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Clinical Neuroscience > Week 8 SCI > Flashcards

Week 8 SCI Flashcards

1
Q

how common is SCI, how many people have SCI, males or females

A 
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
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2
Q

what are some types of SCI

A

trauma, vascular (AVM), Nutritional B12, epidural abscess, neoplasms, infectious myelitis (viral and Lyme disease), or inflammatory (MS, lupus)

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3
Q

what are the common causes of SCI

A

falls (28.3%). this is increasing because of the age of people are increasing
MVC (39.2%)

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4
Q

over 55% of SCI are in what region

A

cervical

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5
Q

what are the most common levels of injury

A

C4,C5,C6, followed by T12 and C7

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6
Q

what happens with cervical level injury and lumbar level injury

A

cervical injury: tetraplegia

lumbar injury: paraplegia

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7
Q

what does the severity of an SCI depend on

A

extent of damage, and location of damage, location and tracts involved

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8
Q

what is spinal shock

A

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

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9
Q

what differentiates between a complete and an incomplete SCI

A

complete: no sensation is preserved in the sacrum
incomplete: you either have sensory or motor involvement

S4-5

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10
Q

what central cord syndrome

A

UE deficits are more than LE symptoms.
you have sacral sparing (so incomplete)
usually in the C-spine

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11
Q

What is brown sequard syndrome

A

hemisection, ipsilateral weakness,

  • loss of ipsilateral light touch, proprioception, vibration
  • loss of contralateral pain and temperature
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12
Q

is brown sequard syndrome common? how can it happen

A

not common, caused by trauma or stenosis

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13
Q

what is anterior cord syndrome

A

flexion injury, damage to the anterior spinal a.

-variable loss of bilateral pain temperature and motor

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14
Q

what is posterior cord syndrome

A

RARE (MS, vitamin deficiency)

-loss of proprioception

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15
Q

what is conus medullaris syndrome, what types of lesions

A

-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

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16
Q

what is caudate equina syndrome

A

very incomplete injury
lower limb paralysis
impact bowel and bladder

LMN

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17
Q

what are the complications with SCI

A

changes in tone, ANS changes, MSK changes, respiratory complications, changes in sexual functions, impaired bowel and bladder, integumentary changes, altered metabolism, cardiovascular, psychosocial

18
Q

what is the most common mechanism of cervical SCI

A

flexion, when the head hits something, and a blow to the back of the head.

19
Q

what motion leads to the highest incidence of neurological injury

A

flexion

20
Q

in what population is compression injuries common, and what location of the body

A

T-spine patients, especially with osteoporosis

21
Q

where are compression injuries most common

A

C4-5

22
Q

what is a burst fracture

A

a comminuted version of a compression fracture

23
Q

how do you get a hyperextension injury

A

strong posterior force, or a fall on the chin, like a MVA

24
Q

where do hyperextension injuries happen

A

in the C-spine (C4-5)

25
Q

hyperextension often results in

A

central cord syndrome

26
Q

what is a flexion rotation injury

A

a posterior to anterior force, while the Spinal column is in rotation

27
Q

what can a flexion rotation injury lead to

A

facet block, when you can’t move, kind of like after a car accident

28
Q

what is syringomyelia

A

a cyst (syrinx) formation in the SC, that can elongate over time and destroy the center of the cord.

29
Q

how do you get a syrinx formation

A

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

30
Q

how do you diagnose a syringomyelia

A

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.

31
Q

what is the prognosis of syringomyelia

A

not great is not caught early enough

32
Q

what are the signs and symptoms of syringomyelia

A

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.

33
Q

what are some predispositions and treatments for syringomyelia

A

Arnold chiari malformation
familial
complication of trauma, meningitis, hemorrhage, tumor or arachnoiditis

Treatment is surgery

34
Q

what is transverse myelitis

A

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

35
Q

what are the symptoms of transverse myelitis

A

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

36
Q

what is the prognosis of transverse myelitis

A

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.

37
Q

with transverse myelitis, rapid onset of symptoms equals what kind of prognosis

A

poor

38
Q

what are the 4 classic features of transverse myelitis

A
  • 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
39
Q

what is the predisposition and treatment for transverse myelitis

A

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

40
Q

what is spina bifida

A

neural tube defect, with permanent damage with varying degrees of paralysis. may not have fully formed vertebrate, or may be missing some vertebrate.

41
Q

what are the 3 types of spina bifida

A

myelomeningocele (severed Spinal tissue exposed)
meningocele
occulta (mildest)

Clinical Neuroscience (20 decks)

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