Spinal cord injury CC4 Flashcards Preview

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Flashcards in Spinal cord injury CC4 Deck (51)
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1
Q

acute consequences of sci

weakness with a neck injury leads to

A

quadriparesis/plegia

2
Q

acute consequences of sci

weakness with a caudal injury leads to

A

paraparesis/plegia

3
Q

htn or hypotension in acute phase of sci?

A

hypotension

4
Q

urinary ___ in acute phase of sci

A

retention

5
Q

Acute consequences of SCI? (5)

A

quadriparesis/plegia (neck) paraparesis/plegia (caudal)

Sensory loss or abnormalities

Hypotension

Urinary retention

Orthopedic pain

6
Q

chornic consequencies of sci? (10

A
  1. involutnary mvoements
  2. bladder problems
  3. decreased bowel motiblity
  4. sexual dysfunction
  5. increased risk fo blood clots
  6. pressure ulcers
  7. autonomic dysfunction
  8. metabolic disorders
  9. musculoskeltal breakdown/fracures
  10. psych
7
Q

above T10 injury , bladder problems are

A

spastic/neurogenic bladder (most common).

Can’t voluntarily relax the external urethral sphincter, so it stays tight as bladder fills.

8
Q

below T12, bladder sx are

A

flaccid bladder, can’t contract for emptying

9
Q

management of flaccid bladder

A

manage using…intermittent catheterization, condom catheter, indwelling/Foley
catheter, or suprapubic catheter

10
Q

male sexual dysfunction?

A

Male, sperm viability is impaired / fertility is impaired.

11
Q

female sexua problems?

A

Female, fertility is mostly unaffected but C-section delivery strongly recommended (b/c of autonomic dysreflexia)

12
Q

Pressure ulcers from __

A

cutaneous ischemia

13
Q

Autonomic Dysfunction: sympathetic damage = impaired ___

A

thermoregulation

14
Q

* Autonomic Dysreflexia with SCI =

A

extreme blood pressure swings (240/160) + low heart rate

15
Q

what causes autonomic dysreflexia?

A

occurs in response to strong afferent input, ex. pain or overly full bladder

16
Q

what can happen with repeated occurenced of autonomic dysrefelxia?

A

chronic hypertension

17
Q

metabolic disorders with spi are often due to

A

lifestyle difficuluties

18
Q

___ sp injuries/year

A

10,000-12,000

19
Q

> 50% of injuries are to ___ spine

A

cervical

20
Q

> 50% are neurologically “incomplete” - means there is sensation

A

in S4-S5 region.

21
Q

“complete” means bilateral injury with total loss of

A

sensation below injury level

22
Q

ASIA scale: A is ___ injury

A

complete/worst injury

23
Q

ASIA sale B-D is ___

A

incomplete

24
Q

ASIA scale e is __

A

is normal

25
Q

Three approaches to SCI treatment:

A
  1. Neuroprotection of surviving cells/axons from toxic injury environment
  2. Neurorestoration via replacement cells, neurotrophins, and establishing a growth-
    permissive environment
  3. Neurorehabilitation by strengthening existing systems and retraining circuits
26
Q

methylpredinisolone (steroids) trials results

A
  1. found higher mortality in higher tx group
  2. another found asia scale improvement in pts who were incomplete, 24 hr dosing
  3. 48 hr dosing beter
27
Q

parapesis/plegia occurs caudal to __

A

t1

28
Q

for___that are crushed by the intial truamtic injury nothing can be done those are gone for food

A

nerve cell bodies

29
Q

among pts who started tx ___ of injury the 48 MP group receovered signfiicantly more funciton at 6 weeksn and 6 months than those with 24 MP

A

3-8

30
Q

Spontaneous ____ movements seen in patient with C5 incomplete SCI for 17 years

A

stepping

31
Q

Spontaneous stepping movements seen in patient with C5 incomplete SCI for 17 years

Caused by arthritic degeneration and subluxation in R. hip —> ___ triggeered CPG

A

pain upon hip extension

32
Q

Characteristics of all these walking CPG manifestations:

Always associated with___nput to the spinal cord

A

pathology / noxious i

33
Q

Can be “trained” to improve ___ walking in persons with incomplete SCI

A

voluntary

34
Q

Studies on Walk-Training with Body-Weight Support
Most subjects show some improvement, but

A

no greater than seen with physical therapy

35
Q

Studies on Walk-Training with Body-Weight Support

is wlaking cpg being trained?

A

no evidence

36
Q

Studies on Walk-Training with Body-Weight Support

where were impovements seen?

A

better balance, stronger leg muscles, improved fitness

37
Q

Autonomic Dysreflexia Typically seen after ___ or ___ SCI

A

cervical or high-thoracic

38
Q

Autonomic Dysreflexia is more common after ___ sci

A

compelte

39
Q

Potential causes of autonomic dysreflexia? (4)

A
  1. loss of brain/brainstem inhibition to symps
  2. excessive sensory
    response to stimuli
  3. excessive sympathetic response to normal sensory input
  4. excessive vascular response to normal sympathetic activity
40
Q

in all cases of cpg walking

all were rhythmic but not reciprocal

A

between agonists and anatogists

41
Q

electrical stim to ___ can give rise to leg emg comparable to cpg results

A

lumbar enlargement

42
Q

what si the cpg in human characterized by?

A
43
Q

interlimb reflexes are observed in all persons with

A

chronic cervical sci

44
Q

interlimb reflex is more common in

A

distal upper limb muscles

45
Q

is interlibm reflex found in able bodied subjects?

A

no

46
Q

early interlimb reflexes from

A

conenctions already established (latents syanspes)

47
Q

late interlimb reflexes are from ___ connections

A

novel (regenerative sproutin)

48
Q

do interlimb reflexes disappear?

A

no

49
Q

what happens to interlimb reflexes once they appear

A
50
Q

interlimb reflexes are liekly due to new growth within the spinal cord ___

A

caudal to the lesion

51
Q

interlimb reflexes are possibly the basis for

A

autonomic dysreflexia