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Flashcards in Neuro Intro to SCI Deck (48)
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1

What are the types of traumatic injuries for SCI?

1. Hyperextension
2. Compression
3. Flexion rotation
4. Hyperfelxion

5

What is the most common type of traumatic damage to a SC lesion in the T-spine? C-spine?

Thoracic: Flexion rotation most common nuero damage
Cervical: Hyperextension

7

Give an example of MOI for traumatic trauma to C-spine

MVA: Especially if headrest isn't there to prevent neck hyperextension

8

List some types of SCIs that are Non-Traumatic

1. Tumor
2. Ischemia (which side more susceptible: Ant or Post to SC?)
3. Congenital malformation (Spina Bifida, Arnold Chiari)
4. Infection

13

Percentage?

C5, C4 or 6, T12
1. 53% Cervical lesion
2. 35.6% Thoracic lesions
3. 10.1% lumbar/sacral lesions

17

What percentage of SCI pts suffer from a stroke? What s/s would you look for?

11.5% have TBI
Signs and Symptoms
• HA
• Nausea
• Inability to Problems solve

22

What is the highest cause of death for SCI pts?

1. 28% Pneumonia/Respiratory disease
2. 18% Cardiac Disease
3. 12% Septicemia
4. 9% Urinary system
5. 5% Unintentional injury, suicide, etc

27

Do Compression Injuries necessarily equal neurological damage?

It may or may not

32

1. What are the demographics for SCI pts?
2. What is the most frequent age at injury?
3. What is the avg age?
4. What is the ratio for male to female?
5. Education?

1. Most pts are in the 16-30 age group (more than all other groups combined)
2. 19 yrs
3. 30 yrs
4. 4:1
5. 49.8% have HS diploma

37

What would be your logic to this data regarding percentage of lesions?

The neck is made for mobility NOT stability. Therefore it safe to assume that most injuries would occur at the Cervical level.

38

Because of this rate of TBI what other pathology/syndrome would you suspect several months post injury?

Post-Concussion Syndrome

39

What is the life expectancy of a 20 yr old tetraplegia?

Normal Life expectancy: 75.3 yrs

42

What is the life expectancy of a 20 yr old Paraplegia?

Normal : 75.3 yrs

ASIA A, B, C: ~ 11 yrs less

ASIA A, B, C: ~ 20 YRS LESS

45

What is the life expectancy of a 20 yr old that is categorized as ASIA D?

Norm 75.3 yrs

ASIA D: ~ 7 yrs less

48

What does the patient present with when diagnosed with an UMN lesion?

Motor and Sensory Loss. Spasticity

49

What does the patient present with when diagnosed with an LMN lesion?

Motor and Sensory Loss. Flaccidity

50

What does the patient present with when diagnosed with a nerve root injury at level of injury?

Pain is frequently present

51

Could you possibly have a pt with both an UMN and LMN injuries?

Yes. i.e. Paraplec with previous brachial plexus injury

52

Describe the events that take place d/t SPINAL SHOCK

Transient, flaccid period. SC ceases to function

53

How soon does spinal shock begin to resolve?

Can begin to resolve within 24 hrs

54

What signals the END of spinal shock?

Return of anal and bladder reflexes

55

What has been deemed an important PROGNOSTIC indicator at the end of spinal shock?

If Motor and Sensory function is present

56

List three complication regarding temperature regulation in SCI pts

1. inability to cool/warm self below level of lesion
2. inability to accurately feel temperature below level
3. inability to make goosebumps or seat below level

59

Between what levels is the Spinal cord reflex center for bowel function located?

S2-4

60

Describe UMN Bowel Dysfunction

Reflexive Bowel.
Requires suppository + digital stimulation to reflexively empty

62

Describe LMN Bowel Dysfunction

Non-intact reflex center, but abdominals working.
Requires attn to diet/fluids.
Schedule bowel programworking.

65

Describe UMN Bladder Dysfunction

Reflexive bladder: Mgmt differes depending if emptying is complete or incomplete

66

Describe LMN Bladder Dysfunction

Arreflexive: must have limited and scheduled fluid intake; on intermittent catheterization

67

Describe UMN Sexual Dysfunction

Males = extremely low fertility rate.
Same reflex center as bladder
Can achieve erection, but maintain and ejaculate is difficult

70

Describe LMN Sexual Dysfunction

Males = flaccidity is biggest obstacle
Females = Would need special obstetrical observation d/t lack of sensation. Pt unable to feel premature contraction/abdominal pain.