5] SCI Part 1

Question 1

Traumatic causes of SCI

Answer 1

MVA
Falls
Violence
Other
Sports

Question 2

Average age of spinal cord injured person is

Answer 2

41

Question 3

56% of injuries occur ?

Answer 3

Between ages of 16-30 (very young)

Question 4

Cause of death with SCI

Answer 4

Pneumonia and septicemia

Question 5

41%

Answer 5

Incomplete tetra

Question 6

Around 22%

Answer 6

Complete para

Question 7

Around 21%

Answer 7

Incomplete para

Question 8

Around 16%

Answer 8

Complete tetra

Question 9

Ethnicity for SCI

Answer 9

Caucasian

Question 10

1 year post SCI, how many are employed

Answer 10

12%

Question 11

20 years post SCI, how many are employed?

Answer 11

35%

Question 12

Primary patho of SCI

Answer 12

Mechanical damage due to deformation of spine

Question 13

Secondary patho of SCI

Answer 13

Cascade of biochemical and cellular processes

Question 14

2 corticosteroids for medical management of acute SCI

Answer 14

Methylprednisone (naloxone)

Tirilazad mesylate

Question 15

In animal studies: (Geisler et al, 1991)
 Promotes growth of nerve cells
 Regeneration of damaged nervous tissues

Answer 15

GM-1 ganglioside

Question 16

Methylprednisolone prevents (3)?

Answer 16

Lipid peroxidation
Post-traumatic ischemia
Destruction of neuronal and microvascular membranes

Question 17

Lipid peroxidation results in

Answer 17

Preservation of: spinal blood flow, metabolism, Na and K homeostasis

Question 18

Reduction of lipid peroxidation

Answer 18

Damage from high levels of extracellular calcium, excitotoxicity, protease-mediated to neuro-filament proteins

Question 19

Available medical evidence does not
support a significant clinical benefit from
the administration of THIS in
the treatment of patients after acute SCI

Answer 19

GM-1 ganglioside

Question 20

For neuropathic pain

Answer 20

Pregablin (lyrica)

Question 21

Mechanism of action for pregabalin (lyrica)

Answer 21

◦ Works similar to gabapentin

◦ reduces the synaptic release of several neurotransmitters

Question 22

MOA for pregabalin is that it reduced the synaptic release of several neurotransmitters by: (2)

Answer 22

 binding to alpha2-delta subunits

 Reduce neuronal excitability and seizures

Question 23

Medical complications of SCI

Answer 23

Autonomic dysfunction

Autonomic dysreflexia

Question 24

Autonomic dysfunction is a ?

Answer 24

Medical emergency

Question 25

sensory loss, motor paralysis, loss of bowel and bladder control

Answer 25

Autonomic dysfunction

Question 26

``` Increased BP Bradycardia  Nasal congestion  Pounding headache  Anxiety  Flushing  Profuse sweating ```

Answer 26

Autonomic dysreflexia (T6 and above)

Question 27

Cause of autnomic dysreflexia

Answer 27

Anything that can be perceived as a noxious stimulation

Question 28

Treatment of autonomic dysreflexia

Answer 28

Immediately sit person upright | Fix problem

Question 29

Medical complications of SCI

Answer 29

``` Skin breakdown DVT UTI Osteoporosis GI issues HO Pain Spasticity ```

Question 30

Factors predisposing individuals to WHAT?  peripheral vasodilation  absent/reduced LE muscle function  immobility  hypercoagulability  trauma  sepsis

Answer 30

DVT

Question 31

``` ◦ Urinary Retension ◦ Reflux ◦ Kidney and bladder stones ◦ Kidney failure ◦ Septicemia ```

Answer 31

UTI complications

Question 32

usually stabilizes 16 months after injury with 2/3 of original bone mass

Answer 32

Osteoporosis

Question 33

Rapid loss in 1st 6 months

Answer 33

Osteoporosis

Question 34

``` Bleeds (steroids) paralytic ileus ◦ gastric dilation - affects respiration ◦ fecal impaction ◦ bowel obstruction ```

Answer 34

GI issues

Question 35

◦ Swelling, pain & local increase in temperature ◦ bone formation at a joint  Hips & knees,  Shoulders & elbows (tetraplegia only)

Answer 35

HO

Question 36

Chronic pain, spinal cord/brain changes in makeup

Answer 36

Nerve root pain

Question 37

Broken, bruised

Answer 37

Traumatic pain

Question 38

Young ppl, sing arms like legs, everything is flexed forward and puts shoulders at disadvantage, impingement

Answer 38

MSK pain

Question 39

Initial period around 2 months of areflexia

Answer 39

Spasticity