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20 Cards in this Set
- Front
- Back
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What is necrosis?
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Swelling and bursting of damaged cells
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What is apoptosis?
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Cell suicide, damaged cells eliminated themselves in controlled way
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What is secondary cell death?
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Tissue damage continues in a process
One mechanism "excitotoxicity"caused by release of gltamate from damaged nerve cells Uncontrolled release of glutamate (after SCI) kills nerve and glial cells |
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What is the immune response to a spinal cord injury?
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Blood brain barrier isolates CNS, after SCI blood brain barrier is damaged, some cells (such as T cells) can do a lot of damage, chemokine is isgnalling molecule to attract T-cells, suggested that 70% of cell damage after injury is due to immune response, if chemokine is blocked - less damage
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What happens during inflammation for SCI?
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Inflammation can lead to complement cascade,
Leads to formation of MAC (membrane attack complex) Targets invading cells After SCI some neurons and glial cells are "tagged" and then become target of MAC attack |
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Explain astrogliosis/scarring after spinal card trauma?
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Role of some astrocytes is to repair or restore the blood brain barrier
Creates scar around injury Scar creates several problems for regeneration Physical barrier to nerve growth Gives off chemical stop signs that inhibit axonal regneration Astrocytes near injury site may also infiltrate and wrap around remaining neurons |
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Explain demyelination after spinal cord trauma?
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Even spared neurons can be rendered ineffective if glial cells that make up the myelin die
After contusion injury there can be spare neurons at the end of the injury but these are often demyelinated |
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What are the 3 procceses for treatment?
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1: Neuroprotection within 1-2 weeks
2: repair/regenreation: facilitate repair/regeneration 3: Plasticity: enhance functional plasticity within surviving circuits |
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What are the 5 stages in assessment?
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HIstory, cognition, cardiorespiratory *cough effectiveness, chest expansion, breathing, musculoskeletal (range of motion, strength, sensation, reflexes, tone), mobility
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What are 6 interventions in acute phase?
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Respiratory management, ROM, positioning, selective strengthening, pain management, education
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What are common pain sources of pain after SCI?
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30 to 90 percent report pain
Most common source is neurogenic or neuropathic pain Neuropathic pain felt at or below level of injury Arises from abnormal signals from damaged nerves |
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What is transitional zone pain (segmental pain)
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Felt at level of injury in a band-like pattern around the trunk, or it may involve the arms
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What is radicular pain?
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Can be felt at any level (caused by nerve root damage)
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What is SCI pain? Central pain, dysesthetic pain, diffuse pain
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Neuropathic pain that occurs below the level of injury
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What are set functional goals - SMART?
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S = Specific
M = measurable A = achievable R = realistic T = time |
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What are intervention (active rehab phase)?
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Continuing acute phase: respiratory management, ROM, positioning
Resistive exercise for innervated muscles Motor control and muscle re-education techniques Postural control Balance Improved CV response to exercise Skin inspection (mirrors, promote independence) Mat programs (achievement of stability within a posture, controlled mobility, skill in function use) |
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What are mat programs?
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Mat programs (achievement of stability within a posture, controlled mobility, skill in function use)
- improved strength and functional ROM - improves awareness of new COG Promotes postural stability Facilitiates dynamic balance Determine most efficient and functional methods for accomplishing specific tasks Develop functional patterns of movement |
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What is functional electrical stimulation (FES)?
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Application of low level electrical current to improve function in paralysed and/or weak muscles
Permanent assitive device versus temporary therapeutic intervention (facilitate movement and improve voluntary Single channel versus multi channel Neuroplasticity (increase corticospinal projections to lower extremity muscles) |
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What is body weight support treadmill training (BWSTT)
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- Patients suspended on a treadmill in an upright position by a harness and cable
- allows safe ambulation by avoiding knee buckling and trunk collapse |
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Pros and cons of BWSTT
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Pros = increased gait speed, increased postural control, increased endurance, muscle strengthening
Cons = skins ulcers/pressure sores, watch for skin irritation, monitor HR and BP |
