Spinal Cord Injury

Front 1

In the cervical spine, which spinal segments are most often injured?

Back 1

C1, C2, C5, C7

Front 2

In the thoracolumbar area, which spinal segments are most often injured?

Back 2

T12 through L2

Front 3

Why does injury occur more frequently at some levels than others?

Back 3

Movement(rotation) is greatest at these segments and leads to instability

Front 4

What is the American Spinal Injury Association

Back 4

Created the international standards for neurological classification of spinal cord injury to standardize the way in which severity of injury is determined

Front 5

Neurological level (ASIA)

Back 5

the most caudal level of the spinal cord with normal motor and sensory function on both the left and right sides of the body

Front 6

Motor level (ASIA)

Back 6

The most caudal segment of the spinal cord with normal motor function bilaterally

Front 7

Sensory Level (ASIA)

Back 7

The most caudal segment of the spinal cord with normal sensory function bilaterally

Front 8

How is the sensory level (ASIA) determined?

Back 8

Sensitivity to light touch and pinprick test

Front 9

What are the types of spinal cord injury?

Back 9

Traumatic

Non-traumatic

Complete Injury

Incomplete Injury

Front 10

What is the number one cause of traumatic spinal cord injury?

Back 10

MVA-40%

Falls-27%

***Most frequent cause of spinal cord injury

Front 11

In the cervical region, what is the most common type of injury cause?

Back 11

Flexion and rotation forces

**Rear-end MVA produce flexion and rotation

Front 12

A pure hyperflexion force causes what type of fracture?

Back 12

Anterior compression fracture due to stretching of the posterior longitudinal ligaments

Front 13

Cervical hyperflexion usually results in what type of spinal cord injury?

Back 13

Severs the anterior artery and results in incomplete anterior cord syndrome

**head on collision

Front 14

What is GM-1 Ganglioside

Back 14

Limits the amount of inflammation, decreases effects of ischemia, and enhances blood flow

Front 15

Once a pt. is injured, what should you do?

Back 15

Immobilize the patient to stabilize the spine to prevent further damagge

Front 16

What does recovery depend on?

Back 16

1. the extent of pathologic changes

2. The prevention of further trauma

3. Prevention of secondary medical complications

Front 17

What are some examples of non-traumatic injury?

Back 17

Arteriovenous malformation

thrombosis/embolus

Hemmorrhage

Vertebral subbluxations

Abscess of the spinal cord

neurological diseases

infections

Front 18

Complete Injury

Back 18

No sensory or motor function in the lowest sacral segments (s4-s5)

Front 19

How are sensory and motor function determined at s4-s5

Back 19

by anal sensation and voluntary external anal sphincter contraction

Front 20

Incomplete injury

Back 20

having partial motor and/or sensory function below the neurological level including sensory and/or motor function at s4-s5

Front 21

What must be present for an injury to be classified as incomplete?

Back 21

Perianal sensation must be present

Front 22

Tetraplegia (quadriplegia)

Back 22

Complete paralysis of all four extremities and trunk

Injuries to cervical spine

Front 23

Paraplegia

Back 23

Complete paralysis of all or part of the trunk and both lower extremities

Results from lesions in the thoracic or lumbar spine

Front 24

Cauda equina injuries

Back 24

Injuries at L1 or below

Front 25

Is it better to have an incomplete or complete lesion?

Back 25

Incomplete-recovery or motor function

**may be able to walk

Front 26

Brown-sequard syndrome

Back 26

Hemisection of the spinal cord caused by penetration wounds

Features on the same side as lesion

Front 27

Clinical features of brown-sequard syndrome

Back 27

Ipsilateral-paralysis, sensory, and motor function loss

Contralateral-loss of sense of pain and temperature

Front 28

Anterior Cord Syndrome

Back 28

Flexion injuries of the cervical region-damage to anterior spinal cord

Front 29

Clinical features of anterior cord syndrome

Back 29

Loss of motor function and sense of pain and temperature bilaterally below the lesion

-proprioception, light touch, and vibratory sense are preserved

Front 30

Central Cord Syndrome

Back 30

**Most common SCI syndrome

results from stenosis, compression that is the consequence of hyperextension in the cervical region

Front 31

Clinical characteristics of central cord syndrome

Back 31

More neurological involvement of UE than LE

Sensory impairment< motor impairment

Preservation of sexual, bowel and bladder

Front 32

Cauda Equina Injuries

Back 32

Direct trauma from a fracture-dislocation below L1

-Usually incomplete

-Peripheral nerve injuries

Front 33

Clinical characteristics of cauda equina injuries

Back 33

Flaccidity, areflexia, loss of bowel and bladder. Lower extremity paralysis and paresis

Front 34

Root escape

Back 34

Damage to the nerve root within the vertebral foramen can lead to a peripheral nerve injury

Front 35

Dorsal Column/Posterior Cord

Back 35

Incomplete injury that results from damage to posterior spinal artery

Loss of sensory functions

**rare

Front 36

Spinal Shock

Back 36

Following an SCI

Period of flaccidity, areflexia, loss of bowel and bladder function, and loss of autonomic functions

Front 37

How long does spinal shock last?

Back 37

24 to 48 hours

Front 38

Autonomic Dysreflexia

Back 38

Autonomic reflex that can be life threatening

Front 39

Where does autonomic dysreflexia occur?

Back 39

Above T6

Front 40

Autonomic dysreflexia is more commin in what what type and stage of recovery?

Back 40

Chronic stage

Complete injury

Front 41

What happens during autonomic dysreflexia?

Back 41

Acute onset of autonomic activity from noxious stimuli below the level of lesion.

Afferent input reach the lower spinal cord and initiate a mass reflex response resulting in Hypertension

Front 42

What are the results of hypertension from Autonomic Dysreflexia?

Back 42

seizures

renal failure

retinal hemorrhage

cardiac arrest

stroke

subarachnoid hemorrhage

Front 43

What is the most common cause of AD ?

Back 43

Bladder and bowel distension/irritation

Front 44

Symptoms of AD

Back 44

Profuse sweating

Bradycardia

INcreased spasticity

Constricted pupils

Piloerection

Blurred vision

Headache

Front 45

Intervention for AD

Back 45

Identify the source of the noxious stimuli

Decrease pt's blood pressure

Loosen tight clothing

Front 46

Spastic hypertonia

Back 46

65% of SCI

Pasticity, muscule spasms, abnormally high muscle tone, hyperactive stretch reflexes, clonus

Front 47

Spastic hypertonic occurs in what spinal level

Back 47

cervical-level

Front 48

What is the cause of spastic hypertonia

Back 48

Result of altered input at the spinal segmental level, imbalance between excitation and inhibition

Front 49

What cardiovascular impairments occur post SCI

Back 49

bradycardia and dilation of the peripheral vasculature below the level of the lesion

Front 50

During SCI is sympathetic or parasympathetic communication lost?

Back 50

sympathetic

Front 51

Symptoms of orthostatic hypotension

Back 51

Blurred vision, ringing in the ears, fainting, light-headedness

Front 52

Orthostatic hypotension occurs in what spinal level?

Back 52

About t6

Front 53

Is temperature control impaired post SCI?

Back 53

Yes, the hypothalamus can no longer control cutaneous blood flow or level of sweating

Front 54

What is tthe leading cause of death in people with high cervical injuries?

Back 54

Pulmonary impairments

Front 55

Injuries below what level will have normal respiratory function

Back 55

below T10

Front 56

Paradoxical breathing pattern

Back 56

Paralysis or paresis of the scalenes and intercostal muscles results in altered breathing pattern

Front 57

Postural hypotension

Back 57

SCI often develop low blood pressure due to lack of efficient skeletal muscle pump

Front 58

BP below what numbers will result in cardiac arrest?

Back 58

70/40mmhg