Week 5 Flashcards
(16 cards)
Types of spinal cord injury
Complete = absence of sensory or motor function in the lowest sacral segments
Incomplete = only used when there is partial preservation of sensory or motor function below the neurological level and including the sacral segment.
Complete spinal cord injur
- Slower recovery time
- Complete loss of sensation and motion
- Both side of the body equally affected
- Severely or fully damage
- Often diagnosis with ASIA impairment scale as grade A
Incomplete spinal cord injury
- Rapid recovery time
- Partial loss of sensation and motion
- Able to feel pain
- One side is more affected than others
- Partially damage
- Depends on functional level
(ASIA B,C,D)
Central cord syndrome
incomplete injury, centre of cord damaged, more weakness in upper limbs than lower limbs
Brown-Sequard syndrome
half of cord damaged causing ipsilateral loss of proprioception (covered in sensory prac) & motor function; contralateral loss of pain & temperature
Anterior cord syndrome
front of cord damaged resulting in variable loss of motor and sensory function, preservation of proprioception
Conus Medullaris syndrome
damage to sacral cord and lumbar nerve roots, impaired bladder, bowel and lower limb function
Cauda Equina syndrome
lower motor neuron injury to lumbosacral nerve roots, impaired bladder, bowel & lower limb function
Tetraplegia
- Functional impairment of arms, trunk, legs (tetra = four)
- Motor and sensory impairment of cervical segments
Paraplegia
- motor and sensory impairment of thoracic, lumbar and sacral spinal segments
Cervical SCI can lead to tetraplegia (quadriplegia)
paralysis of both arms and legs—due to the interruption of motor pathways controlling limb and trunk muscles.
What determines severity of SCI
- the level (C1–C8)
- completeness of the injury
Secondary impairments of SCI
- Respiratory Complications
- Pressure Injuries (Pressure Ulcers)
- Neurogenic Bladder and Bowel
- Spasticity and Contractures
- Pain
- Thermoregulation Impairment
- Psychological and Cognitive Issues
- Sexual Dysfunction
evaluation of sensation.
- Pain awareness test:
Using a safety pin to prick the skin - Temperature awareness test:
Use hot and cold discrimination glass test tubes filled with warm and cool water. - Stereognosis: place an object on the patients palm and they manipulate the object and try and name it
- Touch threshold:
Explain to the patient that you will be applying a monofilament (show it to them) to the skin and that they should indicate if they feel it by saying “touch”. - Proprioception kinesthesia
Explain to the patient that you will be placing their ‘impaired’ arm in different positions and you want them to describe verbally the direction (up, down, in (towards body), out (away from body), and so forth) and range of movement while the extremity is in motion.
Clinical Presentation
Initial Signs:
- Loss of motor and sensory function below the level of injury
- Paralysis
- Loss of reflexes
- Impaired autonomic function: bladder/bowel dysfunction, hypotension, bradycardia
Spinal Shock Phase:
- Occurs immediately post-injury
- Can last days to weeks
components of a pressure care assessment
- skin integrity assessment (color, moisture, breakdown)
- Pressure injury history
Risk assessment tools (e.g., Braden Scale) - Mobility and positioning assessment
- Seating and support surfaces
- Continence status
- Education: Individual and caregiver training
- Monitoring and documentation: Regular reviews and risk management plans
