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NURS 2514 > Week 9 - Spinal Cord Injury > Flashcards

Week 9 - Spinal Cord Injury Flashcards

1
Q

what is the cervical plexus formed from (2)

A
  • C1 to C5

- CN 6 and 7

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2
Q

what does the cervical plexus create (4)

A

nerves that innervate the

  • neck (sternocleidomastoid)
  • shoulder
  • chest
  • trapezius
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3
Q

what is the phrenic nerve

A
  • nerve that innervates the diaphragm
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4
Q

what are the 4 plexus

A
  • cervical
  • brachial
  • lumbar
  • sacral
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5
Q

what is the brachial plexus formed from

A
  • formed from ventral rami of C5 to T1
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6
Q

what does the brachial plexus innervate

A
  • arm & chest
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7
Q

what is the lumbar plexus formed from

A
  • L1 to L5
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8
Q

what does the lumbar plexus innervate (4)

A
  • abdominal wall
  • hip flexors
  • thigh
  • genital regions
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9
Q

what is the sacral plexus formed from

A
  • L4 to S4
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10
Q

what does the sacral plexus innervate (5)

A
  • buttocks
  • lower limbs
  • pelvic regions
  • genitals
  • anus
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11
Q

what are common causes of spinal cord injuries (SCI) (2)

A

traumatic events that causes:

  • fracture
  • dislocation of the vertebrae
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12
Q

what are other causes of SCI (2(

A
  • ischemia

- necrosis

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13
Q

where do most SCI occur in

A
  • cervical & lumbar regions (areas that provide more mobility)
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14
Q

where do penetrating wounds occur

A
  • can occur anywhere in the column
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15
Q

what are 4 leading causes of SCI

A
  • motor vehicle accidents (#1)
  • falls
  • violence
  • sports injuries
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16
Q

with aging, what becomes the most frequent cause of SCI (2)

A
  • falls

- also osteoporosis is a contributing factor

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17
Q

what are contributing factors to SCI in youth (2)

A
  • alcohol

- drugs

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18
Q

which sex are SCI more common in

A
  • males
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19
Q

is SCI temporary or permanent

A
  • can be either

- but neurons in the CNS do not regenerate adequately = some degree of permanent loss is usually present

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20
Q

what does complete transection of the spinal cord cause

A
  • loss of all neural transmission to & from the brain below the cut
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21
Q

what does transection of motor tracts cause (2)

A
  • paresis

- or paralysis

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22
Q

what does transection of sensory tracts cause

A
  • paraesthesia
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23
Q

what do partial transections cause

A
  • patterns of functional loss related to the specific tracts destroyed
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24
Q

describe the effect spinal cord transections have on spinal cord reflexes

A
  • most remain intact

- and many are exaggerated (Hyperreflexia)

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25
Q

why are many spinal cord reflex exaggerated after SCI

A
  • bc “descending” inhibition from the brain is lost
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26
Q

what is spinal shock

A
  • in the initial period after injury, all neural activity below or slightly above the site of injury ceases
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27
Q

what effect does spinal shock have on BP

A
  • drops
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28
Q

how long might spinal shock last

A
  • days to weeks
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29
Q

what is spinal shock characterized by (4)

A
  • flaccid paralysis
  • sensory loss
  • arflexia
  • absence of central control of autonomic functions
30
Q

what is areflexia

A
  • absense of all reflex responses
31
Q

what occurs after recovery from spinal shock

A
  • spinal reflex return
32
Q

what is spinal reflex return characterized by (3)

A
  • spastic paralysis
  • reflex urinary incontinence
  • reflex defecation
33
Q

what do cervical SCIs commonly occur from (2)

A
  • hyperflexion & hyperextemsion trauma of the neck
34
Q

what are 2 common causes of a cervical SCI

A
  • MVA

- fall

35
Q

where does the phrenic nerve originate from?

A
  • C3 to C5
36
Q

damage to C5 or above requires…

A
  • ventilator assistance
37
Q

what are both cervical & thoracic nerves responsible for

A

innervating accessory muscles of breathing like

  • sternocleidomastoid
  • intercostal muscles
38
Q

what does damage above the cervical & thoracic areas cause (3)

A
  • shallow breathing
  • weak cough reflex
    = pooled resp secretions
39
Q

what are the arms innervated by

A
  • brachial plexus (C5-T1)
40
Q

what does damage above C5 cause r/t motor function

A
  • quadraplegia/tetraplegia
41
Q

what is quadraplegia/tetraplegia

A
  • paralysis of all four limbs
42
Q

what does damage within the brachial plexus (C5-T1) cause r/t motor

A
  • incomplete loss of function in arms (paresis)
43
Q

what does damage below T1 cause r/t motor function

A
  • paraplegia
44
Q

what is paraplegia

A
  • impairment of motor and/or sensory function in lower extremities
45
Q

what do cervical SCIs result in (4)

A
  • no sensation
  • no voluntary movement
  • no central control of SNS
  • autonomic reflexes present, but with no voluntary control (incontinence)
46
Q

what is autonomic dysreflexia; what does it occur w?

A
  • occur w a T6 or above SCI
  • where the NS overreacts to stimuli
  • sensory stimulus triggers a massive & exaggerated SNS reflex that cannot be controlled by the medulla
47
Q

what does autonomic dysreflexia result in (3)

A
  • increased vasomotor tone
    = increased BP
    = HA
    = baroreceptors decrease HR
48
Q

what happens if autonomic dysreflexia goes unnoticed

A
  • heart failure
  • MI
  • CVA

may occur

49
Q

what often causes lumbar SCI

A
  • compression fractures when a force is applied to the head, coccyx, or feet
50
Q

what is required for lumbar SCI to occur? what makes it more likely?

A
  • great force required

- but osteoporosis makes it more likely

51
Q

what does damage to the cord above L1 cause

A
  • paralysis of the legs = paraplegia
52
Q

what does damage to the cord below L1 cause

A
  • paresis of the legs
53
Q

where does PSNS innervation of the bladder & bowel region originate from

A
  • sacral region
54
Q

what effect can cord damage have on the bladder & bowel & genitals

A
  • loss of voluntary control of the bladder & bowel

- erection can occur but may be difficult to maintain

55
Q

what is do incomplete transections result in

A
  • results in tract & gray matter specific loss of function
56
Q

what does damage to one side of the cord cause (4)

A

contralateral loss of

  • pain
  • temp sensation

ipsilateral loss of

  • touch sensation
  • paresis
57
Q

why do we get contralteral loss of pain & temp sensation w an incomplete transection

A

ascending tracts for pain & temp cross over at the spinal cord level where they enter

58
Q

why do we ipsilateral loss of touch & paresis w an incomplete transection

A
  • cross over in the medulla
59
Q

damage to the right side of the cord can cause..

A
  • damaged pain & temp sensation to the L side of the body

- damaged touch and pressure senation, & motor control to the right side of the body

60
Q

what are complications of SCI usually secondary to

A
  • immobility
  • paralysis
  • paresis
61
Q

what are 7 complications of SCI

A
  • pressure ulcers
  • resp tract infections
  • UTI
  • gastric stress ulcers
  • contractures
  • DVT
  • chronic pain
62
Q

what causes resp tract infections r/t SCI (4)

A
  • immobility
  • impaired, shallow respirations
  • paresis of secondary resp muscle
  • weak cough reflex
63
Q

what causes UTI r/t SCI

A
  • urinary retention due to spinal shock

- paresis of secondary muscles involved in micturition

64
Q

what are contractures

A
  • spastic reflexes involving skeletal muscle may cause contracted muscle that fail to reflex
65
Q

what can cause DVT r/t SCI

A
  • immbolity

- pressure can cause venous stasis

66
Q

what are risks of DVT

A
  • pulmonary embolism
67
Q

what does chronic pain more frequently occur in r/t SCI (2)

A
  • incomplete transection

- paraplegia

68
Q

pain may initially occur due to

A
  • fracture of the vertebra
69
Q

pain may persist as…

A
  • radiating pain
  • visceral pain
  • central pain
70
Q

who do chronic pain cycles often effect

A
  • people who have been immobilized for a long period of time

NURS 2514 (75 decks)

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