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Spinal Cord Injury

QuestionAnswer
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
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
Types of injuries a. Trauma: Accidents, falls violence, sporting b. Flexion, flexion with rotation, extension, vertical compression C. Penetrating injuries that pierce the cord
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
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
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
Incomplete Injury Results in some preservation of sensory and/or motor function below level of injury
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
Central Cord Syndrome 1. Usually in the cervical region 2. loss of motor power and sensation greater in upper limbs
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.
Posterior Cord Syndrome 1. produces loss of position sense and motor function with preservation of pain sensation.
Conus Medullars Syndrome May produce areflexia (flaccidity) in bladder, bowel and or lower limbs
Cauda Equina Syndrome May produce areflexia in bladder, bowel, and/or lower limbs
Sacral sparing Damage that affects a major part of the cord but preserves radicular arteries which allows sensation in sacral area
ASIA Frequently used scale that reflects severity of impairment
ASIA level A Complete: no sensory function or motor function preserved in sacral segments 4-5
ASIA level B Incomplete: Sensory and function (but not motor function) preserved below the neurological level and extends through sacral segments 4-5
ASIA level C Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are grade 3 or lower
ASIA level D Incomplete: Motor function preserved below the neurological level. and the majority of muscles below the level are Grade 3 or higher
ASIA level E Normal
Poikilothermia Take on the temperature of enviroment
Respiratory injury above C4 paralysis of respiratory muscles, including diaphragm, Ventilator dependent
Respiratory injury C4-T6 paralysis of the intercostal and abdominal muscles, usually weaned for ventilator, requires aggressive pulmonary management
Respiratory injury T6-T12 paralysis of some abdominal muscles, does not require a daily respiratory program
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.
Autonomic Dysreflexia HTN, pounding H/A, flushing, sweating above the injury, pallor below injury, bradycardia, tachycardia, blurred vision, nasal congestion, anxious, feel funny
Neurogenic Bladder Injury above T12-L1 Reflex bladder, Dyssenergia, bladder hypertrophy, high PVR
Neurogenic Bladder Injury at/below T12-L1 Flaccid bladder, weak or absent detrusor contractions, overflow incontinence, high PVR
Neurogenic Bowel Injury above T12-L1 Reflex bowel, no voluntary control
Neurogenic Bowel Injury at/below T12-L1 Flaccid bowel, incontinence/retention
Zone of Partial Preservation Consist of the dermatomes and myotomes that are caudal to the neurological level and that remain partially innervated
Digital stimulation would most likely be used as a component of a bowl routine for a client with? spinal cord injury at T1
When does autonomic dysreflexia occur after SCI? Only after recovery from spinal shock
What types of medical conditions can precipitate autonomic dysreflexia? Conditions that are below the level of T6. Most common is related to bladder
What serious complications may result with an episode of autonomic dysreflexia? Stroke, Heart Attack or Seizure
Anterior spinothalimic tract transmits impulse regarding touch and some types of pressure
Lateral spinothalamic tract relays pain and temperature impulses
Posterior columns convey impulses regarding touch, pressure, two point tactile discrimination and vibration
Anterior spinocerebellar tract transmitting impulses regarding body position
Sacral sparing Damage that affects a major part of the cord but preserves radicular arteries, which allow sensation in sacral area
Cauda equine syndrome Caused by damage below conus to lumbosacral nerve roots
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
ASAI A Complete: No sensory or motor function preserved in sacral segments -5
ASAI B Incomplete: Sensory function (no motor function) preserved below the neurological level and extends through sacral segments 4-5
ASAI C Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are Grade 3 or lower
ASAI D Incomplete: Motor function preserved below the neurological level, and the majority of muscles below the level are at Grad 3 or higher.
Created by: janet patrick