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69 Cards in this Set
- Front
- Back
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what usually causes a traumatic SCI
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damage to the vertebral column
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what is the difference between contusion and a laceration (relative to a SCI)
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- contusion: compression of the spinal tissue but the gross structure of the cord is intact
- laceration: very rare- severed! |
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what happens following the damage to the vertebral column in a SCI
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cascade of chemical and cellular responses are initiated that contribute to further tissue damage.... including inflammation, swelling, free radicals
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what is spinal shock
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areflexia, flaccidity that may last for days to weeks acutely after an injury
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what causes nontraumatic SCI
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loss of blood flow to the spinal cord, tumor, or infection
(aka spinal cord stroke) |
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difference between tetraplegia and paraplegia
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tetra is a quadriplegic (all 4 limbs involved)
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whats the difference between a complete and incomplete SCI
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complete: no sensory/motor remaining
incomplete: some sensory/motor remains below level of lesion |
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difference between UMN and LMN classification of SCI
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if spinal cord is intact below the lesion, UMN signs will be present below the level of the lesion.... at the level of the lesion, now is a LMN lesion contains cell body of that level
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how common are SCIs
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12,000/ year or 40 cases/million
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how many people live with SCI disability
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255,000
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what usually causes a traumatic SCI
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damage to the vertebral column
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what is the difference between contusion and a laceration (relative to a SCI)
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- contusion: compression of the spinal tissue but the gross structure of the cord is intact
- laceration: very rare- severed! |
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what happens following the damage to the vertebral column in a SCI
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cascade of chemical and cellular responses are initiated that contribute to further tissue damage.... including inflammation, swelling, free radicals
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what is spinal shock
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areflexia, flaccidity that may last for days to weeks acutely after an injury
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what causes nontraumatic SCI
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loss of blood flow to the spinal cord, tumor, or infection
(aka spinal cord stroke) |
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difference between tetraplegia and paraplegia
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tetra is a quadriplegic (all 4 limbs involved)
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whats the difference between a complete and incomplete SCI
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complete: no sensory/motor remaining
incomplete: some sensory/motor remains below level of lesion |
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difference between UMN and LMN classification of SCI
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if spinal cord is intact below the lesion, UMN signs will be present below the level of the lesion.... at the level of the lesion, now is a LMN lesion contains cell body of that level
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how common are SCIs
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12,000/ year or 40 cases/million
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how many people live with SCI disability
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255,000
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what age groups are at highest risk for SCI
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- young adults 16-30 (>50%)
- seniors >60 |
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what is the common MOI for young adults vs. seniors for an SCI
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young adults = risk takers
seniors = falls |
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what is the men to woman ration for SCI
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4 men to 1 woman
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race for SCI
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caucasion: 63%
african american: 27% hispanic: 11% |
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what are the two main categories for populations more likely for SCI
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- peopple active in sports (football and diving)
- predisposing conditions (osteoporosis, arthritis) |
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what is the order of most to least common levels of injury
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1) cervical 2) thoracic and 3) lumbosacral
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_____plegia is more common than _____ plegia
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tetraplegia more common than paraplegia
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__complete is more common than __complete
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incomplete is more common than complete
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what are the most common causes of SCI
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1) MVA (42%)
2) falls (after 65) 27% 3) acts of violence (15%) 4) sports/recreation (7%) 5) disease |
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what is the leading cause of SCI
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42%
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what is the most common MOI (related to trauma of the spinal cord)
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- flexion
- compression - hyperextension - flexion-rotation |
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what is the most common MOI
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flexion
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where is hyperextension injury most likely to occur
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cervical region
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flexion is associated with ____ syndrome and hyperextension is associated with _____ syndrome
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- flexion associated with anterior cord syndrome
- hyperextension associated with central cord syndrome |
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hyperextension injuries involve the _____ structures and flexion rotation injuries involve the _____ structures
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- hyperextension: posterior structures
- flexion rotation: lateral vertebral structures |
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most people with a SCI will recover some function, which can continue for how long after injury
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2 years post injury (but full recovery is VERY RARE)
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what is the IV steroid that may improve recovery for SCI injuries
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methylprednisolone
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methylprednisolone may improve recover by ____% if given within ____ hours after injury
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improve recovery by 20% if given within 8 hours after injury
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SCI-related death (acute) is usually due to
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respiratory issues or septicemia
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what medical testss/procedures can be used for dx SCI
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- x-rays for vertebral problems, tumors, fx, degenerative changes
- CT, MRI- for discs, clots, masses - myelography |
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what is myelography
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a special die is injected into the spinal canal to see the spinal nerves better- then use x-ray or CT
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what determines the neurological level of a SCI
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the most caudal level that still has normal function (sensory and muscle)
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what determines the motor level of a SCI
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there is a key muscle designated for each spinal cord level that must be at least a 3/5 in order to be considered intact
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all muscles above the level of the SCI should be ______ for MMT
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5/5
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the muscles AT the level of the SCI should be _____ for MMT
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min. 3/5
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what determines the sensory level of a SCI
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the highest level of injury that shows asymmetric, impaired, or absent sharp/dull and light touch
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on the impairment scale A =
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complete (no motor/sensory below the level of the lesion)
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on the impairment scale B=
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incomplete, sensory but no motor
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on the impairment scale C=
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incomplete, sensory and motor more than half <3
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on the impairment scale D=
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incomplete, sensory and motor more than half 3 or >
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on the impairment scale E=
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normal
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what is sacral sparing
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preservation of sensation and/or motor function in the sacral region
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what does the presence/absence of sacral sparing tell about the SCI
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presence of sacral sparing = incomplete SCI
absence of sacral sparing = complete SCI |
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what is "zone of partial preservation
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still considered a complete injury (assumes no sparing) but there's some residual function (sensory/motor - typically sensory) below the neurological level
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what is central cord syndrome
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UE>LE involvement
- paralyzed arms and intact legs with sacral sparing |
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what injuries could cause central cord syndrome
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- hyperextension injury
- compression of cord b/t ligamentum flavum and vertebral body |
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what is anterior cord syndrome
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loss of motor and pain/temp with preserved proprioception, kinesthesia, vibration and variable function loss
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what injuries could cause anterior cord syndrome
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flexion injuries
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what is brown-sequard syndrome
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- hemisection of the cord
- weakness and loss of sensation on the ipsilateral side - ALL LMN! - pain and temp loss on CL side |
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what injuries could cause brown-sequard syndrome
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penetration injuries (GSW, stab/pierce)
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what is cauda equina syndrome
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injury to spinal roots (LMN) in cauda equina
- areflexic bladder, bowel, LEs |
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UMN lesion Signs
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- spasticity
- spasms - maintains muscle bulk even with no active movement |
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LMN lesion signs
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- flaccidity
- atrophy |
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what is the emergency care for SCI
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- stabilize the pt. (collar, backboard)
- maintain airway/breathing/circulation - immobilize the spine |
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what are the options for decompression
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- traction (cervical)
- surgery (to reduce compression on the cord d/t swelling) |
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what are the types of surgery done for decompression
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1) laminectomy: provides space in vc by removing lamina and spinous process
2) fusion: internal stabilization |
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what are the options for external stabilization
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- orthoses
- halo -minerva -CTLSO (cervical-thoracic-lumbar spine orthosis) - TLSO - LSO - Cervical collars |
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what is the prophylactic medication for SCI and why
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anticoagulants because SCI are at high risk for DVTs
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what are the 3 research/experimental therapies currently for SCI
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1) activated macrophages to help repair the cord
2) altrnating currents to stimulate regeneration 3) drugs to stimulate growth factors and stem cell proliferation |
