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deck_3444932 (1) Flashcards

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1
Q

SCI cause

A

*MVA most common 44% (motorcycle only 7%, die)Falls 18%Violence 16%Sporting, mostly diving 12.7%

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2
Q

SCI age

A

most 16-30 yrs: participate in high risk activities median age 26 yrsavg age 41

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3
Q

SCI gender

A

Male: Female ration is 4:1

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4
Q

SCI Ethnicity

A

73.9 Caucasiancaucasian (MVA) > AA (violence) > Hispanic (violence)

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5
Q

leading cause SCI below 45yrs, above 45 yrs

A

below 45: MVAabove 45: falls

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6
Q

When is SCI most common

A

JulySaturday Daytime hoursalcohol or substance abuse plays a role in 17-49% of cases

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7
Q

epidemiologytetra vs paraplegia/ complete vs incomplete SCI common

A

Incomplete Tetraplegia (quad): 29.5%—arms, legs, trunkComplete Paraplegia 27.9%Incomplete paraplegia: 21.3%complete tetraplegia (quad): 18.5%

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8
Q

epidemiology most frequent level SCI

A

C5then: C4, C6, T12

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9
Q

what % of pts SCI have complete neuro recovery by discharge?

A

<1%

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10
Q

what are the most vulnerable areas of the spine levels in SCI?

A

C5-C7T4-T7

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11
Q

What ASIA level most likely to be employed?

A

D

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12
Q

Who is most likely to return to work post SCI? What kind of work?

A

ASIA Dwork fulltimeif return in one yr its the same jobmore likely to return to work: younger, male, white, more educated, higher IQ

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13
Q

Rehab

A

the restoration through personal health services of handicapped individuals to their fullest physical, mental, social, and economic usefulness of which they are capable including ordinary tx and tx in special rehab

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14
Q

Vertebral Column # vertebrae

A

7 cervical 12 thoracic5 Lumbarsacrum and coccyx not considered vertebrae31 spinal nerves 21 vertebrae

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15
Q

Processes on vertebrae

A

7 proceses4 articular2 transverse 1 spinous

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16
Q

about the dis

A

central nucleus puplposes surrounded by annulus fibrosisavascular: bld supply from peiphery adjacent blood vessels mobility

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17
Q

what is for mobility and stability in spine

A

muscle attachements and ligaments for stabilityarticulation of facet joints and IV disc mobility

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18
Q

ALL

A

anterior longitudinal ligamentanterior vertebral bodyatlas to sacrum limits extension

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19
Q

PLL

A

posterior body within spinal canal from axis to sacrum, limits flexion

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20
Q

Ligamentum flavum

A

laminae of adjacent vertebrae, upright head

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21
Q

ligamentum ncha

A

extend protub of skull to C7 for head upright

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22
Q

supraspinous infraspinous ligament

A

btwn spinous pocessupright head

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23
Q

intertrnsverse ligament

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A

ptween transverese process limit lateral flexion of spine (rotation?)

24
Q

dura mater

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A

envelopes roots, ganglia, nerves, dense fibrous tissue, little vascualr supply, protective functionif tumor problem

25
arachnoid mater:
delicate, cobweblike fine elastic tissue in subarachnoid spacedistribute CSF in CNS
26
Pia Mater
adhere firmly to cord and help hold cord in place
27
most imp structure between brain and body
spinal cord
28
where is spinal cord
foramen of first magnum where it is continuous with medulla to level of the first or second lumbar vertebrae
29
size of spinal cord
45 cm males42 cm females1.5 cm wideweigh 30 grams--light
30
where are the nerve roots
2 rows of nerve roots emerge from the cord on each of tis 2 sides, the nerve roots join distally to form 31 pairs of spinal nerves. there is one pair of roots per spinal segment, upper roots almost horizontal, others downward oblique
31
ventral root
anterior, efferentsomatic = motorhave a visceral (sympathetic) portion originate from ventral and lateral grey
32
dorsal root
posterior, afferent root
33
SAME
sensory afferent motor efferent
34
DAVE
dorsal afferent ventral efferent
35
how do dorsal and ventral combine
dorsal horn (sensory( and ventral horn (motor) come out of the central grey and join together to form the spinal nerve (31 pairs on each side)
36
T/Fwhere does damage to L5 vertebrae cause damage
spinal nerves come out straight around C3, as you go down the nerves travel a little further down each time, the cord ends at L1. damage to L5 vertebrae doesnt mean L5 damagedamage to L5 vertebrae doesnt mean L5 damage
37
grey area
H shaped area containing cell bodies of neuronsinitial axonal segments, terminals of axons that synapse with these neurons
38
dorsal horn
sensory
39
ventral horn
motor
40
lateral horn
visceral
41
spinal cord white matter
ascending and descending fiberswhen fibers performing similar tracts are grouped together they are called tractsmyelenated = white
42
what happens if posterior cord is damaged?
sensation lossfasciulus gracilis, fasciculus cuneatueyou can have corticospinal sparing and save motoryou can stull have some sensory from lateral and ventral spinothalamic tracts
43
lesion to most anterior SC
lose motor from ventral corticospinal tracts as well as sensory from the spinothalamic tracts
44
anatommical relationships between the spinal cord and ventral vertebral column
Different growth rate of cord and spine. Cord segments are displaced upward from corresponding vertebrae, greater discrepancy occurs as you go down use spinous processes, add 2 to the number of spinous processes and resulting number is that of underlying spinal cord segment, from C2-T10Ex: SP C5 over cord segment C7SP + 2 = # of the underlying segment Because the cord is shorter than the vertebral column, nerve roots have to travel downwards (caudal), prior to exiting the vertebral canal
45
Cord Segment-->Vertebral body-->spinous processVertebral C6Vertebral T4
Cord Segment-->Vertebral body-->spinous process (don’t need to memorize this, use the rule): more discrepancy as you go down1. C8--> lower C6/upper C7-->C62. T6--> lower T3/upper T4-->T33. T12-->T9-->T84. L5--> T11-->T105. S--> T12/L1-->T12
46
Vascular Supply to the Spinal Cord
the spinal cord is highly vascularized, it needs oxygen/nutrients and with loss of vascularization major damage will occur (trauma, spinal stroke loss of blood supply due to ischemia or hemorrhage)*vascularization is dense because it is important *without the vasculature have extensive cord damage
47
Anterior spinal artery:where is itwhat does it supply
supplied by intracranial artery and vertebral arteryit is a single solitary trunk, along anterior fissure to thoracic spineand it gives rise to sulcal artery which will supply central cord
48
lateral spinal artery:where is itwhat does it supply
single set of branches from the vertebral artery C2-T2supplies lateral structures
49
segmental radicular artery: where is itwhat does it supply
prolongation of anterior spinal artery below T4, intercostal artery from aorta, supply segment bridge to spinal cordsupply nerve root areas
50
intercostal artery: from where
from aorta
51
Vessel of Adamkieicz: what does it supply
supplies the anterior spinal artery between T8-L4. Supplies thoracic, lumbar, and sacral areas,
52
Terminal artery: what does it supply
supplies filum terminale
53
Posterior Spinal Artery: what is itwhat does it supply
supplies the posterior horns and posterior vertebral structures descends as a pair (unlike the anterior) along the medial edge of the posterior roots,
54
Centrifugal systemwhat does it supplywhere is it
supply exclusively cord –supply grey matter of the cord a. arise from the anterior spinal artery and supplies the central region of the cord—mostly grey matter b. includes most of gray matter and ½ inner, posterior, lateral, and anterior white matter
55
Centripetal system: what does it supply?
supply exclusively cord –supply white matter of the cord-----Supplies part of dorsal horns, posterior column, outer lateral and anterior columnArise from the anterior and posterior spinal arteries and supplies the peripheral region of the cord. Anterior artery gives rise to pial arteries and travel circumferentially supplies periphery.
56
Capillary Network: more dense in grey or white matter?
more dense in the grey matter than in the white matter. This suggests that grey matter is more important needs more vascular supply, when there is ischemia to cord itself the grey matter cells die more quickly than the white matter cells

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