Week 2: Spinal Cord injuries Flashcards
what do SCIs result from
fracture
dislocation of vertebrae
cervical spine injuries
can result from hypertension or hyperflexion of neck with possible fracture
hyperflexion
chin to chest
hyperextension
neck bend back
dislocation of vertebra
may crush or compress spinal cord
compression
causes injury to spinal cord when force applied to top of skull or feet
simple fracture
single line break
compression fracture
crushed or shattered bone in multiple fragments
wedge fractures
displaces angular section of bone
dislocation
vertebra forced out of its normal position
laceration of nerve tissue by bone fragements
permanent loss of conduction in affected tracts
complete transection or crushing of cord
irreversible loss of all sensory and motor function at and below level of injury
partial transection or crushing
may allow recovery of some function
brusing
reversible damange
mild edema and minor bleeding
prolonged ischemia and necrosis
leads to perm. damage
NE
serotonin
histamine are released by
damaged tissue (vasoconstriction)
assessment using dermatome map
- assessment of movement and sensory responses
- can determine the degree of damage or recovery
what are 2 stages of the posttraumatic period
spinal shock, recovery and recognition of extent of functional loss
spinal shock
- initially, all neurologic activity ceases below and slightly above the level of injury
- absence of all reflexes; flaccid paralysis
- loss of central control of autonomic function (bladder and bowel function)
- as long as inflammation is present it occurs (days or weeks)
recovery
- gradual return of reflex activity below level of injury
- voluntary motor activity and sensory impulses blocked at and below level of damage
- may develop hyperreflexia
what are permanent effects post spinal shock at the cervical level
no sensation
sensory movement
central control of SNS
below injury
bladder and bowel incontinence
normal above
what are perm effects post spinal shock at the lumbar level
no function at level of injury
no sensation or voluntary movement below
bowel and bladder incontinence
spastic paralysis of legs
normal upper body function
whats a paralysis of all 4 extremeties called
tertaplegia (quadriplegia)
what is a paraplegia
paralysis of the lower part of the trunk and legs
ipsilateral paralysis and contralateral loss of pain and temperature sensation
- result of partial cord injury
- depends on point of decussation and location
what do cervical injuries affect
respiratory function
tetraplegia
all functions controlled by thoracic, lumbar and sacral
what do thoracic injuries affect
blocks sympathetic nervous system
bradycardia, hypotension, loss of perspiration
lumbar and sacral
what do lumbar injuries affect
paraplegia
sacral function
what do sacral injuries affect
parasymp nerves
loss bladder and bowel control
whats autonomic dysreflexia
massive sympathetic reflex response that cannot be controlled from the brain
where does autonomic dysreflexia occur
injury of cervical spine
above level T6
what causes autonomic dysreflexia
infection
genital inflammation
other stimuli
what does autonomic dysreflexia lead to
increased bp
bradycardia
vasocons below injyry
vasodila above injury
what are some complicaitons of spinal cord injuries
- UTI
- pneumonia
- skin breakdown
- spasm and pain
- depression
- sexual dysfunction and reproductive capacity
when does treatment and rehab occur for SCI
at time of injury
what are the main goals of treatment with SCI
immobilize spine
maintain breathing
prevent shock
relieve pressure
repair tissues
reduce enema
stabilize vascular system
