiness above lesion Elevated blood pressure Throbbing headache
59
What causes Autonomic Dysreflexia?
Over distension of bladder or bowel skin conditions disorders of internal organs musculoskeletal eg fracture
60
What is the treatment for Autonomic Dysreflexia?
Elevate legs and lower head remove stimulus antihypertensive drugs if no relief ring ambulance
61
True or false, 48% of people with an injury at T6 or above will have Autonomic Dysreflexia?
True
62
What are secondary complications of SCI associated with immobility?
``` Oedema Muscle shortening contractures scoliosis osteoporosis pain respiratory complications ```
63
What are secondary complications of SCI associated with sensory loss?
``` Skin abrasions burns pressure injuries posture and seating issues pain ```
64
What are secondary complications of SCI associated with autonomic function?
Autonomic Dysreflexia Temperature regulation (Hyper/hypothermia) Bladder (incontinence, UTI, renal problems) Bowel (incontinence, constipation, haemorrhoids)
65
What is the aim on SCI rehabilitation?
Minimise primary impairment from the SCI Prevent secondary complications retrain activity promote participation
66
What is the role of OT in SCI rehabilitation?
``` Optimise independence in self-care, productivity and leisure Self care retaining Assessment and treatment of UL Home assessment and equipment selection Domestic retraining Transport Community living skills Leisure skills Vocational skills ```
67
True or false, in most cases SCI causes are not preventable.
False, most causes are preventable
68
True or false, SCI results in reduced life span
True, SCI exacerbates the aging process

Clinical Medicine - OT (35 decks)

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