Spinal cord Injuries quiz 2
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| Main causes of spinal cord injuries (SCI) | MVA, falls, violence, sport accidents
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| Most common sites for sci: Between the lower __ area and the upper ___ segment | cervical, thoracic
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| between the lower ____ area and the upper ___ segment | thoracic; lumber
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| between the lower ___ segment and the ___ | lumbar, sacrum
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| Mechanisms of SCI Injuries to the vertbral column: | hyperflexion, hyperextension, compression injuries
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| Mechanisms of SCI Injuries of the cord: | contusion laceration, compression
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| Clinical manifestations | Spinal shock
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| spinal shock is a ___ depression of both somatic and autonmic reflexes below the ____ of injury immediately following sci | temporary; level
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| How long does it usually last for | 2 weeks to 2 months
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| S/S during spinal shock: Flaccid muscle tone ___ the lesion | below
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| .... Areflexia ____ ____ | below the lesion
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| .... Loss of ___ below the lesion | sensation
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| .... Atonic bowel and bladder if the | injury is above S2, 3, 4
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| Hypotension and bradycardia if sci is | above T6
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| Skin below the injury | pink dry and warm
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| S/S after spinal shock ____ muscle tone below lesion | rigid
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| ____ below lesion | hyperreflexia
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| loss of ___ below lesion | sensation
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| _____ bowel and bladder if injury is above __ _ _ | spastic s2, 3, 4
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| autonomic hyper/dysreflexia if sci | above t6
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| skin | pale cold clammy below injury
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| Autonomic hyper/dyreflexia occurs in pt with SCI | above T6
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| Autonomic hyper/dyreflexia is an acute episode of exaggerated ___ response uncontrolled by the higer ____ in the ____ | sympathetic, centers, brain
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| Autonomic hyper/dyreflexia occurs | after the period of spinal shock
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| Autonomic hyper/dyreflexia and is often triggered by stimuli such as | fecal impaction or bladder distention
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| Mechanism of autonomic hyperreflexia: 1--> ____ receptors are stimulated below the lesion | sensory
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| Mechanism of autonomic hyperreflexia: 2--> stimulate sympathetic ___ ___ lesion | outflow below
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| Mechanism of autonomic hyperreflexia: 3--> ____ below level of injury | vasospasm
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| Mechanism of autonomic hyperreflexia: 4---> ___ BP | Increased
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| Mechanism of autonomic hyperreflexia: 5--> produced baroreflex mediated ___ response | Vagal
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| Mechanism of autonomic hyperreflexia: 6--> | Bradycardia
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| Degree of injury: | Complete or incomplete
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| total loss of sensory and motor function below level of injury | complete
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| incomplete or partial | mixed loss of voluntary motor function and sensations and leaves some tracts intact
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| Level of injury | Cervical thoracic or lumbar
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| The degree of sensory and motor loss varies depending on the lesion and reflexes the specific ___ ___ damaged and those spared | nerve tract
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| What are associated with incomplete lesions | 6 syndromes
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| We need to know what 4 (ABCP) | Anterior cord syndrome
Brown sequard syndrom
central cord syndrome
Posterior cord syndrome
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| Anterior cord syndrome is caused by damage to the | anterior spinal artery
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| this results in compromised | blood flow to the anterior spinal cord
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| It is typically a result from acute compression of the anterior spinal cord often what type of injury | flexion injury
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| Manifestations include | motor paralysis and loss of pain and temp sensation below the level of injury
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| What syndrome is the result of damage to one half of the spinal cord | brown-sequard
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| manifestation include | loss of motor function and position and vibration sense as well as vasomotor paralysis on the same side of the lesion
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| What happens to the opposite side | loss of pain temp sensation below level of lesion
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| What is central cord syndrome | damage to the center of the spinal cord
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| where and who does it occur in most commonly | cervical cord region; older adults
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| where are motor and sensory loss located at | upper and lower extremities, but upper extremities are affected more
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| The degree of sensory and motor loss varies depending on the lesion and reflexes the specific ___ ___ damaged and those spared | nerve tract
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| What are associated with incomplete lesions | 6 syndromes
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| We need to know what 4 (ABCP) | Anterior cord syndrome
Brown sequard syndrom
central cord syndrome
Posterior cord syndrome
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| Anterior cord syndrome is caused by damage to the | anterior spinal artery
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| this results in compromised | blood flow to the anterior spinal cord
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| It is typically a result from acute compression of the anterior spinal cord often what type of injury | flexion injury
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| Manifestations include | motor paralysis and loss of pain and temp sensation below the level of injury
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| What syndrome is the result of damage to one half of the spinal cord | brown-sequard
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| manifestation include | loss of motor function and position and vibration sense as well as vasomotor paralysis on the same side of the lesion
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| What happens to the opposite side | loss of pain temp sensation below level of lesion
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| What is central cord syndrome | damage to the center of the spinal cord
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| where and who does it occur in most commonly | cervical cord region; older adults
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| where are motor and sensory loss located at | upper and lower extremities, but upper extremities are affected more
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| Posterior cord syndrome results from | compression or damage to the posterior spinal artery
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| It is a very rare condition but results in | loss of proprioception
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| Manifestations of spinal cord injury are related to the: | level and degree of injury.
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| Cervical Level | altered respiratory function; teraplegia; ANS dysfunction; altered bowel bladder and sexual function
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| Respiratory muscle control: Diaphragm | C3-5
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| Respiratory muscle control: Scapula | C5,6
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| Respiratory muscle control: Intercostals | T1-11
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| Respiratory muscle control: abdominal | T7-12
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| Respiratory complications closely correspond to the | level of the injury.
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| Cervical injury above the level of C4 presents special problems because of the | total loss of respiratory muscle function.
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| Any cord injury above the level of T6 greatly decreases the influence of the | sympathetic nervous system
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| Complications of SCI | loss of sensation
paralysis
Spinal shock
autonomic hyperreflexia
skin breakdown
thromboemboli
altered bowel, bladder, sexual dysfunction
altered body temp regulation
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| Assessment | neuro exam
x-ray
ct
mri
myelography
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| Medical management 1 | Immediate immobilization of spine
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| 2 | decompression laminectomy
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| 3 | corticosteriods
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| 4 | management of spinal shock
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| 5 | management of autonomic hyperreflexia
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| 6 | rehab program
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