Spinal Cord Injury

Front 1

What are the four vertebral bone segment sections, and how many segments does each contain?

Back 1

-cervical (C1-C7)
-thoracic (T1-T12)
-lumbar (L1-L5)
-sacral (S1-S5)

Front 2

What is the tail bone called?

Back 2

coccygeal

Front 3

Dermatome

Back 3

area of skin mainly supplied by a single spinal nerve

Front 4

What are the two descending nerve fibre tracts in the spinal cord, and what is the function of each?

Back 4

-corticospinal (voluntary movement)
-recticulospinal (walking and posture)

Front 5

What are the three ascending nerve fibre tracts in the spinal cord, and what is the function of each?

Back 5

-dorsal columns (touch, proprioception, vibration)
-spinocerebellar (movement regulation)
-spinothalamic (pain, temperature)

Front 6

What are the five same side impairments, and one opposite side impairment exhibited in Brown-Sequard syndrome?

Back 6

-same side: movement, proprioception, vibration, 2-point discrimination, joint/position sensation
-opposite side: temperature/pain sensation

Front 7

Central pattern generator

Back 7

possible neuronal circuit for generating rhythmic reciprocal activity for walking based on switching due to self-inhibition of inhibitory interneurons

Front 8

Where is the rhythmic pattern generating network for walking located, and what was the evidence supporting its existence?

Back 8

-lumbar spinal cord
-electrical stimulation of SC evoked rhythmic activity in leg muscles seen on electromyograms

Front 9

Why is control of bladder and bowel function often lost after SCI?

Back 9

coordination of autonomic and somatic responses for normal bladder function require neural networks in the brain stem

Front 10

What are the U.S. incidence, prevalence, and age group most commonly injured statistics for spinal cord injury?

Back 10

-approx. 10000/year, 80% males
-est. 183000 to 230000 trauma-related SCI
-16 to 30 years (43%) followed by 31 to 45 years (28%)

Front 11

What are the leading causes of spinal cord injury in the categories of vehicle accidents, violence, and sports?

Back 11

-car crashes
-gun shots
-driving

Front 12

Needs/function deficits of SCI patients (8)

Back 12

-independent respiration
-bladder/bowel function
-sexual function
-freedom from pain, hypertonus, and spasms
-arm and hand function
-trunk posture
-standing
-walking

Front 13

Additional complications of SCI (5)

Back 13

-development of hyperactive reflexes/spasms
-autonomic dysreflexia
-pressure ulcers
-loss of bladder and bowel control
-neuropathic pain weeks/months after injury

Front 14

Paraplegic

Back 14

impairment of legs, lower trunk, and bladder/bowel function

Front 15

Quadriplegic (tetraplegic) and neck region deficit

Back 15

partial/total loss of limb/torso function and bladder/bowel function; maybe unable to breath if damage in neck region (C1-C5)

Front 16

Autonomic dysreflexia

Back 16

extended bladder activates SNS resulting in dangerously high blood pressure that isn't compensated by central inhibition to the heart

Front 17

What is the function of the drug baclofen, and how is it administered?

Back 17

-an inhibitory neurone GABAa receptor agonist that increases presynaptic inhibition of transmission from sensory afferents
which reduces severe spasticity
-intrathecal (spinal canal) or orally for mild spasticity

Front 18

Immediate treatments for SCI (3)

Back 18

-immobilization
-sometimes surgery to decompress cord, remove bone fragments, and align vertebra
-drugs to reduce swelling and inflammation

Front 19

What is secondary damage in SCI and what seven factors are involved with it?

Back 19

-increase in cell death and demyelination in days/weeks following primary injury
-ischemia, edema, glutamate increase, blood brain barrier breakdown, invasion from macrophages, activation of microglia, and inflammation

Front 20

Walkaid

Back 20

device electrically stimulates nerve to ankle flexor muscle near the end of stance (designed by Dr. Stein)

Front 21

Why can't damaged axons in the CNS regenerate? (2)

Back 21

growth inhibitors on CNS myelin, and mechanical barrier like scar tissue

Front 22

Growth inhibitors

Back 22

molecules on CNS myelin or extracellular matrix that prevent growth cone extension

Front 23

Growth inhibitor examples (4) hints:MAG, OMgp, CSPGs

Back 23

-nogo-A
-myelin associated glycoprotein MAG
-oligodendrocyte myelin glycoprotein OMgp
-Chondroitine sulphate proteoglycans CSPGs

Front 24

How do researchers plan to promote regeneration of damaged axons? (3)

Back 24

blocking growth inhibitory molecules, bridging damaged regions, and digesting scar tissue

Front 25

How do researchers plan to enhance the function of existing nerve cells? (2)

Back 25

remyelinate axons, and promote sprouting

Front 26

What are four ways to bridge a lesion site?

Back 26

mechanical bridges, Schwann cells to produce myelin, olfactory ensheathing cells, and stem cell to produce a growth promoting environment

Front 27

How are researchers trying to block inhibitors on myelin or receptors on growth cones?

Back 27

applying antibodies tested for Nogo on oligodendrocytes, and anti-nogo is currently in clinical trials

Front 28

What enzyme digests a scar?

Back 28

chondroitinase

Front 29

What is a promising approach to enhancing plasticity of undamaged neurons?

Back 29

increase cAMP levels in undamaged neurons