Spinal Cord Injury
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| Quadriplegia | a. Loss of motor sensory function in cervical segments causing impairment in arms, trunk, legs and pelvic organs. b. Usually occurs as a result of injuries at T2 or above
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| Paraplegia | a. Loss of motor and sensory function in thoracic, lumbar, or sacral segments causing impairment in trunk, legs and pelvic organs. b. Usually occurs as a result of injuries at T2 or below
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| Types of injuries | a. Trauma: Accidents, falls violence, sporting
b. Flexion, flexion with rotation, extension, vertical compression
C. Penetrating injuries that pierce the cord
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| Level of spinal cord injury: UMN | 1. evident in lesions above T12/L1 vertebrae
2. Causes loss of cerebral control over all reflex activity below level of lesion
3. Causes spastic paralysis
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| Level of spinal cord injury: LMN | 1. Evident in lesions below T12/L1 vertebrae
2. Causes destruction of the reflex arc
3. Causes flaccid paralysis
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| Complete spinal cord injury | 1. Loss of all voluntary motor and sensory function below level of injury 2. There may be a zone of partial preservation: a. Consists of the neurologic levels below the level of complete injury. may be zone partial preservation below level of injury
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| Incomplete Injury | Results in some preservation of sensory and/or motor function below level of injury
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| Anterior Cord Syndrome | 1. Affecting anterior 2/3's of cord 2. Paralysis and loss of pain and temp. sensation below lesion with preservation of position senese
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| Central Cord Syndrome | 1. Usually in the cervical region 2. loss of motor power and sensation greater in upper limbs
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| Brown-Sequard Syndrome | 1. damage to one side of the cord 2. loss of motor function and position sense on the same side as the damage and loss of pain and temperature sensation on the opposite side.
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| Posterior Cord Syndrome | 1. produces loss of position sense and motor function with preservation of pain sensation.
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| Conus Medullars Syndrome | May produce areflexia (flaccidity) in bladder, bowel and or lower limbs
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| Cauda Equina Syndrome | May produce areflexia in bladder, bowel, and/or lower limbs
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| Sacral sparing | Damage that affects a major part of the cord but preserves radicular arteries which allows sensation in sacral area
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| ASIA | Frequently used scale that reflects severity of impairment
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| ASIA level A | Complete: no sensory function or motor function preserved in sacral segments 4-5
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| ASIA level B | Incomplete: Sensory and function (but not motor function) preserved below the neurological level and extends through sacral segments 4-5
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| ASIA level C | Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are grade 3 or lower
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| ASIA level D | Incomplete: Motor function preserved below the neurological level. and the majority of muscles below the level are Grade 3 or higher
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| ASIA level E | Normal
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| Poikilothermia | Take on the temperature of enviroment
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| Respiratory injury above C4 | paralysis of respiratory muscles, including diaphragm, Ventilator dependent
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| Respiratory injury C4-T6 | paralysis of the intercostal and abdominal muscles, usually weaned for ventilator, requires aggressive pulmonary management
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| Respiratory injury T6-T12 | paralysis of some abdominal muscles, does not require a daily respiratory program
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| Autonomic Dysreflexia | Hypertensive crisis for persons with a T6 injury and above, uninhibited sympathetic response to noxious stimulation below level of injury, assess and treat in the least provocative was possible.
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| Autonomic Dysreflexia | HTN, pounding H/A, flushing, sweating above the injury, pallor below injury, bradycardia, tachycardia, blurred vision, nasal congestion, anxious, feel funny
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| Neurogenic Bladder Injury above T12-L1 | Reflex bladder, Dyssenergia, bladder hypertrophy, high PVR
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| Neurogenic Bladder Injury at/below T12-L1 | Flaccid bladder, weak or absent detrusor contractions, overflow incontinence, high PVR
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| Neurogenic Bowel Injury above T12-L1 | Reflex bowel, no voluntary control
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| Neurogenic Bowel Injury at/below T12-L1 | Flaccid bowel, incontinence/retention
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| Zone of Partial Preservation | Consist of the dermatomes and myotomes that are caudal to the neurological level and that remain partially innervated
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| Digital stimulation would most likely be used as a component of a bowl routine for a client with? | spinal cord injury at T1
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| When does autonomic dysreflexia occur after SCI? | Only after recovery from spinal shock
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| What types of medical conditions can precipitate autonomic dysreflexia? | Conditions that are below the level of T6. Most common is related to bladder
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| What serious complications may result with an episode of autonomic dysreflexia? | Stroke, Heart Attack or Seizure
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| Anterior spinothalimic tract | transmits impulse regarding touch and some types of pressure
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| Lateral spinothalamic tract | relays pain and temperature impulses
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| Posterior columns | convey impulses regarding touch, pressure, two point tactile discrimination and vibration
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| Anterior spinocerebellar tract | transmitting impulses regarding body position
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| Sacral sparing | Damage that affects a major part of the cord but preserves radicular arteries, which allow sensation in sacral area
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| Cauda equine syndrome | Caused by damage below conus to lumbosacral nerve roots
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| Spinal shock | Immediate response to traumatic or sudden spinal cord injury, may subside within 1 hour or last for weeks, ends with the return of lperianal reflexes
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| ASAI A | Complete: No sensory or motor function preserved in sacral segments -5
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| ASAI B | Incomplete: Sensory function (no motor function) preserved below the neurological level and extends through sacral segments 4-5
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| ASAI C | Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are Grade 3 or lower
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| ASAI D | Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are at Grad 3 or higher.
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Created by:
janet patrick
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