Spinal cord injury CC4

Question 1

acute consequences of sci

weakness with a neck injury leads to

Answer 1

quadriparesis/plegia

Question 2

acute consequences of sci

weakness with a caudal injury leads to

Answer 2

paraparesis/plegia

Question 3

htn or hypotension in acute phase of sci?

Answer 3

hypotension

Question 4

urinary ___ in acute phase of sci

Answer 4

retention

Question 5

Acute consequences of SCI? (5)

Answer 5

quadriparesis/plegia (neck) paraparesis/plegia (caudal)

Sensory loss or abnormalities

Hypotension

Urinary retention

Orthopedic pain

Question 6

chornic consequencies of sci? (10

Answer 6

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
10. psych

Question 7

above T10 injury , bladder problems are

Answer 7

spastic/neurogenic bladder (most common).

Can’t voluntarily relax the external urethral sphincter, so it stays tight as bladder fills.

Question 8

below T12, bladder sx are

Answer 8

flaccid bladder, can’t contract for emptying

Question 9

management of flaccid bladder

Answer 9

manage using…intermittent catheterization, condom catheter, indwelling/Foley
catheter, or suprapubic catheter

Question 10

male sexual dysfunction?

Answer 10

Male, sperm viability is impaired / fertility is impaired.

Question 11

female sexua problems?

Answer 11

Female, fertility is mostly unaffected but C-section delivery strongly recommended (b/c of autonomic dysreflexia)

Question 12

Pressure ulcers from __

Answer 12

cutaneous ischemia

Question 13

Autonomic Dysfunction: sympathetic damage = impaired ___

Answer 13

thermoregulation

Question 14

* Autonomic Dysreflexia with SCI =

Answer 14

extreme blood pressure swings (240/160) + low heart rate

Question 15

what causes autonomic dysreflexia?

Answer 15

occurs in response to strong afferent input, ex. pain or overly full bladder

Question 16

what can happen with repeated occurenced of autonomic dysrefelxia?

Answer 16

chronic hypertension

Question 17

metabolic disorders with spi are often due to

Answer 17

lifestyle difficuluties

Question 18

___ sp injuries/year

Answer 18

10,000-12,000

Question 19

> 50% of injuries are to ___ spine

Answer 19

cervical

Question 20

> 50% are neurologically “incomplete” - means there is sensation

Answer 20

in S4-S5 region.

Question 21

“complete” means bilateral injury with total loss of

Answer 21

sensation below injury level

Question 22

ASIA scale: A is ___ injury

Answer 22

complete/worst injury

Question 23

ASIA sale B-D is ___

Answer 23

incomplete

Question 24

ASIA scale e is __

Answer 24

is normal

Question 25

Three approaches to SCI treatment:

Answer 25

1. Neuroprotection of **surviving cells/axons from toxic injury environment** 2. Neurorestoration **via replacement cells, neurotrophins, and establishing a growth-** permissive environment 3. Neurorehabilitation by **strengthening existing systems and retraining circuits**

Question 26

methylpredinisolone (steroids) trials results

Answer 26

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

Question 27

parapesis/plegia occurs caudal to \_\_

Answer 27

t1

Question 28

for\_\_\_that are crushed by the intial truamtic injury nothing can be done those are gone for food

Answer 28

nerve cell bodies

Question 29

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

Answer 29

3-8

Question 30

Spontaneous ____ movements seen in patient with C5 incomplete SCI for 17 years

Answer 30

stepping

Question 31

Spontaneous stepping movements seen in patient with C5 incomplete SCI for 17 years Caused by arthritic degeneration and subluxation in R. hip ---\> ___ triggeered CPG

Answer 31

pain upon hip extension

Question 32

Characteristics of all these walking CPG manifestations: Always associated with\_\_\_nput to the spinal cord

Answer 32

pathology / noxious i

Question 33

Can be “trained” to improve ___ walking in persons with incomplete SCI

Answer 33

voluntary

Question 34

Studies on Walk-Training with Body-Weight Support Most subjects show some improvement, but

Answer 34

no greater than seen with physical therapy

Question 35

Studies on Walk-Training with Body-Weight Support is wlaking cpg being trained?

Answer 35

no evidence

Question 36

Studies on Walk-Training with Body-Weight Support where were impovements seen?

Answer 36

better balance, stronger leg muscles, improved fitness

Question 37

Autonomic Dysreflexia Typically seen after ___ or ___ SCI

Answer 37

cervical or high-thoracic

Question 38

Autonomic Dysreflexia is more common after ___ sci

Answer 38

compelte

Question 39

Potential causes of autonomic dysreflexia? (4)

Answer 39

1. loss of brain/brainstem inhibition to symps 2. excessive sensory response to stimuli 3. excessive sympathetic response to normal sensory input 4. excessive vascular response to normal sympathetic activity

Question 40

in all cases of cpg walking all were rhythmic but not reciprocal

Answer 40

between agonists and anatogists

Question 41

electrical stim to ___ can give rise to leg emg comparable to cpg results

Answer 41

lumbar enlargement

Question 42

what si the cpg in human characterized by?

Answer 42

Question 43

interlimb reflexes are observed in all persons with

Answer 43

chronic cervical sci

Question 44

interlimb reflex is more common in

Answer 44

distal upper limb muscles

Question 45

is interlibm reflex found in able bodied subjects?

Answer 45

no

Question 46

early interlimb reflexes from

Answer 46

conenctions already established (latents syanspes)

Question 47

late interlimb reflexes are from ___ connections

Answer 47

novel (regenerative sproutin)

Question 48

do interlimb reflexes disappear?

Answer 48

no

Question 49

what happens to interlimb reflexes once they appear

Answer 49

Question 50

interlimb reflexes are liekly due to new growth within the spinal cord \_\_\_

Answer 50

caudal to the lesion

Question 51

interlimb reflexes are possibly the basis for

Answer 51

autonomic dysreflexia