Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

529 Neuro > Spinal Cord Injury Pathology and Acute Management > Flashcards

Spinal Cord Injury Pathology and Acute Management Flashcards

(57 cards)

Start Studying
1
Q

Neuroanatomy: sensory nerve root

A

impulses about bodily sensations from sensory nerve fibers converge to form nerve roots at the back of the spinal cord
- impulses are conveyed to the brain via nerve fiver tracts

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

Neuroanatomy: sensory root ganglion

A

a cluster of nerve cell bodies, connects to sensory spinal root

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

Neuroanatomy: motor nerve root

A

bundles of fibers that leave the front of the spinal cord, the fibers conduct impulses from the central nervous system
- control voluntary movement and involuntary processes (like digestion)

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

Neuroanatomy: meninges

A

protective connective tissue around the spinal cord

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

Neuroanatomy: central canal

A

space where CSF fills to provide nourishment to nerve cells

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

Causes of a spinal cord injury:

A

39.2% MVA
14.6% acts of violence
28.3% falls
9.7% other/unknown
8.2% sports

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

Who is more commonly affected by SCI?

A

men (80.9%) > women (19.1%)

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

Common SCI injury sites:

A

C4, C5, C6

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

Prevention of SCI

A
  • distraction while driving with phones
  • child safety seats
  • fall prevention in elderly
  • wear your seatbelt
  • helmets with bikes/scooter
  • watch where you dive when swimming
  • don’t dive head first at the beach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Classification of SCI

A

cervical = tetraplegia
thoracic = paraplegia
lumbar = paraplegia

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

What did most people expire from in the early 1900s?

A

respiratory or circulatory problems

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

What year was the radical shift in medical care?

A

1970s

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

What did the radical shift in medical care create?

A

reductions in complete injuries
- improvements in precautions in the emergency room
- intermittent bladder cauterization for renal failure

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

What did they use to stabilization unstable spinal cord before the use of vertebral internal stabilization?

A

stryker frames (bed that patient is tied to that turns used for SCIs and burns)

THINK JOHNNY IN THE OUTSIDERS- HE WAS FLIPPED FACING THE FLOOR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medical improvements in SCI

A
  • surgical interventions in the 1970s (vertebral stabilization)
  • spasticity medications (baclofen, intrathecal baclofen, botox)
  • urological management
  • lighter wheelchairs
  • lightweight orthotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of SCI: traumatic

A
  • rarely complete disruption of the spinal cord
  • burst fracture or vertebral body
  • usually a younger age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of SCI: non-traumatic

A
  • lower incidence of complete SCI
  • shorter length of stay
  • lower secondary complications
  • usually 55+ years
  1. transverse myelitis
  2. epidural hematoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Etiology: direct trauma

A
  • fractured vertebrae
  • edema and bone fragments
  • vertebral dislocation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Non-traumatic SCI:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Transverse myelitis

A
  • inflammation of the spinal cord
  • lesions on the C spine from antibodies when a person becomes sick (virus/bacteria)
  • antibodies build up and attack spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Initial presentation of transverse myelitis

A
  • sharp pain at level of inflammation
  • sensory alterations (paresthesia)
  • bowel and bladder dysfunction (voiding problems)
  • arm and leg weakness
  • headache
  • nausea/vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Viral etiology of transverse myelitis

A
  • herpes
  • enterovirus
  • epstein barr
  • west nile
  • hep B
  • measles
  • mumps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bacterial etiology of transverse myelitis

Study These Flashcards
A
  • syphilis
  • tuberculosis
  • middle ear infection
  • GI infections
  • tetanus
24
Q

Inflammatory disorder etiology of transverse myelitis

Study These Flashcards
A
  • sjogren’s
  • lupus
  • mixed connective tissue disease
  • scleroderma
25
Vascular disorders that cause SCI
- ischemia (anterior or posterior spinal arteries) - vasculitis of spinal arteries - vascular malformations (arterial or venous)
26
Spinal cord compression can be caused by:
- epidural hematoma - metastasis - spinal stenosis
27
Etiology of spinal stenosis
- OA - DDD/DJD - facet joint enlargement - narrow spinal canal - scoliosis - spondylolisthesis - RA
28
Syringomyelia
fluid within the spinal cord from a cyst grows or distention of the central canal
29
Phases of a traumatic SCI
acute, cell death, chronic
30
Traumatic SCI: acute phase
- spinal shock 30-60 mins - flaccid paralysis - no DTRs for 24 hrs
31
Traumatic SCI: cell death phase
- glutamate 6x higher for 15 mins to weeks - apoptosis
32
Traumatic SCI: chronic phase
- apoptosis continues days to years - demyelination - changes in neural circuitry - chronic pain - spasticity
33
SCI pathology: inflammation acute
0-48 hrs - 3 levels above and below site - compression of neural tissue - hemorrhage - spinal shock
34
SCI pathology: subacute
2-14 days - hemorrhage - edema - glial scar tissue - ischemia - excitotoxicity - cytokine number increases - oxidative stsess
35
Chronic phase: SCI
- white matter disruption (demyelination axons) - gray matter disruption - glial cell cyst formation - axonal sprouting (regeneration and sprouting after SCI)
36
What happens to the injured area several weeks after injury?
- damaged tissue is cleared my microglia and macrophages - a cavity is formed and is filled with fluid - a glial scar is formed with astrocytes
37
What does the glial scar do at the injury site?
the scar secretes molecules that inhibit regrowth of severed axons
38
What is the fluid filled cavity called?
syrinx - it forms a barrier to the reconnection of the two sides of the damaged spinal cord
39
What do oligodendrocytes do in an injury?
IN NORMAL BODY - produce neurotrophic factors to support the maintenance of nerve cells IN SCI - oligodendrocytes are lost due to the toxic environment resulting in loss of myelin and neuronal regeneration
40
Differential diagnosis of SCI
- spinal epidural hematomas and abscesses may cause acute cord compression - spinal cord compression from metastatic disease - aortic artery dissection - epidural and subdural infections - syphilis - transverse myelitis - acute intervertebral disc herniation
41
Central cord syndrome
UE deficits are greater than the LE deficits - LE corticospinal tracts are located lateral in the cord - the most common incomplete cord syndrome - frequently in elderly with underlying spondylosis or younger people with severe extension injury (forced extension!!) - average prognosis WILL HAVE: - complete loss of motor function in UE - incomplete loss of motor function in torso - UE > LE - distal muscles > proximal muscles
42
Anterior cord syndrome
- caused by an extreme flexion injury (flexion tear drop fracture), burst fracture, or herniated disc - presents with immediate paralysis bc the corticospinal tracts are located on the anterior aspect of spinal cord - poor prognosis WILL HAVE: - loss of motor function below lesion (ipsilateral) - loss of pain and temp below lesion (contralateral) - preserved position, touch, and vibration
43
Posterior cord syndrome
- uncommon - disruption of dorsal columns - due to extension injury - good prognosis WILL HAVE: - loss of positioning sense
44
Brown sequard syndrome
- rotational injury (fracture, dislocation, penetrating trauma) - hemisection of spinal cord - extradural compression - hyperreflexia in weak leg WILL HAVE: - ipsilateral motor weakness and decreased joint position/vibration - contralateral sensory deficit (pain/temp)
45
What are the 2 things we do for immediate management of SCI?
stabilization and pharmacology/modalities
46
Immediate management of SCI: stabilization
short term --> traction to stabilize C SPINE - surgical = fusion with philadelphia collar - traction = halo for bone healing 6-12 weeks T/L SPINE - internal fixation - TSLO (thoracic lumbar sacral orthosis)
47
Immediate management of SCI: pharmacology
NO MEDS - hypothermia to reduce edema/inflammation (ice packs)
48
What does hypothermia do for SCI?
- reduces inflammation/edema - protects against ischemia - MAY increase complications (pneumonia) *** not a certain benefit in neurologic recovery/outcomes
49
Motor recovery prognosis for incomplete lesions
- C spine 2x greater recovery if incomplete - preservation of sensation at the motor level improves the probability of motor return - recovery at 72 hours post injury is predictive
50
Motor recovery prognosis for incomplete lesions: walking function
- increased motor scores between one month and one year - first six months has the GREATEST recovery - one month post injury ambulate with orthosis
51
What ASIA scores are needed to begin ambulation training?
- 10/50 motor score - at least 2/5 in hip flexors and knee extensors
52
5 areas of critical concern for the SCI team:
1. cardiovascular/hypotension 2. autonomic changes 3. bowel/bladder dysfunction 4. respiratory 5. skin integrity
53
What complications result from autonomic dysfunction?
hypotension and cardiovascular complications
54
Autonomic dysreflexia
above T6 level is LIFE THREATENING - loss of supraspinal regulation of autonomic function 1. irritation below the point of SCI sends nerve signals up the spine 2. nerve signals are blocked at the SCI causing blood vessels to tighten and raise in BP 3. brain sends signals to lower BP but but the signals are blocked so other symptoms result (sweating/headache)
55
Common causes of autonomic dysreflexia
- bladder distention - UTI - constipation - hemorrhoids - pressure ulcers - bone fractures
56
S/S of autonomic dysreflexia
- headache - high BP - bradycardia - sweating - cardiac arrhythmias - flushing of the skin
57

529 Neuro (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions