WK2 & 3 - Intro to SCI Flashcards
What is the number of spinal nerves and vertebrae for each region?
Cervical - 8 pair spinal nerves, 7 vertebrae
Thoracic - 12 pair spinal nerves, 12 vertebrae
Lumbar - 5 pair spinal nerves, 5 vertebrae
Sacral - 5 pair spinal nerves, 5 vertebrae (fixed)
Coccyx, 1 pair spinal nerves
Cord, column and nerves dont all line up. T or F?
T
At level of T12 there is Vertebral column at T12, spinal cord at L3 and spinal nerves for T12, L1/2/3
Upper border L2 vertebra and termination of cord (segment Co1)
At L3 there is vertebral column L3, Cauda equina (spinal nerves L3 - Co1), actual cord unaffected
What is the basic segmental structure of grey matter?
Signals are transferred from ventral horn, through spinal nerves to targeted area
Return from dorsal root of spinal nerve to dorsal root ganglion to white matter of spinal cord
What is the segmental innervation of shoulder ABD, ADD, Flex, Ext, IR and ER?
C5-6
C5-8
C5-7
C6-8
C5-8
C5-6
What is the segmental innervation of elbow flex, ext?
C5-6
C7-8
What is the segmental innervation of wrist flex and ext?
C6-8
What is the segmental innervation of finger and tumb movements?
C7-T1
What is the segmental innervation of trunk abdominals and spinal ext?
T5-L1
C1-L5
What is the segmental innervation of hip flex, ext, abd, add?
L1-L3
L5-S2
L4-S1
L2-L4
What is the segmental innervation for knee ext, flex and ankle dorsi and plantar?
L2-L4
L5-S2
L4-S1
S1-S2
what happens with injury to Lumbar nerves?
L1-L5
- result in some function loss in hips/legs
- little/no voluntary control of bowel/bladder, can manage with special equipment
- depending on leg strenght, may need wheelchair and walk in braces
What happens to damage of sacral nerves?
S1-S5
- result in some loss of function in hips/legs
- little/no voluntary control of bowel/bladder but can be managed
- most likely able to walk
What happens to injury of thoracic nerves?
T6-T12
* affects trunk muscles (abs and back) depending on injury level
* usually results in paraplegia, normal UL movement
* fair-good ability to control/balance trunk while seated
* should be able to cough productively (if ab muslces intact)
* little/no voluntary control of bowel/bladder but can be managed
* most likely to use a manual wheelchair
* can learn to drive modified car
* some can stand in standing grame, others may walk in braces
What happens to injury of high cervical nerves?
C1-C4
* most severe
* paralysis in arms, hands, trunk and legs,
* independent breathing, bladder, bowel??
* speech impairment
* complete assistance with ADLs
* potential use of powered wheelchairs with special controls
* requires 24hr personal care
What happens to injury of low cervical nerves?
C5-C8
- corresponding nerves control arms/hands
- may be able to speak normally/breath independently
What happens when C5 nerve is injured?
can raise arm / bend elbow, some / total paralysis of wrists, hands,
trunk and legs,
can speak / use diaphragm with weakened breathing,
assistance with most ADLs – moving independently with power wheelchair
What happens when C6 nerve is injured?
Affected wrist EXT, paralysis in hands, trunk and legs (typically)
Speak + use diaphragm with weakened breathing, can move in/out of
wheelchair/bed with assistive equipment, may be able to drive an adapted vehicle,
little/no voluntary control of bowel/bladder, but may be
able to manage with special equipment.
What happens to injury of C7 nerve?
Nerves control elbow EXT and some finger EXT, most can straighten arm and have normal shoulder movement,
can complete ADLs independently, may need assistance with difficult tasks,
may be able to drive an adapted vehicle
Little/no voluntary control of
bowel/bladder, but may be able to manage independently with
special equipment
What happens with injury to C8 nerve?
Nerves control some hand movement – can grasp/release objects, with difficult tasks
may be able to drive an adapted vehicle
little/no voluntary control of bowel/bladder, but may be
able to manage independently with special equipment.
What happens with injury to C8 nerve?
Nerves control some hand movement – can grasp/release objects, with difficult tasks
may be able to drive an adapted vehicle
little/no voluntary control of bowel/bladder, but may be
able to manage independently with special equipment.
What is the segmental function of white matter?
Lat corticospinal tract = skilled voluntary movement
Dorsal columns = fine touch and proprioception
Spinocerebellular tract = muscle and joint receptors
Spinothalamic tract = pain, temp, coarse touch, pressure
What are the main causes of injury?
- 46% land crashes
- 29% unprotected land transport users
- 36% falls (low = 14%, hgih = 21%)
- 7% water-related
- 1% football (inc. rugby codes)
- 80% male
- largest case number 25-34y (21%), followed by 55-84y (18%)
*level of injury: 55% Cx spine, 43% incomplete quadraplegia