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neurodegenerative diseases > Spinal cord injury > Flashcards

Spinal cord injury Flashcards

1
Q

Name as many SCI injury facts as possible?

A
  • 42 (average age at injury)
  • predominately males (80% of SCI cases)
  • 282,000 number of people in the US living with an SCI
  • Pneumonia and septiciaemia (common cause of death of SCI patient)
  • 12,500/ year (US); 1,000-2,000/ year (UK)
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2
Q

what are common causes of SCI?

A
  • motor vehicle accidents
  • falls
  • sports injuries
  • violence
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3
Q

Describe the anatomy of the spinal cord

A

31 spinal nerves
Cervical 1- Cervical 8
Thoracic 1- Thoracic 12
Lumbar 1- Lumbar 5
Sacral 1- Sacral 5
Coccygeal 1

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4
Q

what information is carried by the posterior columns tract?

A

vibration, light touch, proprioception

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5
Q

what information is carried by the anterior spinothalamic tract ?

A

Pain and temperature

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6
Q

what information is carried in the lateral corticospinal tract?

A

motor control

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7
Q

what are the important motor (descending) tracts in the SC?

A

lateral corticospinal tract
rubrospinal tract
medial reticulospinal tracat
lateral reticulospinal tract
cestibulospinal tract
tectospinal tract

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8
Q

what is the motor tract also known as?

A

desccending tract

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9
Q

what is the sensory tract also known as?

A

ascending

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10
Q

what does a C4 injury cause?

A

Quadriplegia/ Tetraplegia, results in complete paralysis below the neck

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11
Q

what does a C6 injury result in?

A

Partial paralysis of hands and arms as well as lower body

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12
Q

what does a T6 injury result in?

A

Paraplegia, results in paralysis below the chest

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13
Q

what does an L1 injury result in?

A

Paraplegia, results in paralysis below the waist

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14
Q

what are the priorities for SCI patients?

A
  • Motor function
  • Arm/ hand function (for individuals with tetraplegia)
  • Mobility (individuals with paraplegia)
  • Bowel and bladder function
  • Sexual function
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15
Q

what happens in central cord syndrome?

A
  • lesion interrupts fibers crossing to enter the spinothalamic tracts and fibers mediating the tendon stretch reflex
  • as the lesion enlarges it affects the intermediolatral columns (autonomic function) and the lateral corticospinal tracts
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16
Q

Name two SCI causing partial lesion syndromes?

A

1) Brown-sequard syndrome of spinal coord hemisection
2) central cord syndrome

17
Q

What is ASIA?

A

The ASIA scale is an indicator of severity of SCI used clinically (A-E)

18
Q

what does ASIA determine?

A

Determines:
- sensory levels for right and left sides
- motor levelsfor right and left sides
- single neurological level - lowest spinal level that is normal on both sides
- whether injury is complete or incomplete

19
Q

what is spinal shock?

A

a state of temporary loss of function in the spinal cord - often lasts 1 day, but can persist up to 1 month post-injury

20
Q

what are the symptoms of spinal shock?

A
  • flaccid paralysis below the lesion (due to removal of descending/ motor input) this is replaced by spastic paralysis following spinal shock
  • loss of tendon reflexes
  • impaired sympathetic outflow to vascular smooth muscle can cause decreased blood pressure (high cervical injury)
  • absent sphincter reflexes and tone
21
Q

what happens to the astrocytes after traumatic injury ?

A

astrocytes become reactive

22
Q

what do reactive astrocytes do?

A
  • become hypertrophic
  • secrete chondroitin sulfate proteoglycans (CSPGs)
  • increase expression of normal molecules (Ex: Glial fibrillary acidic protein (GFAP))
23
Q

what do reactive astrocytes result in after traumatic injury?

A

formation of a glial scar

24
Q

In CNS injury what happens when Glial scar + myelin debris?

A

Area which growing axons cannot pass through

25
Q

what causes the formation of a glial scar after CNS injury?

A

Reactive astrocytes
by:
- becoming hypertrophic
- secreting CSPGs
- increase expression of molecules (like GFAP)

26
Q

what three key things happen in SCI that cause the death or degeneration of axons/ neurons?

A

1) Glial scar + myelin debris = create an area which growing axons cannot pass through
2) inflammatory cellsl flood the lesion and release pro-inflammatory cytokines = affect neuronal viability
3) diffusable inflammatory mediators (nitrous oxide) = affect neuronal excitability

27
Q

what cells flood the lesion in SCI and what do they do?

A

Inflammatory cells (microgloa, lymphocytes, macrophages) and release pro-inflammatory cytokines which affect neuronal viability

28
Q

what affects neuronal viability?

A

inflammatory cells flooding the lesion and releasing pro-inflammatory cytokines

29
Q

what affects neuronal excitability in SCI?

A

diffusable inflammatory mediators (nitrous oxide)

30
Q

what is Wallerian degeneration?

A

active process of retrograde degeneration at the distal end of an axon that is the result of a nerve lesion

31
Q

what happens in a system that regenerates after injury? (wallerian degeneration)

A

1) the axon becomes fragmented at the injury site
2) myelin debris is released into lesion site
- schwann cells become reactive

32
Q

what happens in Wallerian degeneration in adult CNS step-by-step after injury?

A

1) fragmentation of distal axon and myelin sheath.
2) microglia and astrocytes become activated. Inflammation ensues.
3) Macrophages begin to remove debris
4) Myelin debris is not completely removed, although oligodendrocytes survive.
5) glial scar is formed.
6) Cell body undergoes chromatolysis and synaptic terminals retract
7) Axons attempt to sprout but regeneration fails as axonak growth is inhibited by persistent myelin debris and glial scar

33
Q

what causes the fail in regeneration of the axons in wallerian degeneration?

A

its inhibited by persistent myelin debris and glial scar

34
Q

what is chromatolysis?

A

it is the dissolution of the Nissl bodies in the cell body of a neuron

35
Q

what happens to neurons undergoing chromatolysis?

A

they have a displacement of the nucleus, Nissl substance only at cell body periphery. Neurons usually undergo apoptosis.

neurodegenerative diseases (11 decks)

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