Week 8 SCI Flashcards
how common is SCI, how many people have SCI, males or females
40 per million 270,000 people living with SCI 1/2 are under 30 years old mean age is increasing, males between 15 and 25 mostly skiing
what are some types of SCI
trauma, vascular (AVM), Nutritional B12, epidural abscess, neoplasms, infectious myelitis (viral and Lyme disease), or inflammatory (MS, lupus)
what are the common causes of SCI
falls (28.3%). this is increasing because of the age of people are increasing
MVC (39.2%)
over 55% of SCI are in what region
cervical
what are the most common levels of injury
C4,C5,C6, followed by T12 and C7
what happens with cervical level injury and lumbar level injury
cervical injury: tetraplegia
lumbar injury: paraplegia
what does the severity of an SCI depend on
extent of damage, and location of damage, location and tracts involved
what is spinal shock
quick period of up to 24hours to a few weeks in which you are very flaccid, and have no tone. So severity of impairment may not match the injury itself
what differentiates between a complete and an incomplete SCI
complete: no sensation is preserved in the sacrum
incomplete: you either have sensory or motor involvement
S4-5
what central cord syndrome
UE deficits are more than LE symptoms.
you have sacral sparing (so incomplete)
usually in the C-spine
What is brown sequard syndrome
hemisection, ipsilateral weakness,
- loss of ipsilateral light touch, proprioception, vibration
- loss of contralateral pain and temperature
is brown sequard syndrome common? how can it happen
not common, caused by trauma or stenosis
what is anterior cord syndrome
flexion injury, damage to the anterior spinal a.
-variable loss of bilateral pain temperature and motor
what is posterior cord syndrome
RARE (MS, vitamin deficiency)
-loss of proprioception
what is conus medullaris syndrome, what types of lesions
-injury to the sacral cord and lumbar roots
-lower limb paralysis
-impacts bowel and bladder
-can have sacral sparing depending on the lesion site.
UMN and LMN lesions
what is caudate equina syndrome
very incomplete injury
lower limb paralysis
impact bowel and bladder
LMN
what are the complications with SCI
changes in tone, ANS changes, MSK changes, respiratory complications, changes in sexual functions, impaired bowel and bladder, integumentary changes, altered metabolism, cardiovascular, psychosocial
what is the most common mechanism of cervical SCI
flexion, when the head hits something, and a blow to the back of the head.
what motion leads to the highest incidence of neurological injury
flexion
in what population is compression injuries common, and what location of the body
T-spine patients, especially with osteoporosis
where are compression injuries most common
C4-5
what is a burst fracture
a comminuted version of a compression fracture
how do you get a hyperextension injury
strong posterior force, or a fall on the chin, like a MVA
where do hyperextension injuries happen
in the C-spine (C4-5)
hyperextension often results in
central cord syndrome
what is a flexion rotation injury
a posterior to anterior force, while the Spinal column is in rotation
what can a flexion rotation injury lead to
facet block, when you can’t move, kind of like after a car accident
what is syringomyelia
a cyst (syrinx) formation in the SC, that can elongate over time and destroy the center of the cord.
how do you get a syrinx formation
when there is an obstruction in the CSF, in the central canal, and CSF is redirected in to the SC, its like a bubble of fluid that grows and moves in the SC
how do you diagnose a syringomyelia
with an MRI
symptoms will present in early adulthood, and some worsen over time, a delayed onset may result in irreversible damage, and you can get weakness, loss of hand sensation, chronic and severe pain.
what is the prognosis of syringomyelia
not great is not caught early enough
what are the signs and symptoms of syringomyelia
slow to progress, pain, weakness, sensory impairment, stiffness in the back, shoulders, arms and legs.
HA, loss of the ability to feel hot and cold, sexual, bowel and bladder dysfunction.
what are some predispositions and treatments for syringomyelia
Arnold chiari malformation
familial
complication of trauma, meningitis, hemorrhage, tumor or arachnoiditis
Treatment is surgery
what is transverse myelitis
inflammation across both sides of one segment of the spinal cord
damages or destroys the myelin which causes scaring which then disrupts the neural impulse transmission
what are the symptoms of transverse myelitis
loss of SC function, from several hours to weeks, sudden LBP, muscle weakness or abnormal sensation, sudden parenthesis in the legs, sensory loss or partial paralysis of the legs, and bowel and bladder dysfunction. can have spasms
what is the prognosis of transverse myelitis
recovery will begin in 2-12 weeks, if you don’t have improvements in 3-6 months, you have a poor prognosis. 1/3 will have a good recovery, 1/3 will have fair, and 1/3 will have no.
with transverse myelitis, rapid onset of symptoms equals what kind of prognosis
poor
what are the 4 classic features of transverse myelitis
- weakness in arms and legs
- pain (in 1/3 or 1/2), LBP radiating in limbs and torso
- sensory alteration (paresthesias, hypersensitivity)
- bowel or bladder dysfunction
what is the predisposition and treatment for transverse myelitis
specific to no one, and there is a peak incidence between 10-19 and 30-39 years old. treatment is symptom management, and corticosteroid injections, and PT intervention
what is spina bifida
neural tube defect, with permanent damage with varying degrees of paralysis. may not have fully formed vertebrate, or may be missing some vertebrate.
what are the 3 types of spina bifida
myelomeningocele (severed Spinal tissue exposed)
meningocele
occulta (mildest)
