week 4 - Mobility PowerPoint (Spinal Cord Injuries) Flashcards
we are giving high doses of _______ to patients with spinal cord injuries.
steroids
A paralyzed patient with a C4 injury is _______________.
tetraplegic or quad
A paralyzed patient with a C6 injury is ___________.
tetraplegic or quad
A paralyzed patient with a T6 and down or an L1 injury is __________.
paraplegic
If a patient has any preserved motor or sensory function below the level of the injury, their spinal cord injury is __________, and their sacrum was spared.
incomplete
which spinal cord injury/ syndrome is being described?
-loss of motor, pain, temperature sensation below the level of the injury, bilaterally
-vibration + proprioception are intact
-usually occurs due to a hyperFLEXION injury or an injury to the anterior spinal artery
Anterior Cord Syndrome (ACS)
which spinal cord injury/ syndrome is being described?
-loss of pain sensation + proprioception, bilaterally
-motor function is intact
-biggest issue with this one is sitting, wounds, burns, because they’re not able to feel
Posterior Cord Syndrome (PCS)
which spinal cord injury/ syndrome is being described?
-sensory + motor deficit, bilaterally
-upper extremities are more affected than lower extremities
-usually a hyperEXTENSION injury or, common in older adults w/ a pre-existing cervical injury/ disease
-most common
Central Cord Syndrome (CCS)
which spinal cord injury/ syndrome is being described?
-IPSILATERAL loss of motor, vibration + proprioception
-CONTRALATERAL loss of pain + temperature sensation
-usually occurs due to a penetrating trauma or lateral cord compression
Brown-Sequard Syndrome
AKA
Lateral Cord Syndrome (LCS)
A complete spinal cord injury is a complete severing of the spinal cord. Which locations of the spinal cord are most prone/ most common to have an injury due to these locations having a greater range of motion?
C5, C6, C7
T12
L1
In a patient with a complete spinal cord injury, the primary injury is caused by _________, and secondary injury is caused by _________ or ____________.
trauma; edema or hemorrhage
With a T6 and above spinal cord injury, what is our biggest priority?
ABC’S, breathing/ respiratory
A complete spinal cord injury at C4 and above means total ___________.
paralysis
_______ cord syndrome is a deficit to the upper extremities, sensory function will vary and there will be bladder and bowel dysfunction, and the cause is usually hyperextension.
central
________ cord syndrome is the loss of motor, pain and temperature sensation at the point of injury and below, bilaterally. Some causes of this include, disc herniation, hyperflexion or a fracture.
anterior
_______ cord syndrome or Brown-Sequard syndrome is ipsilateral paralysis loss of touch, pressure vibration and motor, and contralateral loss of pain and temperature. - usually due to trauma or lateral cord compression.
lateral
usually with an incomplete _______ cord syndrome/ injury, patients can possibly recover with some movement.
anterior
damage is towards the front of the spinal cord
With an incomplete __________ cord injury/ syndrome, depending on the case, some arm, bladder/ bowel function may be preserved. And it is possible to recover from this injury, it usually will start with the legs and ascend gradually.
central
damage is in the center of the spinal cord
with an incomplete _________ cord syndrome/ injury, one side will have pain and temperature sensation with impaired loss/ movement. then the other side will have functioning movement with no pain or temperature sensation.
lateral (brown-Sequard)
damage is toward one side of the spinal cord
usually with an incomplete _________ cord syndrome/ injury, this patient may have good muscle strength, pain and temperature sensation but they’d have difficulty coordinating movement; but it can also be loss of pain + proprioception sensations and intact motor function
posterior
**damage is towards the back of the spinal cord **
what are some of the signs and symptoms of a spinal cord injury?
-difficulty breathing, coughing or clearing secretions
-no movement or mobility
-loss/ altered sensation
-no bowel or bladder control
-spasms
-changes in sexual function
-intense pain or other uncomfortable sensations
a ________ spinal cord injury is all feeling and movement is lost below the site of the injury.
complete
an ________ spinal cord injury is when you have some feeling and movement below the site of injury; this can vary
incomplete
tetraplegia AKA quadriplegia is when:
1.
2.
3.
4.
are all affected by the injury
1.arms
2.legs
3.trunk
4.pelvic organs
paraplegia affects some or all of the:
1.
2.
3.
1.trunk
2.legs
3.pelvic organs
what are the 4 main ways we need to manage a patients care ESPECIALLY with a spinal cord injury?
ABCs
pressure injuries
pain
temperature
____________ shock results from a spinal cord injury and disrupts the body’s ability to regulate BP, HR + temperature; this type of shock is characterized by sudden hypotension and bradycardia
we need to manage BP w/ fluids and vasopressors
neurogenic
_________ shock occurs immediately following the spinal cord injury and is characterized by immediate flaccid paralysis, loss of sensation/ reflexes, loss of bladder/ bowel control and may have hypotension and bradycardia as well.
spinal
_________ ________ is a condition resulting from many different conditions like SCI, stroke, MS, tumor, etc. and the signals are disrupted and don’t make it to the bladder, so urination is difficult.
neurogenic bladder
what is the medical management for neurogenic bladder?
suprapubic tube NOT a foley - and fluids
when giving peri care to patients with urinary catheters (Q8 hours), why is it important to twist the catheter to the left and right?
so that the tube doesn’t stick to the urethral wall and cause damage
___________ _________ is an overstimulation of the sympathetic nervous system as a result of a stimulus below the level of injury (usually when the SCI is at or above T6)
autonomic dysreflexia
AKA autonomic hyperreflexia
what are 10 of the sudden s/s of autonomic dysreflexia?
-flushing
-pounding headache
-goosebumps
-sweating
-high BP
-anxiety
-bradycardia
-blurry vision
-dilated pupils
-SOB
what are 5 complications related to autonomic dysreflexia a patient with a SCI can develop?
- DVT (antiembolism therapy)
- bladder/ bowel distension
3.retinal hemorrhage/ CVA due to HTN - severe bradycardia
- pain/ pressure injuries
when a patient is experiencing bradycardia from autonomic dysreflexia for example, what medication will we give them to bring the HR up?
atropine
