Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/38

Click to flip

38 Cards in this Set

  • Front
  • Back
SCI
spinal cord injury, traumatic injury to the spinal cord
spinal elements

spinal injury
bone

injury to BOTH Spinal elements AND spinal cord
Pedicle Screws
screws/bar to stabilize spine
patient will have fused spinal elements in lumbar spine for stability
SCI is usually due to injury of...
spinal elements
not destabilizing injuries?

destabilizing injury
injuries in back half of vert containing spinous process
injury to body of vertebrae
Minor spinal injuries

major spinal injuries
do NOT cause instability

cause instability (4types)
compression/wedge, burst, flexion-distraction, fracture/dislocation
what is the most common destabilizing spinal injury?
compression(wedge) fractures
bony elents in spinal canal

just bony fragments, no protrustion
SCI

Spine Injury
Compression(wedge) fractures
from axial loading/unloading
failure of ant column
VERY common
Burst Fractures
typically result in SCI
axial loading w/ both Ant and Middle colums compromised
retropulsion
Fracture Dislocation
typically cause SCI
MOST DAMAGING- failure in all 3 columns
dislocation and displacement
SCI
spinal cord injury
injury to the SC resulting in fxnl deficits
SCI has 2 elements
1. direct mechanical injury. Initiating event
2. Lengthy secondary injury
*Clinician's main concern
Functional Incomplete



Functional Complete
limited sensory/motor function at or below level of injury. SC not cut in half
-90% SCI patients
no sens/motor below level or injury
*cord still not severed, but enough damage
*typicaly involves SACRAL cord
4:1 gender ratio in SCI

average age?
81% male, 19% female
same cross-culturally
38-median is 34
average age is increasing
most common cause of SCI

location
driving accidents and Falls

c5-14%, c4-13%
almost everyone above C5 is...
intubated in acute care
complete C5 is ventilated for life
quadriplegic

paraplegic
everything below C4/C5

everything below T12
life expectancy of 20yr old w/o SCI

w/ SCI
58yrs

45yrs if paraplegic
Life expectancy singificantly decreaes with?
ventilator-dependent injury
increasing demographic of SCI
elderly females.
SCI over 60 is INCREASING

falls, osteoporosis (10yrs post menopause)
in research, can older animals have same recovery as younger?
YES. can reduce higher secondary complications with immediate treatment

DO NOT TRIAGE PEOPLE BASED ON AGE
Von Frey Filaments
used in neurological exam
determine if pt can feel at dfft levels/dermatomes
Neuro Exam


C8/T1 lesion
L1/L2/L3
1. patient movement
2. von frey filaments

reduced finger abduction
reduced hib flexion/rotation
Shock
1st thing that happens after trauma
SC shock lasts 48hours
standard of care for blunt SCI
methylprednisone (corticosteroid)
start w/i 8hours of inury
dont use w/ gunshot wound
highest return of function request by SCI patients
bowel/bladder
sexual fxn

NOT movement
chirstopher reeves died of what?

significant complication
pressure sore complications

bed sores/pressure sores
4 stages
90% of SCI patients have this
chronic neuropathic pain
starts from CNS damage
typically burning pain sensation
sugery to cut nerve root worsens pain
Nicotinic Ach Rec involved in what?
neuropathic pain after SCI
Pathophys of acute SCI
1. ischemia
2. edema
3. Ionic changes
4. excitotoxicity
Ischema
hypoperfusion of grey mater
indescriminate rel of Vasoconstrictors
Edema
Maximum damage in this stage!
main target of methyl prednisone
Ionic changes
inc intracellular Ca- peaks at 8hrs- lasts 1 week
wide therapeutic window for treatment
Excitotoxicity
indiscriminate rel of Glu
Animal Models
have high face validity
estrogen neuroprotective?
17B-estradial (E2)- ring B saturated
low toxicity profile

Premarin (horse urine) has high toxicity profile
Triage
any complaint of neck/back pain is assumed spine injury
*airway, breathing, circulation, stabilize spine
immobilize spine for trans
neurological testing