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Types of SCI's

Two main types of SCI

What is the definition of a Complete Injury? It is a result of complete spinal cord transection, spinal cord compression or vascular impairment.
What is the definition of an Incomplete Injury? Injuries in which there is partial preservation of some motor or sensory function below the neurologic level in the lowest sacral segments. Perianal sensation must be present to be an incomplete injury. 50% of SCI's are incomplete.
What is sacral sparing? Pt's with sacral sparing have perianal sensation. They can flex the great toe and have voluntary control over the rectal sphincter muscle.
What does a pt. with an incomplete injury present with? Abnormal tone or muscle spasticity. Display more abnormal tone than a pt. with a complete injury.
What are the following signs and symptoms that are present if an individual has an SCI? 1. Motor paralysis or paraesis below the level of injury. 2. sensory loss 3.cardiopulmonary dysfunction 4. impaired temperature control from sympathetic nervous system damage 5. spasticity- can develop as the spinal cord recovers.
The following signs and symptoms of an individual with an SCI cont.? 6. bowel and bladder dysfunction 7. sexual dysfunction
What is one of the most common complications seen after an SCI? Pressure ulcers- develop over bony prominences because pt. does not know how to shift weight or relieve pressure.
How often should pressure relief exercises be done? Instructed to perform 1 minute for every 15 to 30 minutes of sitting.
What is autonomic dysreflexia? Occurs in patients with injuries above T6. Sympathetic nervous system instability. The impulses are unable to travel below the level of injury to lower the pt's blood pressure, hypertension occurs.
What are common signs or symptoms of autonomic dysrefelxia? Hypertension, severe and pounding headache, vasoconstriction below the level of lesion, vasodilation above the level of lesion, profuse sweating, constriction of pupils, goose bumps, blurred vision and a runny nose.
What happens if a patient with autonomic dysreflexia is not treated right away? Retinal hemorrhage, seizures, renal failure, cerebral hemorrhage or they may die.
As an OTA what should we look as noxious stimuli for autonomic dysreflexia? Patient's catheter is kinked or the bag may need to be emptied. Lower the patient's bp by sitting and standing the pt.
How can pain develop in a patient with an SCI? Result of irritation, damage to neural elements-such as sensory pathways, surgical intervention, poor handling and positioning.
If the patient is in pain what will they complain of? numbness, tingling, burning, shooting, and aching pain and visceral discomfort below the level of injury.
How can contractures develop in a patient with an SCI? Flexion contractures due to flexor reflex activity that develops after the injury and prolonged sitting. Good stretching program can be beneficial.
What is heterotopic ossification? Bone can form in the soft tissues below the level of injury.
What are the clinical signs of heterotopic ossification? ROM limitations, swelling, warmth, and pain; fever may or may not be present.
What is Deep Vein Thrombosis? a common life-threatening complication. Greater risk 2 months after the injury. SCI pt's are immoblized and medications are given intravenously to prevent blood clots.
Osteoporosis in patients with an SCI? In SCI's due to changes in calcium metabolism. Demineralization of the bones can occur. Calcium from the bones can deposit into the kidneys which form kidney stones. -Early mobilization and therapeutic standing are beneficial
Respiratory Compromise of patients with an SCI? C3-C5 primary muscle of inspiration higher level cervical injuries may lose the ability to breathe on their own. Patients that are unable to produce enough muscle force to cough likely to have pneumonia and inability to tolerate exercise.
What happens to the bladder during spinal shock? The bladder is either flaccid or areflexia.
If a patient's injury is above S2 what type of bladder do they have? Spastic bladder- the bladder empties reflexively when the pressure inside reaches a certain level.
If a patient's injury is to the cauda equina or the conus medullaris what type of bladder do they have? Flaccid bladder-the bladder requires manual emptying at predetermined time periods.
Upper Motor Neuron Injuries? Brain or spinal cord, result in spastic type of paralysis, Neurogenic spastic bowel and bladder.
Lower Motor Neuron Injuries? Occur at or below conus medullaris (T10-L1), result in a flaccid type of paralysis, flaccid bowel or bladder.
Created by: lcurtis
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