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Sem 4 - Nervous System > Spinal Cord Injuries > Flashcards

Spinal Cord Injuries Flashcards

(45 cards)

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1
Q

What is the most common cause of spinal injuries?

A

Physical trauma

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2
Q

Are spinal injuries more common in males or females?

A

Males

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3
Q

What spinal levels do spinal injuries most commonly occur at?

A

Half occur at C6 or C7

30% occur at C2

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4
Q

What spinal levels do injuries most commonly occur at in children? Why?

A

C1, C2

Heavier head, lax ligaments

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5
Q

What are the different mechanisms of spinal injury? What do they each mean?

A

Hyperflexion, forward movement of the head

Hyperextension, backward movement of the head

Lateral stress, sideways movement of the head

Rotation, twisting of the head

Compression, force along the axis of the spine downward from the head or upward from the pelvis

Distraction, pulling apart of the vertebrae

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6
Q

What are some examples of flexion injuries?

A

Atlanto-occipital dislocation

Atlanto-axial dislocation

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7
Q

What are some examples of extension injuries?

A

Hangman’s fracture

Atlanto-axial dislocation

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8
Q

What are the different types of cord injuries?

A

Complete cord transection syndrome

Brown-Sequard syndrome

Anterior cord syndrome

Central cord syndrome

Posterior cord syndrome

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9
Q

What is complete cord transection syndrome?

A

Injury to a whole section of the spinal cord

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10
Q

What are the causes of complete cord transection syndrome?

A

Trauma

Infarction

Transverse myelitis

Abscess

Tumour

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11
Q

What is transverse myelitis?

A

Inflammation of both sides of one section of the spinal cord

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12
Q

What spinal tracts are injured in complete cord transection syndrome?

A

All of them

  • dorsal-column medial-lemniscus pathway
  • spinothalamic tract
  • corticospinal tract
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13
Q

What are the signs and symptoms of complete cord transection syndrome?

A

Complete loss of all sensory modalities below the lesion

Flaccid paralysis followed by UMN lesion signs below the lesion

Autonomic dysfunction

  • hypotension
  • priapism
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14
Q

What is priapism?

A

Prolonged sustained erection

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15
Q

What are the types of complete cord transection syndromes?

A

Paraplegia

Tetraplegia/quadriplegia

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16
Q

What is paraplegia?

A

Complete cord transection syndrome in the thoracic, lumbar or sacral regions affecting the lower limbs

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17
Q

What are the causes of Brown Sequard syndrome?

A

Penetrating trauma

Fractured vertebrae

Tumour

Abscess

Multiple sclerosis

-all giving unilateral cord injury

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17
Q

What is tetraplegia/quadriplegia?

A

Complete cord transection syndrome in the cervical region affecting both upper limbs and lower limbs

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19
Q

What are the causes of anterior cord syndrome?

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A

Flexion injury

Injury to anterior spinal artery

19
Q

What is anterior cord syndrome?

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A

Injury to the anterior half of a section of the spinal cord

21
Q

How does flexion injury lead to anterior cord syndrome?

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A

Fracture

Dislocation

Herniated discs

22
Q

What can cause injury to the anterior spinal artery?

Study These Flashcards
A

Vascular disease
-atherosclerotic disease

Cross-clamping of aorta during surgery, gives reduced blood flow through anterior spinal artery

23
Q

What spinal tracts are injured in anterior cord syndrome?

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A

Spinothalamic tract

Corticospinal tract

24
Q

What are the signs and symptoms of anterior cord syndrome?

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A

Loss of temperature, pain, pressure modalities below the lesion

Flaccid paralysis followed by UMN lesion signs below the lesion

Autonomic dysfunction

  • bowel problems
  • bladder problems
  • sexual problems
25
What is central cord syndrome?
Injury to the middle of a section of the spinal cord
26
What are the causes of central cord syndrome?
Trauma Ischaemia of spinal cord Cervical spinal stenosis Degenerative spinal disease Syringomelia
27
How does trauma cause spinal cord syndrome?
Hyperextension injury of cervical spine in elderly Hyperflexion injury of cervical spine in younger people
28
What is syringomelia?
Development of cyst in central canal
28
What causes syringomelia?
Unknown cause
29
What spinal tracts are injured in syringomelia?
Spinothalamic fibres decussating in white commissure
30
What are the signs and symptoms of syringomelia?
Loss of temperature, pain and pressure modalities | In the neck, shoulders and arms as cervical fibres are more medial
32
What are the causes of posterior cord syndrome?
Spondylosis Spinal stenosis Infections Vitamin B12 deficiency Injury of paired posterior spinal arteries
32
What are the signs and symptoms of central cord syndrome?
More motor symptoms than sensory symptoms Upper half of body affected more than lower half of body, due to nerve fibres of upper half of body being more medial in corticospinal tract Distal extremities affected more than proximal Autonomic dysfunction -urinary retention
34
What spinal tracts are injured in posterior cord syndrome?
Dorsal-column medial-lemniscus pathway
35
What are the signs and symptoms of dorsal-column medial lemniscus pathway?
Loss of light touch, proprioception, vibration modalities below the lesion
36
What signs and symptoms suggest the patient has a spinal cord injury?
Head injury Unconscious, confused Spinal tenderness Loss of sensation Extremity weakness
37
How are spinal cord injuries immediately managed?
ABCDE approach Manual inline stabilisation for short-term Log-roll, backboard, rigid C-collar for long-term Assess bladder volume, insert urinary catheter
38
What parts of the ABCDE approach are particularly important with a spinal cord injury?
Monitor vital signs e.g. heart rate, blood pressure, respiratory rate, % saturation, temperature If patient is hypotensive, give fluid challenge and vasoconstrictors e.g. adrenaline If patient is not breathing, if injury is C5 or above meaning loss of innervation to diaphragm, intubate patient If patient is hypoxic, give oxygen If patient has hypothermia, give blankets
39
Why do patients with spinal cord injuries become hypotensive?
Loss of sympathetic output | Vasodilation, decreased systemic vascular resistance and hence blood pressure
40
Why do patients with spinal cord injuries become hypothermic?
Loss of sympathetic output Vasodilation of arterioles in skin, loss of heat by radiation Loss of piloerection reflex, can’t conserve heat Loss of voluntary motor output, can’t shiver to generate heat
41
Why do patients with spinal cord injury get urinary retention?
Flaccid paralysis of bladder detrusor muscle
42
What is manual inline stabilisation?
Crouching above the patient, hands placed on mastoid process or cradle their occipital Or standing beside patient, hands placed on sides of heads, forearms resting on patient’s chest
43
How are spinal cord injuries managed after the patient is stable?
C-spine restriction for approx. 6 weeks Physiotherapy, occupational therapy Surgery if neurological deficits are progressing, or to correct unstable spinal fractures
44
What is meant by clearing the spine?
Removing the C-collar
45
What are the criteria for clearing the spine?
Alert and oriented Not intoxicated No midline posterior tenderness No focal neurological deficit No language barrier

Sem 4 - Nervous System (25 decks)

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