W8 - Soinal Cord Injuries

Question 1

Ame the 3 ascending afferent sensory spinal tracts

Answer 1

Dorsal column
Spinocerebellar
Spinothalamic

Question 2

Name the descending efferent motor spinal tracts

Answer 2

Corticospinal tracts (anterior & lateral)
Rubrospinal tract
Retículo spinal tract
Vestibulospinal tract
Tectospinal tract

Question 3

What are the 2 causes of a spinal cord injury

Answer 3

Traumatic
Non-traumatic

Question 4

What are the 3 different mechanisms of a traumatic SCI

Answer 4

Destruction from direct trauma
Compression by done fragment, hematoma or disc material
Ischemia damage or impingement on the spinal arteries

Question 5

What can cause a non traumatic SCI

Answer 5

Degenerative disc disease & soinal canal stenosis
Soinal infarct
Tumour
Inflammation of soinal cord
Viral infection
Developmental/congenital abnormalities

Question 6

Name the 2 types of SCI

Answer 6

Complete
Incomplete

Question 7

What is a complete SCI

Answer 7

Complete loss of function below the injury

Question 8

What areas are affected in a complete SCI

Answer 8

Motor
Sensory
Autonomic dysfunction

Question 9

Name some symptoms of a complete SCI

Answer 9

Postural hypotension - vasomotor control
Autonomic dysreflexia (medical emergency)
Promblems with bladder & bowel function
Problems with sexual function

Question 10

What is autonomic dysreflexia

Answer 10

When the autonomic nervous system overreacts to stimulation causing an exaggerated reflex that increases blood pressure in response to a stimuli from below the level of injury
Normally a noxious stimuli & occurs in in injuries above T6

Question 11

Symptoms of autonomic dysreflexia

Answer 11

Severe headaches, pale skin, cold, bradycardia, facial flushing & sweating in the lower body

Question 12

What is the type of SCI called that causes an impaired ent at the cervical segments & affects all 4 limbs

Answer 12

Tetraplegia or Quadraplegia

Question 13

What is the name for the type of SCI that causes an impairment at the thoracic, lumbar or sacral segments & affects lower limbs

Answer 13

Paraplegia

Question 14

What vertebrae in the cervical spine are more vulnerable to SCI and why

Answer 14

C5-7
Due to holding the weight of the head, pivot point & increase mobility

Question 15

Where in the thoracolumbar region of the spine are SCI more likely to happen

Answer 15

T12

Question 16

What are the majority of traumatic SCI due to

Answer 16

Dislocations

Question 17

Name the 5 incomplete spinal cord injuries

Answer 17

Central cord syndrome
Anterior cord syndrome
Brown-sequard syndrome
Posterior cord syndrome
Cauda equina syndrome

Question 18

What dysfunctions does central cord syndrome cause

Answer 18

Motor dysfunction in upper limbs
Bladder dysfunction

Question 19

Why does central cord syndrome cause motor dysfunction in the upper limbs

Answer 19

Due to the positioning of the corticospinal tract fibres.
The fibres that supply the upper limbs sit more centrally compared to the fibres that supply the lower limbs ( they sit more laterally)

Question 20

What 2 spinal tracts are involved in a central cord syndrome

Answer 20

Corticospinal & spinothalamic tracts

Question 21

What symptoms can occur due to a central cord syndrome

Answer 21

Loss of sensation of pain, temperature and motor control in the limbs below the level of injury

Question 22

What does anterior cord syndrome cause cause

Answer 22

Motor paralysis below the lesion
Loss of pain & temperature sense
Retained proprioception & vibration (due to dorsal column still being in tact’s)

Question 23

What can cause an anterior cord syndrome

Answer 23

Disc herniation

Question 24

What is affected in an anterior cord syndrome

Answer 24

2/3 of the spinal cord

Question 25

What cause brown-sequard syndrome cause

Answer 25

Motor deficit & numbness to touch & vibration on the same side of lesion Loss of pain & temp sensation on opposite side (due to the crossing over of the tracts)

Question 26

What causes a brown-sequard syndrome

Answer 26

Stab or gunshot wound to cervical or thoracic spine

Question 27

What areas of the spinal cord is affected by a brown-sequard syndrome

Answer 27

Half of the spinal cord

Question 28

What does a posterior cord syndrome cause

Answer 28

Sensory disturbance & less motor loss (corticospinal tract still in tact) Compression to posterior/sensory section of the spinal cord

Question 29

What causes a posterior cord syndrome

Answer 29

Posterior impact or hyper-extension trauma (common in infection or toxic causes)

Question 30

What is affected in a cauda equina syndrome

Answer 30

Motor & sensory loss in lower limbs below Saddle anaesthesia Bilateral lower limb sensory changes

Question 31

What can cause a cauda equina

Answer 31

Lumbar stenosis Spinal trauma Metastatic tumour

Question 32

Immediate medical management for a SCI

Answer 32

Stabilisation treatment Normal o2, perfusion & acid/base balance to aid management of the injury Vasogenic oedema & altered flow account for clinical deterioration (hypotension & shock can aggravate SCI) surgery = decompression, removal of foreign body, stabilisation of spine

Question 33

Post acute management of complications to a SCI

Answer 33

Urinary & bowel management Skin integrity (pressure sires) DVT from reduced movement Autonomic dysreflexia at or above T6 Orthostatic hypotension

Question 34

Define the level of lesion

Answer 34

The first spinal segmental level that shows abnormal neurological loss

Question 35

What outcome measure is used to measure SCI

Answer 35

ASIS impairment scale