Exam 2- SCI part 1 Flashcards Preview

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Flashcards in Exam 2- SCI part 1 Deck (47)
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what are the 5 leading causes of SCI

  1. MVA
  2. falls; mostly in elderly
  3. GSW/ stabbing/ acts of violence
  4. other
  5. sports


other non-traumatic etiologies

  • ~Infection
  • ~Autoimmune
  • ~Cancer/ tumor
  • ~Stenosis (the spondy ies)
  • ~Cyst
  • ~Stroke; embolic or thrombus
  • ~Laxity of ligaments in the joints (Downs syndromes have lax joints- don’t do gymnastics)


stereotypical SCI pt

  • ~18-27
  • ~male
  • ~white

*average age is going up because more falls from the elderly


Details on Quads

~cervical region injured

~will affect UE and LE


Details on Paras

~thoracic, lumbar, or sacral region injuried

~will normally have full UE ability and not LE


cervical SCI injury causes

  • ~hyperextension
  • ~hyper flexion
  • ~axial loading
  • ~rotation
  • ~side bending


cervical SCI: hyperextension

  • ~Will affect ALL (rupture), PLL(disruption), distraction of vertebra, SC will get stretched, vertebra may be fractured and go into the SC
  • ~Person who falls and catches chin on something as they fall


cervical SCI: hyper flexion

  • ~Will affect posterior structures; tear drop fracture- off the anterior vertebra body
  • ~Whip lash; football (leading with head)


cervical SCI: axial loading

  • ~Pressure straight down
  • ~have loaded vertebra that will cause the vertebra to burst- lots of pieces; a bone fragment can get to the SC


cervical SCI: rotation

  • ~Facets can break
  • ~Usually on one side; can cause brown sequard- injures one side of the SC


What is different about cervical (compared to thoracic)

  • ~More mobility
  • ~Thoracic is protected by more muscles and ribs
  • ~Will take more to cause damage (a lot more!) in the thoracic


Thoracic SCI injuries

  • ~GSW and stabbing is the most common (Associated with Brown Sequard)
  • ~MVA
  • ~Compression fracture


What levels of the thoracic are injured the most often?

T12, L1 is where most of the injuries occur


compression fractures of the thoracic

  • ~Little old ladies
  • ~Falling/ plopping- sitting to fast
  • ~They are curved over (causing the vertebra the be shaped more wedged)
  • ~boobs cause the lades to curve over more


MVA of the thoracic

  • ~Seat belt could cause a SCI instead of the pt dying in a major MVA
  • ~When the force of the accident causes the vertebra to move completely forward
  • ~Where there is more of a slope/ more movement


Lumbar SCI injuries

  • ~Falls/ compression
  • ~MVA (Seat belts)

**same that happens in Thoracic spine happens in lumbar spine


What surgical fixation do you use for a compression fraction

  • ~ORIF- open reduction internal fixation
  • ~to help fuse the spine together when the pt has major displacement of the spine


What surgical fixation do you use for a burst fracture

repair with a cage with crushed bone


Complete SCI injury

no sacral sparing


Incomplete SCI injury

  • ~If they have sacral sparing at levels S4-5, this is intact; sensation, motor, or both intact
  • ~Tested by inserting a finger in anus (can they feel it, squeeze, both)


Spinal shock

  • ~Don’t label a person as incomplete or complete right away bc of spinal shock
  • ~Can last days, weeks, months
  • ~Body is in a state of shock and may or may not recover
  • ~Can test primitive reflexes here


what primitive reflexes are tests for spinal shock?

  1. ~Bulbocavernosus
  2. ~Cremasteric
  3. ~Anal wink


Bulbocavernosus reflex is

  • ~pull on glans penis
  • ~can also pull on catheter

Reflex causes anal sphincter contraction


Cremasteric reflex is

rub on inside of thigh and will cause scrotum will tighten up


Anal wink reflex is

stroke the area around the anus

reflex causes contraction of external anal sphincter


syndromes of the spinal cord

  1. ~central cord syndrome
  2. ~brown- sequard
  3. ~anterior cord
  4. ~posterior cord
  5. ~conus medullaris
  6. ~cauda equina


Central cord syndrome

  • ~Effects the center of the spinal cord
  • ~More UE than LE
  • ~Flaccid UE; relatively fine LE
  • ~Can’t get up, but can walk when they are up *he think of a penguin*


Brown sequard syndrome

  • ~Hemi section of the SC
  • ~Ipsilateral loss - motor, proprioception, vibratory sense, deep touch, discriminative touch
  • ~Contralateral loss - pain, temperature, crude touc


anterior cord syndrome

  • ~Anterior part is damaged
  • ~You have proprioception, vibratory, deep touch, discriminative touch
  • ~Don’t have motor, pain, temp, crude touch


posterior cord syndrome

  • ~Use to be associated with syphilis
  • ~Loss dorsal column input; don’t know where your legs are in space (no proprioception)
  • ~If the lights are off, they have no idea where the limbs are