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53 Cards in this Set
- Front
- Back
What is the structure of the SC
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Diagram of SC spinal nerves and their innervations.
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What is the etiology for SCI
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#1 MVA
#2 falls #3 gunshot wounds #4 sports (diving) |
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How many vertebrae are there?
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33
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How many spinal nerve pairs are there?
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31
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How many types of SCI are there? Name them.
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2:
Incomplete and Complete |
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What are the 4 types of incomplete SCI
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1 Central Cord
2 Brown sequard syndrome 3 Anterior cord syndrome 4 Cauda equina |
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Where is the damage for a Central Cord inj?
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Middle of the SC
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What is lost due to a central cord inj?
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Loss of: motor and sensory to arms but not legs.
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What is the etiology for a central cord inj?
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Whip lash
fall |
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Where is the damage for Brown sequard syndrome
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One side of cord is damaged while the other is spared
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What is the loss due to brown sequard damage?
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Motor and proprieoception of ipsilateral and
loss of sensation (pain, temp, touch) of contralateral side |
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What is the etiology for brown sequard syndrome?
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gunshot and stabbing
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Where is the damage for Anterior cord syndrome?
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Damage is to the anterior spinal artery
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What is loss due to anterior cord syndrome?
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motor, pain, temp, touch, sensation below lesion EXCEPT proprioception.
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What is the etiology for anterior cord syndrome?
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Gunshot and stabbing
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Where is the damage for cauda equina?
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The bundle of peripheral nerves that comes out at the bottom of the sacral
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What is the prognosis for cauda equina?
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Good as the damage is to the PNS vs the CNS.
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What are the 2 types of complete cord injuries
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quadraplegia (tetraplegia)
and paraplegia |
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What parts of the body are affected in tetraplegic cases?
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arms, legs, trunk and pelvic organs (sex, bladder and bowel organs)
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What parts of the body are affected in paraplegic cases?
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legs, some trunk and some pelvic organs
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What is the prognosis for complete spinal injuries?
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depends upon the lesion: the lower the lesion the better the prognosis
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What is the 1st stage of posttraumatice progression?
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Spinal shock: (1-3 months) areas below lesion are *flaccid paralysis
*absent reflexes *flaccid bladder *no bowel control |
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What are possible medical tx?
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ventilator
traction bed |
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What is the 2nd stage of posttarumatice progression?
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(6-12 months)
*reflexes may resume *spasticity may increase |
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What is the final stage of posttraumatice progression?
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1 year post inj, tone fluctuations end
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What are the 9 complications of SCI?
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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 |
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What causes skin breakdown?
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pressure, heat or skin shearing
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What are the 4 stages of skin breakdown (one of the SCI complications)
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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 |
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Describe the site of stage 1 skin breakdown? How is treated?
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Skin turn dark read, like when a blister is about to develop.
TX: relieve pressure until redness subsides |
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Describe the site of stage 2 skin breakdown? How is treated?
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Red open skin with blister or scab
TX: wound dressing used ad pressure is kept off site |
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Describe the site of stage 3 skin breakdown? How is treated?
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Skin breakdown is deep and wound drains. Muscle may show w/necrotic ulcer
TX: surgery may be necessary to close wound |
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Describe the site of stage 4skin breakdown? How is treated?
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All structures from epidermis to bone is destroyed: infection and bone decay.
TX: May require grafting |
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What is Decreased Vital Capacity?
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*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 |
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What is Osteoporosis?
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*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 |
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How can we slow down osteoporosis of this type?
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daily use of standing frames ro standing box
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What is orthostatic hypotension?
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* 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 |
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What are the symptoms of orthostatic hypotension?
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dizziness, nausea, faint
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How do you treat orthostatic hypotension?
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lift legs above head
"face is pale, raise the tail" If in W/C tilt the w/c back |
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What is autonomic dysreflexia?
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*Life threatening...pt 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 |
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What are the symptoms for Autonomic dysreflexia
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severe headaches, high blood pressure, sweating, face turns red
"face is red raise the bed" |
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What is the TX for Autonomic dysreflexia
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Check leg bag for kincks;
loosen clothing, ab binders and socks |
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Which is more common in tetraplegic patients?
osteostatic hypotension or autonomic dysreflexia |
autonomic dysreflexia
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Which complications are more typical in the acute stage of SCI?
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Orthostatic hypotension and autonomic dysreflexia
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What is spasticity?
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It is a SCI complication more common in higher level inj (quads)
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What increases spasticity?
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Stress, pain, illness and emotions
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What is heterotropic ossification?
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It is a SCI complication where bone starts to lay on tendons and ms: most often in hips and knees
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When can heterotropic ossification occur?
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1-4 months post injury
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What are the symptoms of heterotropic ossification?
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swelling, warmth and redness
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What is the TX for heterotropic ossification?
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A lot of PROM
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What is Thermal regulation?
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a SCI complication during 1st yr. Pt may become too cold or hot. Pt's body assumes the external enviro temp
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What is Urinary complications
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SCI victims rely upon catheterization. Urine is a breeding ground for bacteria which can spread throughout urinary sys
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What are the symptoms for Urinary comp
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dark urine, fowel smelling, fever, chills, increased spasticity
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What is Bowel complications
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Constipatoin and impacted fecal.
May result in autonomic dysreflexia in T6 or above lesion |