Term
| what is the leading improvement in morbidity associated w/spinal cord injury? |
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Definition
| improved bladder function |
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Term
| what level of spinal cord injury is associated w/the worst prognoses? |
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Definition
| C3-4 damage (ventilator dependent = pneumonia) |
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Term
| what is the etiology for spinal cord trauma? |
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Definition
| MVA, falls, violent acts, sports, other (pathology, iatrogenic, inflammatory). 90% are traumatic starting w/MVAs, then GSWs, then falls, then sports. |
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Term
| what does the ventral root connect to? dorsal root? |
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Definition
| ventral root: myotome and dorsal root: dermatone |
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Term
| what motor function is associated w/C5? |
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Definition
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Term
| what motor function is associated w/C6? |
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Definition
| wrist extension (extensor carpi radialis) |
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Term
| what motor function is associated w/C7? |
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Definition
| elbow extension (triceps) |
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Term
| what motor function is associated w/C8? |
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Definition
| finger flexion (flexor digitorum profundus) |
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Term
| what motor function is associated w/T1? |
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Definition
| small finger abductors (abductor digiti minimi) |
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Term
| what motor function is associated w/L2? |
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Definition
|
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Term
| what motor function is associated w/L3? |
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Definition
| knee extension (quadriceps) |
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Term
| what motor function is associated w/L4? |
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Definition
| ankle dorsiflexion (tibialis anterior) |
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Term
| what motor function is associated w/L5? |
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Definition
| great toe extension (extensor hallucis longus) |
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Term
| what motor function is associated w/S1? |
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Definition
| ankle plantar flexion (gastrocsoleus complex) |
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Term
| what is the motion most associated w/spinal injury? |
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Definition
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Term
| what are the mechanisms of injury for the bony part of the spine? |
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Definition
| fracture, dislocation, fracture/dislocation, stenosis |
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Term
| what are the mechanisms of injury for the ligamentous part of the spine? |
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Definition
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Term
| what are the mechanisms of injury for the spinal cord itself? |
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Definition
| mechanical, contusion, laceration, bleed, edema |
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Term
| how does hyperflexion of the cervical spine lead to injury? |
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Definition
| damage to posterior ligaments, compression fx of vertebrae, and bilateral facet dislocation/fx. hyperflexion *and rotation = unilateral facet dislocation. |
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Term
| how does hyperextension of the cervical spine lead to injury? |
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Definition
| this creates a risk for pinch between the vertebra and buckling the ligamenta flava = central cord syndrome (teardrop fx) |
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Term
| how can vertebral compression fracture in the cervical region lead to spinal cord damage? |
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Definition
| advance-burst fracture and vertebral body repulsion |
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Term
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Definition
| a transient phenomenon where the cord temporarily ceases to function below the level of the lesion = spinal reflexes, voluntary motor, sensory function, and autonomic control are absent below the level. (at this point can't tell if pt has sacral sparing, tested via bulbocavernosus reflex) |
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Term
| what are the pathophysiologic evens of a spinal cord injury? |
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Definition
| physical force incites a process w/in the spinal cord which consists of a progressive decrease of microperfusion at the site of injury, beginning in the central gray matter. microzones of hemorrhage in the central gray matter w/in 15 min (by 4 hrs parenchymal and vascular necrosis is noted centrally). 4-8 hrs later, central hematoma and advancing edema w/NE and bioamines add to the vasospasm and parenchymal destruction. |
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Term
| what is considered the level of injury in a spinal cord injury? |
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Definition
| the most caudal segment of the spinal cord w/normal sensory (dermatomal) and motor (myotomal) function on both sides of the body. this can differ from side-side and between motor-sensory. the ASIA impairment scale is concerned w/the most caudal segment of the spinal cord w/normal motor & sensory function on BOTH sides of the body. |
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Term
| what is complete spinal cord injury (SCI)? |
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Definition
| absence of sensory and motor function in the lowest sacral segment |
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Term
| what is incomplete spinal cord injury (SCI)? |
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Definition
| partial preservation of sensory and/or motor function below the neurological level - includes the lowest segment. |
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Term
| what tracts decussate w/in the spinal cord? |
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Definition
| spinothalamic and medial corticospinal tract |
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Term
| what tracts decussate w/in the brainstem? |
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Definition
| the posterior columns and the lateral corticospinal tract |
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Term
| what characterizes anterior cord syndrome? |
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Definition
| lesions which result from damage to the anterior 2/3 of the spinal cord - but the posterior columns are spared = variable loss of motor and pinprick sensation, little effect on proprioception/vibration. |
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Term
| what are the incomplete syndromes? |
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Definition
| central cord (arm greater than leg weakness), brown-sequard (asymmetric pattern of weakness and sensory less), anterior cord (absent motor function w/sparing of sensory modalities), posterior cord (varying degrees of motor function loss w/some sensory loss), conus medullaris syndrome, and cauda equina syndrome |
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Term
| what complications are associated w/SCI pts? |
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Definition
| DVT/pulmonary emboli, pulmonary muscle innervation loss, autonomic hyperreflexia, heterotopic ossification (1st hip, then knee, then shoulder), spasticity (however, this may be somewhat useful to the disabled pt), contractures, cardiac (altered physiology = more prone to MIs: major cause of death), fever (common: r/o UTI, skin, DVT, osteomyelitis), GI (altered ANS: high risk for gastric atony/ileus), pain, and syringomyelia (if there is already central canal damage, particularly in thoracic and lumbar this is common - pain/numbness = presenting symptoms). |
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Term
| which cervical level needs to be intact in order for pts to use a wheelchair? |
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Definition
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