Spinal Cord Injury Flashcards

(41 cards)

1
Q

cervical injury and involves any degree of paralysis of the
four limbs and trunk musculature

A

Quadriplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

paralysis caused by a thoracic, lumbar or sacral injury and
involves any degree of paralysis of the lower extremity with involvement of
the trunk, legs, feet and toes, depending on the level of the lesion

A

Paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most caudal level of the spinal cord with normal motor
and sensory function on both the left and right sides of the body

A

Neurological Level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

all segments above must be 5/5

A

Motor Level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

all segments above must be 2/2

A

Sensory Level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

No motor or sensory function is preserved in S4-S5 (Asia Scale)

A

A - Complete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SENSORY BUT NOT MOTOR fxn is preserved below the neurological level and includes S4-S5 (ASIA Scale)

A

B - Incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Motor function is preserved below the neurological elevel and MORE THAN HALF of key muscles below the neuro level have a muscle grade less than 3

A

C - Incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Motor function is preserved below neuro level, and AT LEAST HALF OF KEY MUSCLES have a muscle grade of 3 or more (ASIA Scale)

A

D - Incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Motor and sensory function is normal (ASIA Scale)

A

E - Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the areas of intact motor and/or sensory
function below the neurological level if an individual has motor and/or sensory function below the neurological level but does not have
function at S4 and S5

A

Zone of Partial Preservation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

complete transection of the spinal cord; no motor or sensory
preserved at S4-S5; may have preservation of strength or sensation below the neurological level

A

COMPLETE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

injury to the spinal cord that does not cause a total transection with some degree of voluntary movement or sensation preserved
at S4-S5

A

INCOMPLETE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Incomplete Injury CLINICAL SYNDROMES

A
  1. Anterior cord
  2. Brown-Sequard
  3. Central cord
  4. Posterior cord
  5. Cauda equina Injuries
  6. Conus medullaris injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • damage to the anterior portion of the cord and/or its vascular supply from the ASA
  • d/t FLEXION INJURIES
  • proprioception is preserved
A

Anterior Cord Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • HEMISECTION of the spinal cord
  • d/t PENETRATING WOUNDS, GSW, STAB WOUNDS
A

Brown-Sequard Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • MC
  • d/t HYPEREXTENSION/WHIPLASH INJURIES to the cervical region, congenital or degenerative narrowing of the spinal canal
  • Most prevalent in aging populations due to arthritic changes
  • UE > LE, potential flaccid paralysis
A

Central Cord Syndrome

18
Q
  • damage to the DCML
  • d/t STDs such as syphilis
  • involvement: gait dev
A

Posterior Cord Syndrome

19
Q
  • do not involve damage to the spinal cord itself but rather to the spinal
    nerves that extend below the end of the spinal cord
  • anatomically incomplete d/t the great number of nerve roots involved
  • considered as peripheral nerve injuries
  • usually occurs with fractures below the L2
  • areflexic bowel and bladder; LMN motor paralysis
A

Cauda Equina Injuries

20
Q
  • injury of the sacral cord and lumbar nerve roots
  • bowel and bladder incontinence and sexual dysfunction are typically
    more severe than cauda equina injuries*
  • Involvement: loss of motor and sensory function below the level of injury
    (not severe); absence of reflex arc, LMN motor paralysis
A

Conus Medullaris Injuries

21
Q
  • immediately after SCI
  • period of AREFLEXIA and flaccid paralysis below level of injur
  • 1 week to 3 months
22
Q
  • MC cause of death
  • T12 and below - normal respiratory status
A

Respiratory Complications

23
Q
  • occurs in lesions above T6
  • Sx: pounding headache,
    diaphoresis, flushing,
    goosebumps, tachycardia
    followed by bradycardia
  • Mx: find the cause and alleviate
    (e.g. emptying the bladder)
A

Autonomic Dysreflexia

24
Q
  • blood tends to POOL DISTALLY in the LE as a result of reduced
    muscle tone in the trunks and legs
  • Sx: light-headedness, dizziness, pallor, sudden weakness,
    unresponsiveness
  • Mx: antiembolism socks, abdominal binders, assuming an
    upright position slowly
A

Postural Hypotension

25
➢ a serious complication after SCI caused by the following main reasons: a. reduced circulation due to decreased tone b. frequency of direct trauma to legs causing vascular damage c. prolonged bed rest ➢ Signs: LE swelling, localized redness, low-grade fever
Deep Vein Thrombosis
26
- maintaining appropriate body temperature is often a problem for SCI patients above T6. ➢ poikilothermia - during the 1st year after injury ➢ cold weather causes discomfort ➢ excessive sweating may occur above the level of injury in warmer weather
Thermal Regulation
27
➢ appears after spinal shock subsides ➢ increase in spasticity can be triggered by: a. infections b. positioning c. pressure sores d. UTIs e. heightened emotional states ➢ beneficial
Spasticity
28
➢ abnormal formation of bone deposits on muscles, joints, and tendons ➢ MC areas: hip and knee ➢ happens in 20% of SCI patients ➢ Signs: heat, pain, swelling, decrease in AROM/PROM
Heterotopic Ossification
29
➢ kidney failure as a result of chronic UTI - one of the MC causes of death ➢ Warning signs: cloudy urine or has excessive particles, dark or foul-smelling urine, fever, chills, increase in spasticity ➢ Tx: PREVENTION
Genitourinary Complications
30
➢ can become either spastic or flaccid ➢ usually flaccid during the state of spinal shock
Complications Associated with the Bowel
31
major reason for hospital admission in SCI patients
Decubitus Ulcer
32
availability of a caregiver 24hrs is the most appropriate safety option
C4 and above
33
may use a phone independently with possible adaptations but may be limited in other emergency responses
C5 and below
34
rely on wheelchair for household and community mobility
Thoracic level and above
35
able to ambulate in short distances with an AD (e.g. lofstrand crutches) and orthosis but practicality during household and communitysettings must be considered.
Lower level thoracic injury
36
requires assistance and some personal attendance care
C6 and above
37
can often live independently; but may require assistance with heavier maintenance tasks
C7 and below
38
Wheelchair Prescriptions
C4 and above - power wheelchair C5 - highest level - power wheelchair (community mobility) manual wheelchair with handrim projections C6 - manual wheelchair with handrim projections C7 - manual wheelchair with handrim projects (friction) C8 - standard handrims; wheelie for community ambulation
39
Orthosis
C4/C5 - balance forearm orthosis C6 - tenodesis splint T1-T8 - KAFO + // bars or walker T9-T12 - KAFO + walker T12-L3 - KAFO + loftstrand crutches L4 - L5 - AFO + loftstrand L5-S1 - rocker bar
40
Transfers
C3 (obese) - hydraulic lift C5 - dependent sliding transfer C6 - independent sliding board transfer C7 - independent transfer s̅ sliding board on all level surfaces T1 - floor to wheelchair T4 - sitting pivot L3 - standing pivot
41