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NPTE - Neuro > Pathology III - PPT for SCI FUNCTIONAL OUTCOMES > Flashcards

Pathology III - PPT for SCI FUNCTIONAL OUTCOMES Flashcards

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1
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with no neural tissue protruding?

A

Occulta

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2
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with neural tissue/mininges protruding outside the neural arch?

A

Meningocele

SPINAL CORD IS not protruding like in myelomenigocele

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3
Q

What type of spina bifida is characterized by an incomplete fusion of the posterior vertebral arch with both meninges and SPINAL CORD protruding outside the neural arch?

A

Myelomeningocele

SPINAL CORD ITSELF IS PROTRUDING

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4
Q

Low levels of what is thought to contribute to the devleopment of spina bifida?

A

folic acid

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5
Q

In what percent of cases of myelomenigocele is a shunt required for hydrocephalus?

A

90%

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6
Q

What are 3 orthopedic conditions associated with spina bifida?

A
  1. scolosis
  2. hip dysplasia
  3. clubfoot
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7
Q

What condition is characterized by a failed closure of the cranial end of the neural tube in which most are born stillborn or die shortly after birth?

A

Anencephaly

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8
Q

What are the expected deficits with Brown-Sequard’s Syndrome?

A

Paralysis and loss of vibration/proprioception on the same side

Contralateral loss of pain and temperature

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9
Q

An injury occuring below what spinal level is considered a cauda equina injury?

A

L1

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10
Q

What are three characteristics of cauda equina injuries?

A

CONSIDERED A PERIPHERAL NERVE INJURY

  1. Flaccidity
  2. Areflexia
  3. Impairment of bowel and bladder funciton
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11
Q

What 3 things are lost with Posterior Cord syndrome and what is preserved?

A
  1. loss of proprioception
  2. Loss of two-point discrimination
  3. loss of sterognosis ( the ability to perceive and recognize the form of an object in the absence of visual and auditory information)

MOTOR FUNCTION IS PRESERVED

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12
Q

What is another name for heterotopic ossification whihc is a common complication of SCI?

A

Ectopic bone

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13
Q

Heterotopic ossification typicaly invovles pharmacological intervention with what drug?

A

Diphosphates

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14
Q

Autonomic dysreflexia can occur at what level?

A

T6 and above

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15
Q

How often should someone with an SCI change position? and how often should they weight shift in sitting?

A

Change position every 2 hours

Weight shift in sitting every 15-20 minutes

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16
Q

What 3 drugs are commonly used to treat spasticity after SCI?

A

Dantrium, Lioresal, and Baclofen

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17
Q

What is a surgical procedure that severs certain tracts within the spinal cord in order to decrease spasticity and improve function?

A

Myelotomy

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18
Q

What is a surgical procedure that involves removal of a segment of a nerve in order to decrease spasticity and improve function?

A

Neurectomy

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19
Q

What is a bladder that is flaccid as a result of cauda equina or conus medullaris lesion and the sacral reflex arc is damaged?

A

Neurogenic nonreflexive bladder

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20
Q

What is a bladder that empties reflexively for a patient with an injury above the level of T12 and the sacral reflex remains intact?

A

Neurogenic reflexive bladder

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21
Q

What is paradoxical breathing?

A

an abnormal form of breathing that is common in tetraplegia where the abdomen rises and the chest is pull inward during inspiration. With expriation the abdomen falls and the chest expands

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22
Q

What is the term for an incomplete lesion where some of the innermost tracts remain innervated?

A

Sacral sparing

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23
Q

What is a physiologic response that occurs between 30 and 60 minutes after trauma to the spinal cord and can last up to several weeks presenting with total flaccid paralysis and loss of all reflexes below level of injury?

A

Spinal shock

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24
Q

What is a surgical release of a tendon in order to decrease spasticity and improve function?

A

Tenotomy

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25
What is the zone of preservation?
a term used to describe poor or trace motor or sensory funciton for up to three levels below the neurologic level of injury
26
After a C7 complete tetraplegia injury what is the most distal segment of the spinal cord that both motor and sensory components remain intact?
C7
27
What are cardiopulm considerations with a C7 spinal cord injury?
impaired cough and ability to clear secretions, altered breathing pattern and poor endurance
28
If the removal of noxious stimuli does not occur quickly with autonomic dysreflexia what is the patient at risk for?
subarachnoid hemmorage
29
What 3 drugs are started immediately after SCI?
methylprednisolone (corticosteroid) Lipid peroxidation inhibitors opiate receptor blockers
30
With C7 tetraplegia what is the expected functional outcome for feeding, grooming, and dressing?
indepent
31
C7 function with self-ROM, WC mobility, and driving?
independent with all with adaptive equpiment
32
Patients with complete L3 paraplegia will have at least partial innervation of what 5 lumbar/lower extremity muscles?
1. Gracilis 2. iliopsoas 3. quadratus lumborum 4. rectus femoris 5. sartorious
33
What type of bladder dysfunction is expected with a complete L3 paraplegia?
nonreflexive bladder
34
Is cauda equina syndrome a central or peripheral nerve injury?
peripheral
35
What is the term for the end of the spinal cord and what is beyond that?
Spinal cord ends at L1 with the CONUS MEDULLARIS The cauda equiina extends beyond this with paired lower lumbar, sacral, and coccygeal nerve roots
36
Why are nerves of the cauda equina more susceptible to damage?
these nerve roots have poorly developed protective epineurium and the tendency to form edema even with mild injury
37
What is the function of the cauda equina with bowel/bladder?
parasympathetic innervation to the bowel and bladder adn voluntary control over the associated sphincters
38
What are sources of compression of cauda equina nerve roots?
Spinal struture pathology (disk, fracture stenosis), trauma, infectious disease, tumor
39
What is one symptom of cauda equina syndrome that can mimic other conditions?
severe bakc pain
40
What condition is characterized by progressive degeneration of the anterior horn cell due to an autosomal recessive genetic inheritance?
Spina Muscular Atrophy (SMA)
41
What are the 3 categories of Spinal Muscular Atrophy(SMA)?When do they occur?
Acute Infantile SMA - birth and two months. <1 year life expectancy Chronic Childhood SMA - presents after 6 months - 1 year. Can survive into adulthood Juvenile SMA - occurs 4-17 years old. Typically survive into adulthood
42
What are characteristics of SMA?
progressive muscle weakness and atrophy, diminished or absent DTRs, intact sensation, and normal intelligence
43
Nerve injury with throacic outlet syndrome can result in neuropraxia and progress to?
Axonotmesis
44
with TOS diffuse pain in the arm is often experienced most often when?
at night
45
Why might individuals with TOS have difficulty sleeping?
due to excessive pillows or malpositioning of the arm
46
What is the ratio of men to women with TOS?
women affected 2-3x more than men
47
If a patients symptoms with TOS persist for how long is surgical intervention warranted?
persisting 3 to 4 months
48
Hypoxia, drug overdoes, near drowing, and acceleration/deceleration injuries are examples of what type of brain injury?
Closed injury
49
Hematoma, hypoxia, ischemia, increased intracranial pressure, and post-traumatic epilepsy can result in what after an initial brain injury?
secondary injury
50
What is the difference between an epidural and subdural hematoma?
Epidural: between skull and dura matter Subdural: due to venous rupture between the dura and arachnoid
51
What is the term for a state of genreal unresponsiveness with arousal occuring from repeated stimuli?
Stupor (not a coma, cause wouldnt arouse)
52
What is the term for a state of consciousness that is characterized by a state of sleep, reduced alterness to arousal , and delayed responses to stimuli?
Obtundity
53
What is the term for a state of consciousness that is characterized by disorientation, confusion, agitation, and loudness?
delirium
54
What is the term for a sate of consciousness that is characterized by quiet behavior, confusion, poor attentions, and delayed responses?
Clouding of consciousness
55
What is the term for a state of altertness, awareness, orientation, and memory?
consciousness
56
What are the names of the 8 levels of the RLA Levels of Cognitive Functioning?
``` I. No response II. Generalized response III. Localized Response IV. Confused - Agitated V. Confused - Inappropriate VI. Confused - Appropriate VII. Automatic - Appropriate VIII. Purposeful - Appropriate ```
57
What are the possible grades of a concussion?
Grade I Garde II Grade III
58
What defines the different grades of concussion?
Grade I: transient confusion lasting 15 minutes of less Grade II: confusion lasts longer than 15 minutes and may have retrograde and anterograde amnesia Grade III: any form of loss of consciousness, form of injury resulting from diffuse axonal injury.
59
Bizzare and non-purposeful behavior along with often nonexistent selective attention characterizes which RLA Level of Cognitive Functioning?
IV. confused-agitated pg. 304
60
What stage of Cognitive Functioning is characterized by going through a daily routine automatically, frequently robot like and showing minimal to no confusion but judgement remains impaired?
VII. Automatic Appropriate pg. 304
61
What stage of Cognitive Functioning is characterized by ability to reponsed to simple commands consistently but with lack of external structure or increased complexity has non-purposeful random responses. Also is highly distractible and lacks the ability to focus attention on specific tasks?
V. Confused - Inappropriate pg. 304
62
What stage of Cognitive functioning do they show gaol directed behavior that is dependent on external input or direction?
VI. Confused - Appropriate pg. 304
63
What stage of Congnitive functioning do they recall and integrate past and recent events and are aware of and responsive to environment showing carryover for new leaning?
VIII. Purposeful - Appropriate pg. 304
64
What are the different ranges on the Glasgow Coma Scale and what are the 3 categories on the scale? Possible range of scores?
range from 3 to 15 <8 Severe brain injury 9-12 moderate brain injury 13-15 mild injury Eye Opening, Best Motor Response, and Verbal Response
65
what is the inability to create new memory?
Anterograde memory
66
What is the time between injury and wehn the patient is able to recall recent events?
Post-traumatic amnesia
67
what is the inability to remember events prior to injury?
Retrograde amnesia
68
What type of memory is usually the last to recover after a comatose state?
Anterograde memory
69
What causes trigeminal neuralgia?
Abnormal pressure or irritation of the trigeminal nerve
70
Is trigeminal neurogalia typically unilateral or bilateral?
unilateral
71
with trigeminal nerualgia how are chronic vs. episodic symptoms described?
Chronic: persistent aching or burning sensations Episodic: sharp, jolting, stabbing, or shock like
72
What 3 things are the most common causes of vestibular disorders in younger inviduals?
1. ear infection 2. whiplash injury 3. head injury

NPTE - Neuro (23 decks)

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