Spinal cord injury/syndromes

Question 1

spinal cord injury

Answer 1

any pt with a severe heady injury should be presumed to have a spine injury/SCI

Question 2

concussion

Answer 2

injury caused by a blow or violent shaking

results in temporary loss of fx

Question 3

contusion

Answer 3

glial tissue/spinal cord surface remain intact

may be a loss of central grey and white matter

Question 4

laceration

Answer 4

the glia is disrupted and the spinal cord tissue may be torn

Question 5

pathogenesis SCI

Answer 5

secondary injury

syringomyelia

Question 6

secondary injury SCI

Answer 6

ischemia

hypoxia

edema

various biochemical events

blood flow changes

demyelination

loss of grey matter

dural scarring

loss of neural function

neurapraxia

Question 7

syringomyelia SCI

Answer 7

d/t cavitation of cervical spinal cord

destruction of ventral white commissure and interruption of decussating spinothalamic fibers

Question 8

syringomyelia SCI leads to

Answer 8

bilateral loss of pain and temp sensation

descending autonomics @T1 (Horner’s syndrome)

scoliosis

Question 9

clinical manifestations SCI

Answer 9

depends on level of injury

Question 10

C5-T1 SCI

Answer 10

brachial plexus

Question 11

L2-S4 SCI

Answer 11

lower limbs

Question 12

T1-L2 SCI

Answer 12

sympathetic NS

Question 13

S2-S4 SCI

Answer 13

parasympathetic

Question 14

spinal cord syndromes

Answer 14

complete transection of spinal cord

Question 15

spinal cord syndromes b/w C1-C3

Answer 15

exitus lethalis

usually death

Question 16

spinal cord syndromes C3-C4

Answer 16

quadriplegia

Question 17

spinal cord syndromes below T1

Answer 17

paraplegia

Question 18

clinical manifestations spinal cord syndromes

Answer 18

spastic paralysis of all voluntary movements below lesion

complete anesthesia below lesion

urinary and fecal incontinence (although reflex emptying may occur)

anhidrosis and loss of vasomotor tone

Question 19

if lesion is above C5 spinal cord syndromes

Answer 19

paralysis of volitional and automatic breathing

phrenic nuclear is found at C3-C5

Question 20

anterior cord syndrome

Answer 20

flexion injury causes loss of blood supply to anterior spinal artery

–> bilateral loss of motor function and pain/temp sensation

Question 21

central cord syndrome

Answer 21

hyperextension injury to C/S

–>severe neurologic involvement in UE

Question 22

posterior cord syndrome

Answer 22

rare

loss of proprioception below lesion

–> wide based steppage gait

Question 23

conus medullaris syndrome

Answer 23

S3-Co (d/t tumor or hemorrhage)

–> destruction of sacral parasympathetic nucleus (bladder/fecal incompetence) , peri anogenital sensory loss (saddle anesthesia)

ABSENCE motor deficits in LE

Question 24

epiconus syndrome

Answer 24

L4-S2 –> bowel and bladder reflex intact but no voluntary control

motor disability: ER & EXT of thigh most affected

affects ventral horn and long tracts

absence of achille’s tendon reflex

Question 25

cauda equina syndrome

Answer 25

L3-Co spinal roots

–> S&S similar to epicondus syndrome

spontaneous radicular pain

Question 26

filum terminalis syndrome

Answer 26

thickened and shorted filum terminale d/t traction

sphincter dysfunction

gait disorders

feet deformities