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sci/campbell
spinal cord injuries
| Question | Answer |
|---|---|
| what percent of sci are male vs female and what age is at risk? | 80% and 16 yrs and 30 yrs |
| before wwII life expectancy | a few months to ten years |
| cause of death before wII | kidney failure and sepsis |
| now cause of death | compromsed respiratory function related to pneumonia |
| tetraplegia | impairment or loss of motor and sensory function cervical segments impairment of arms trunk legs and pelvic orgrans |
| tetraplegia occurs at injury of | t-1 |
| paraplegia | impairment or loss of motor and or sensory function in the thoracic lumbar, or sacral segments. causing impairment of trunk legs pevic organs. |
| paraplegia occurs at injury of | t-2 or below |
| Hard fall onto the buttocks | flexion-axial compression injury |
| often seen in elderly, fall that causes a blow to the chin or the face. | hyperextension |
| driver turns head collision occurs, spinal cord is twisted in different directions at the same time | rotation injury |
| high velocity blow to top of the head, head striking the bottom of a swimming pool | vertical compression |
| upper motor neuron UMN injury | above t12-L1 |
| UMN | causes spastic paralysis |
| UMN | causes loss of cerebral control over all reflex activity below the level of injury |
| lower motor neuron LMN injury | below T12-L1 |
| LMN | causes destruction of the reflex arc |
| LMN | causes flaccid paralysis |
| complete -sci | involement of all tracks of spinal cord, absence of message transmission and motor and sensory function below injury |
| incomplete-sci | partially able to transmit messages to and from the brain. retains some motor/sensory function below injury |
| central cord syndrome | motor deficit and sensory loss in the upper extremities |
| central cord syndrome | associated with hyperextension injuries |
| anterior cord syndrome | loss of pain and temperature sensation and motor function below level of injury |
| anterior cord syndrome | associated with flexion injuries. |
| lateral cord syndrome | brown sequard syndrome |
| lateral cord syndrome | side that works dosent feel side that feels dosent work |
| lateral cord syndrome | ipsilateral loss of touch and pressure, vibration |
| conus medullaris syndrome | caused by damage to the conus and lumbar nerve roots |
| conus medullaris syndrome | may produce flaccidity (areflexia) in bladder, bowel, and or lower limbs |
| cauda equina syndrome | caused by damage below conus to lumbar sacral nerve roots |
| cauda equina syndrome | may produce areflexia in bladder bowel, or lower limbs |
| posterior cord syndrome | difficulty with coordinating movement of limbs |
| sci emergency management | assess cognitive,motor and sensory status, reflexes and cranial nerves. mri, myelography |
| myelography | can detect blockage and infection |
| methylprednisolone | emergency tx for sci give within 3 hrs, suppresses immune response throughout the body. |
| lazaroids | prevents lipid peroxidation |
| anti-excititoxins | fights ischemia |
| injury to c1-c3 | total loss or respiratory function |
| injury below c-4 | edema and hemorrhage my cause respiratory insufficiency. |
| Halo vest traction | immobilizes the cervical spine but allows for early ambulation |
| crutchfield tongs | inserted between the external auditory meatus and transverse processes of the cervical vertebrase above the area of the temporal bone. |
| harrington rods | tx for thoracic or lumbar fracture |
| tx for sacral and coccygeal injuries | bed rest, support affected area with a brace, evaluate for bladder and bowel function |
| complications of sci | spinal shock, AD,neurogenic bladder/bowel, gi ulceration, dvt |
| spinal shock | complete loss of reflex function below the level of lesion. |
| return of reflexes signals the end of spinal shock occurs in what direction? | ascending pattern |
| autonomic dysreflexia | injuries above t-6 |
| most common stimuli | distended bladder, then constipation. |
| sx of ad | rapid rise in bp, ha, bradycardia, diaphoresis and nausea. |
| tx of ad | elevate head to 90 degree angle, monitor bp ever 3-5 minutes, determind the cause and remove stimulus. |
| neurogenic bladder UMN | injury or dz at or above t12 or s1 |
| neurogenic bladder UMN management | reflex voiding with alpha blocker or IC with anticholinergic drugs or surgery |
| neurogenic bladder LMN management | IC, valsalva maneuver (strain), crede methods |
| neurogenic bladder LMN | injury at or below T12 or S1 |
| hemorrhagic shock | increased pulse and resp, drop in bp, hct less than 36, and hgb less than 12. |
| whats new in research | regeneration of damaged axons |
Created by:
jchlpka
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