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53 Cards in this Set

  • Front
  • Back
What is the structure of the SC
Diagram of SC spinal nerves and their innervations.
What is the etiology for SCI
#1 MVA
#2 falls
#3 gunshot wounds
#4 sports (diving)
How many vertebrae are there?
How many spinal nerve pairs are there?
How many types of SCI are there? Name them.
Incomplete and Complete
What are the 4 types of incomplete SCI
1 Central Cord
2 Brown sequard syndrome
3 Anterior cord syndrome
4 Cauda equina
Where is the damage for a Central Cord inj?
Middle of the SC
What is lost due to a central cord inj?
Loss of: motor and sensory to arms but not legs.
What is the etiology for a central cord inj?
Whip lash
Where is the damage for Brown sequard syndrome
One side of cord is damaged while the other is spared
What is the loss due to brown sequard damage?
Motor and proprieoception of ipsilateral and
loss of sensation (pain, temp, touch) of contralateral side
What is the etiology for brown sequard syndrome?
gunshot and stabbing
Where is the damage for Anterior cord syndrome?
Damage is to the anterior spinal artery
What is loss due to anterior cord syndrome?
motor, pain, temp, touch, sensation below lesion EXCEPT proprioception.
What is the etiology for anterior cord syndrome?
Gunshot and stabbing
Where is the damage for cauda equina?
The bundle of peripheral nerves that comes out at the bottom of the sacral
What is the prognosis for cauda equina?
Good as the damage is to the PNS vs the CNS.
What are the 2 types of complete cord injuries
quadraplegia (tetraplegia)
What parts of the body are affected in tetraplegic cases?
arms, legs, trunk and pelvic organs (sex, bladder and bowel organs)
What parts of the body are affected in paraplegic cases?
legs, some trunk and some pelvic organs
What is the prognosis for complete spinal injuries?
depends upon the lesion: the lower the lesion the better the prognosis
What is the 1st stage of posttraumatice progression?
Spinal shock: (1-3 months) areas below lesion are *flaccid paralysis
*absent reflexes
*flaccid bladder
*no bowel control
What are possible medical tx?
traction bed
What is the 2nd stage of posttarumatice progression?
(6-12 months)
*reflexes may resume
*spasticity may increase
What is the final stage of posttraumatice progression?
1 year post inj, tone fluctuations end
What are the 9 complications of SCI?
1 Skin Breakdown
2 Decreased Vital Capacity
3 Osteoporosis (from disuse)
4 Orthostatic hypotension
5 Autonomic Dysreflexia
6 Spasticity
7 Heterotropic Ossificaiton
8 Thermal Regulation
9 Urinary complications
10 Bowel complications
What causes skin breakdown?
pressure, heat or skin shearing
What are the 4 stages of skin breakdown (one of the SCI complications)
1 Dark or red skin (epidermal layer)
2 Red open skin w/blister or scab (deeper epidermal layer damage)
3 Deep wound starts to drain; MS may show w/necrotic ulcer
4 All structures from epidermis to bone is destroyed
Describe the site of stage 1 skin breakdown? How is treated?
Skin turn dark read, like when a blister is about to develop.
TX: relieve pressure until redness subsides
Describe the site of stage 2 skin breakdown? How is treated?
Red open skin with blister or scab
TX: wound dressing used ad pressure is kept off site
Describe the site of stage 3 skin breakdown? How is treated?
Skin breakdown is deep and wound drains. Muscle may show w/necrotic ulcer
TX: surgery may be necessary to close wound
Describe the site of stage 4skin breakdown? How is treated?
All structures from epidermis to bone is destroyed: infection and bone decay.
TX: May require grafting
What is Decreased Vital Capacity?
*Weakness or paralysis of the diaphragm, intercostal and latissimus dorsi ms:
*Consequences include risk for respiratory tract infections
*Symptoms include shallow cough, congestion and low energy levels
What is Osteoporosis?
*Inability to lay down new bone due to no weight bearing on bones.
* in SCI usually developes 1 yr post inj due to disuse
* Will develop pathological bone fractures
How can we slow down osteoporosis of this type?
daily use of standing frames ro standing box
What is orthostatic hypotension?
* Not life threatening
*hypotension when pt goes from supine to upright, or chgs position quickly.
*The blood pools in the ab or legs instead of head
What are the symptoms of orthostatic hypotension?
dizziness, nausea, faint
How do you treat orthostatic hypotension?
lift legs above head
"face is pale, raise the tail"
If in W/C tilt the w/c back
What is autonomic dysreflexia?
*Life can have stroke!
*Those w/T6 and above are prone to this complication
*A reflex of the autonomic nervous system due to stimulus from tight clothing, packed fecal, catheter blockage, extreme temp
What are the symptoms for Autonomic dysreflexia
severe headaches, high blood pressure, sweating, face turns red
"face is red raise the bed"
What is the TX for Autonomic dysreflexia
Check leg bag for kincks;
loosen clothing, ab binders and socks
Which is more common in tetraplegic patients?
osteostatic hypotension or autonomic dysreflexia
autonomic dysreflexia
Which complications are more typical in the acute stage of SCI?
Orthostatic hypotension and autonomic dysreflexia
What is spasticity?
It is a SCI complication more common in higher level inj (quads)
What increases spasticity?
Stress, pain, illness and emotions
What is heterotropic ossification?
It is a SCI complication where bone starts to lay on tendons and ms: most often in hips and knees
When can heterotropic ossification occur?
1-4 months post injury
What are the symptoms of heterotropic ossification?
swelling, warmth and redness
What is the TX for heterotropic ossification?
A lot of PROM
What is Thermal regulation?
a SCI complication during 1st yr. Pt may become too cold or hot. Pt's body assumes the external enviro temp
What is Urinary complications
SCI victims rely upon catheterization. Urine is a breeding ground for bacteria which can spread throughout urinary sys
What are the symptoms for Urinary comp
dark urine, fowel smelling, fever, chills, increased spasticity
What is Bowel complications
Constipatoin and impacted fecal.
May result in autonomic dysreflexia in T6 or above lesion