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Neuroanatomy 2 > Module 10 > Flashcards

Module 10 Flashcards

0
Q

What is the mean age of onset of SCIs?

A

33

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1
Q

What is the definition of a spinal cord injury?

A

Usually begins with a sudden traumatic blow to the spine that fractures or dislocates vertebrae and destroys axons

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2
Q

What is the gender influence of SCIs?

A

Males 4:1

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3
Q

What is the prevalence of SCIs?

A

270,000

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4
Q

What is the incidence rate of SCIs?

A

12,000

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5
Q

What is the percent of SCIs due to MVA?

A

39.2%

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6
Q

What is the percent of SCIs due to falls?

A

28.3%

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7
Q

What is the percent of SCIs due to violence?

A

14.6%

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8
Q

What is the percent of SCIs due to sports?

A

8.2%

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9
Q

What is the percent of SCIs due to other/unknown causes?

A

9.7%

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10
Q

What a the diagnostic procedures for SCIs?

A

X-ray
Computerized tomography (CT)
Magnetic resonance imaging (MRI)

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11
Q

What’s the treatment of SCIs?

A

Stabilization- preventing further injury
Fixation- fuse, rods, halo, replace bone, collars, LSOs
Rehabilitation- upright tolerance, bed mobility, other basics
Functional recovery-house
Community re-entry

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12
Q

What level of the vertebrae is required for independence?

A

C7

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13
Q

At what level of injury in the vertebrae is there problems breathing and need a ventilator?

A

C4 and up

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14
Q

What is associated with C5 in the neurological classification of SCI?

A

Elbow flexors

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15
Q

What is associated with C6 of the neurological classification of SCIs?

A

Wrist extensors

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16
Q

What is associated with C7 in the neurological classification of SCIs?

A

Elbow extensors

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17
Q

What is associated with C8 in the neurological classification of SCIs?

A

Finger flexors

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18
Q

What is associated with T1 in the neurological classification of SCIs?

A

Finger abductors

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19
Q

What is associated with L2 in the neurological classification of SCIs?

A

Hip flexors

20
Q

What is associated with L3 in the neurological classification of SCIs?

A

Knee extensors

21
Q

What is associated with L4 in the neurological classification of SCIs?

A

Ankle dorsiflexors

22
Q

What is associated with L5 in the neurological classification of SCIs?

A

Long toe extensors

23
Q

What is associated with S1 in the neurological classification of SCIs?

A

Ankle plantar flexors

24
Q

What does ASIA stand for?

A

American spinal injury association

25
Q

What is the classification of ASIA A?

A

Complete- no sensory or motor function preserved in sacral segments S4-S5

26
Q

What is the classification of ASIA B?

A

Incomplete- sensory but not motor function preserved below neurological level and includes sacral segments S4-S5

27
Q

What is the classification of ASIA C?

A

Motor function is preserved below neurological level, and more than half of key muscles below neurological level have a muscle grade less than three

28
Q

What is the classification of ASIA D?

A

Incomplete- motor function is preserved below neurological level, and at least half of key muscles below neurological levels have a muscle grade greater than or equal to 3

29
Q

What is the classification of ASIA E?

A

Sensory and motor function is normal.

30
Q

What is quadriplegia or tetraplegia?

A

Paralysis of all 4 extremities and trunk resulting from cervical spine lesion

31
Q

What is paraplegia?

A

Paralysis of part of trunk and booth lower extremities from thoracic, lumbar, or caudally equina lesion.

32
Q

What is a neurological level?

A

Most caudal level of spinal cord with normal motor and sensory function bilaterally

33
Q

What two levels make up the neurological level?

A

Motor level and sensory level

34
Q

What is a motor level?

A

Most caudal level of spinal cord with normal motor function bilaterally

35
Q

What is a sensory level?

A

Most caudal level of spinal cord with normal sensory function bilaterally

36
Q

What are the categories of classification for a SCI?

A

Complete-no sensory or motor function in lowest sacral segments S4-5
Incomplete- sensory and/or motor function below neurological level including sensory and/or motor of S4-5
Zones of partial preservation- sensory and/or motor function below neurological level excluding S4-5

37
Q

What are the different syndromes that could be part of a SCI?

A 
Anterior cord syndrome
Posterior cord syndrome
Central cord syndrome
Brown-sequard syndrome
Conus medullaris lesion
Cauda equina lesion
38
Q

What is anterior cord syndrome?

A

More sensory neurons
Lesions involving anterior two thirds of spinal cord; posterior columns preserved; variable loss of motor function (corticospinal tract) and sensitivity to pain/temperature,pinprick sensation (spinothalamic tract); preservation of proprioception/light touch

39
Q

What is posterior cord syndrome?

A

Lesion involving posterior columns; proprioceptive loss (dorsal columns); pain, temperature, light touch are preserved; variable motor function preserved.

40
Q

What is central cord syndrome?

A

Lesion involving center of spinal cord; sacral sensory sparing, greater motor weakness in UE than LE; bladder dysfunction, most commonly urinary retention; variations sensory loss below level of lesion.
Cause may be due to burst fracture.

41
Q

What is brown-Sequard syndrome?

A

Gun shots/knife/axe
Lesion involving spinal cord hemi-section; ipsilateral motor and proprioception deficits; contralateral pain and temperature deficits

42
Q

What is conus medullaris lesion?

A

Lesion involving injury to the sacral cord (conus) and lumbar nerve roots within the spinal canal; usually results in areflexic bladder and bowel; areflexic lower limbs (low lesion)

43
Q

What is cauda equina lesion?

A

Lesion involving injury to the cauda equina; lower motor neuron; results in areflexic bladder, bowel and lower limbs.

44
Q

What are the drugs used in a SCI?

A

Acute SCI- medrol: steroid to help stop swelling
OH- ephedrine: helps get body up and moving and keeps blood pressure up
Spasticity- Baclofen
Pain- Vicodin
Insomnia- ambien
DVT- Coumadin: prevents clots and thins blood.

45
Q

What a the direct implications of SCIs?

A

Spinal shock- spine shuts down
Autonomic dysreflexia- initiates autonomic nervous system if uncomfortable or catheter kinked
Orthostatic hypotension- BP drop: use compression clothes
Thermoregulation impairment- cant sweat or cool themselves, must wet themselves down
Respiratory impairment- hard time coughing, need a cough assist or hands to push under diaphragm
Spasticity
Bladder and bowel dysfunction- need program to stimulate bladder: teach them to pee at a certain time of day
Sexual dysfunction

46
Q

What are indirect impairments of a SCI?

A 
Respiratory complications- anemonia
Pressure sores
Deep vein thrombosis 
Contractures
Heterotropic (ectopic) ossification- bone develops extra bone in joints or muscle
Pain
47
Q

What are the implications for O and P for SCI patients?

A 
Spasticity-stretch and brace
Contracture control
Standing/gait (>t12= RGO, <L1=KAFOs)
Walk vs. roll
Heterotopic ossification- prevent bone growth and contractures
TLSO, halo
Neck bracing/ collars
Flaccidity
Fractures/walking boots
FES/walkaide

Neuroanatomy 2 (8 decks)

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