Spinal Injuries

Question 1

why can spinal injury classification not be diagnosed acutely?

Answer 1

due to spinal shock

Question 2

describe complete spinal injury

Answer 2

> no chance of recovery
no sacral sensation
no sensory function distally
no motor function distally

Question 3

describe an incomplete spinal injury

Answer 3

some function is present below the site of the injury and it carries a more favourable prognosis

Question 4

describe grade a classification of spinal injury

Answer 4

complete

Question 5

describe grade b classification of spinal injury

Answer 5

incomplete

sensory is preserved

Question 6

describe grade c classification of spinal injury

Answer 6

> incomplete
motor function is preserved
majority key muscles have a grade 3> motor function

Question 7

describe grade d classification of spinal injury

Answer 7

> incomplete
motor function is preserved
majority of key muscles have grade 3

Question 8

describe grade e classification of spinal injury

Answer 8

normal motor and sensory function

Question 9

what can cause a spinal injury?

Answer 9

> thoracoabdominal aortic aneurysm
> infarct
> tumours
> sport
> RTA
> falls

Question 10

what is tetraplegia?

Answer 10

partial loss of use of all 4 limbs and the trunk due to loss of function in cervical segments of the spinal cord

Question 11

what is the presentation of tetraplegia?

Answer 11

> respiratory failure due to loss of innervation of the diaphragm
spasticity (increased muscle tone)

Question 12

what is paraplegia?

Answer 12

partial/total loss of lower limb use due to loss of function in the thoracic lumber or sacral segments

Question 13

is the bladder and bowel function affected in paraplegia?

Answer 13

yes

Question 14

what can cause central cord syndrome?

Answer 14

hyperextension injury (in older patients with an arthritis neck

Question 15

what is affected in central cord syndrome?

Answer 15

the central cervical tracts

Question 16

how does central cord syndrome present?

Answer 16

> weakness is in the arms more than the legs
perianal sensation affected
lower extremity power preserved

Question 17

what can cause an anterior cord syndrome?

Answer 17

hyperflexion injury- anterior compression fracture

Question 18

what is damaged in anterior cord syndrome?

Answer 18

anterior spinal artery

Question 19

how does anterior cord syndrome present?

Answer 19

> profound weakness

> preserved proprioception and fine touch

Question 20

what is a hemi-section of the cord called?

Answer 20

brown-sequard syndrome

Question 21

what can cause brown-sequard syndrome?

Answer 21

a penetrating injury

Question 22

how can brown-sequard syndrome present?

Answer 22

> paralysis on the affected side (corticospinal)
loss of proprioception and fine discrimination (dorsal columns)
pain and temperature loss on the opposite side (spinothalamic)

Question 23

what is spinal shock?

Answer 23

transient depression of cord function below the level of the injury

Question 24

how does spinal shock present?

Answer 24

> areflexia
flaccid paralysis
lasts several days

Question 25

how does neurogenic shock present?

Answer 25

> hypotension > bradycardia > hypothermia

Question 26

what is neurogenic shock?

Answer 26

secondary disruption of the sympathetic flow

Question 27

what management can be offered in unstable fractures?

Answer 27

surgical fixation

Question 28

what long term management is available for spinal injuries?

Answer 28

> psychological support > OT > physiotherapy > urological and sex counsellung