acute consequences of sci
weakness with a neck injury leads to
acute consequences of sci
weakness with a caudal injury leads to
htn or hypotension in acute phase of sci?
urinary ___ in acute phase of sci
Acute consequences of SCI? (5)
quadriparesis/plegia (neck) paraparesis/plegia (caudal)
Sensory loss or abnormalities
chornic consequencies of sci? (10
1. involutnary mvoements
2. bladder problems
3. decreased bowel motiblity
4. sexual dysfunction
5. increased risk fo blood clots
6. pressure ulcers
7. autonomic dysfunction
8. metabolic disorders
9. musculoskeltal breakdown/fracures
above T10 injury , bladder problems are
spastic/neurogenic bladder (most common).
Can’t voluntarily relax the external urethral sphincter, so it stays tight as bladder fills.
below T12, bladder sx are
flaccid bladder, can’t contract for emptying
management of flaccid bladder
manage using...intermittent catheterization, condom catheter, indwelling/Foley
catheter, or suprapubic catheter
male sexual dysfunction?
Male, sperm viability is impaired / fertility is impaired.
female sexua problems?
Female, fertility is mostly unaffected but C-section delivery strongly recommended (b/c of autonomic dysreflexia)
Pressure ulcers from __
Autonomic Dysfunction: sympathetic damage = impaired ___
* Autonomic Dysreflexia with SCI =
extreme blood pressure swings (240/160) + low heart rate
what causes autonomic dysreflexia?
occurs in response to strong afferent input, ex. pain or overly full bladder
what can happen with repeated occurenced of autonomic dysrefelxia?
metabolic disorders with spi are often due to
___ sp injuries/year
> 50% of injuries are to ___ spine
> 50% are neurologically “incomplete” - means there is sensation
in S4-S5 region.
“complete” means bilateral injury with total loss of
sensation below injury level
ASIA scale: A is ___ injury
ASIA sale B-D is ___
ASIA scale e is __
Three approaches to SCI treatment:
1. Neuroprotection of surviving cells/axons from toxic injury environment
2. Neurorestoration via replacement cells, neurotrophins, and establishing a growth-
3. Neurorehabilitation by strengthening existing systems and retraining circuits
methylpredinisolone (steroids) trials results
1. found higher mortality in higher tx group
2. another found asia scale improvement in pts who were incomplete, 24 hr dosing
3. 48 hr dosing beter
parapesis/plegia occurs caudal to __
for___that are crushed by the intial truamtic injury nothing can be done those are gone for food
nerve cell bodies
among pts who started tx ___ of injury the 48 MP group receovered signfiicantly more funciton at 6 weeksn and 6 months than those with 24 MP
Spontaneous ____ movements seen in patient with C5 incomplete SCI for 17 years