Neuro Physio - Repat Visit Lecture Flashcards

Vocabulary flashcards based on the Neuro Physio lecture notes.

SRU Team

Team including Medical Staff, Nursing staff, and allied health professionals managing SCI patients.

ORIF

Surgical procedure involving Open Reduction and Internal Fixation used in SCI management.

ASIA Classification

Classification system for SCI determining the degree of motor and sensory loss. Ranges include A, B, C, D, and E.

ASIA A

Complete motor and sensory loss including S4-5 segments in SCI.

ASIA B

No motor function, some sensation preserved in S4-5 segments in SCI.

ASIA C

Motor in S4-5 segments are preserved or sensory in S4-5 and motor function in more that 3 levels below the injury level in SCI.

ASIA D

Half or more of the key muscles below the level are grade 3-5 in SCI.

ASIA E

Normal motor and sensory function in SCI.

Zone of partial preservation

Area of partial sensory or motor function below the level of injury.

Pain in SCI

Mechanical or operational pain, secondary to muscle imbalances or neurogenic in SCI patients.

Bladder, bowel, sexual dysfunction in SCI

Dysfunction of bladder, bowel, and sexual function due to SCI.

Skin breakdown (pressure injuries)

Breakdown of skin due to prolonged pressure from immobility in SCI patients.

Respiratory issues in SCI

Issues like reduced lung volume and increased risk of infections in SCI patients.

Changes in tone / spasms

Changes in tone or spasms, potentially leading to increased tone or flaccidity depending on the lesion.

Spinal shock

Temporary flaccid tone immediately following SCI.

UMN lesion

Increased muscle tone associated with upper motor neuron lesions.

LMN lesion

Flaccid muscle tone associated with lower motor neuron lesions.

Heterotopic ossification (HO)

Formation of bone in soft tissue around joints, common in SCI.

Autonomic dysreflexia

Life-threatening condition due to uncontrolled sympathetic nervous system response in SCI patients with lesions above T6.

Triggers of Autonomic Dysreflexia

Bladder distension, constipation, pressure areas, trauma, or SLR can trigger this condition .

Signs of Autonomic Dysreflexia

Sweating and flushing of skin (above the lesion), pounding headache.

Treatment for Autonomic Dysreflexia

Remove cause, sit up, seek medical help. If untreated, it can be life-threatening.

Clinical Syndromes of SCI

Specific patterns of neurological deficits following incomplete SCI, such as Brown-Sequard, Central Cord, Anterior Cord, Posterior cord and Cauda Equina syndromes.

Rehabilitation goals

Maximizing mobility, independence, and function are the main focus.

Immobilization

Prevent further damage in the early stages of SCI.

Blood pressure control

Maintaining adequate spinal cord perfusion (mean arterial pressure >85 mmHg) helps reduce further damage.

Steroid use (Methylprednisolone)

Previously used to reduce inflammation, but its effectiveness is now debated due to potential side effects (like infections and GI bleeding).

Early surgical intervention

Studies suggest that decompressing the spinal cord within 24 hours of injury improves recovery.

Stem cell therapy

Research is exploring whether stem cells can regenerate damaged nerve tissue.

Neuroprotective agents

Drugs that aim to minimize secondary damage and promote nerve healing.

Muscle Function Grading 0

Total Paralysis

Muscle Function Grading 1

palpable or visible contraction

Muscle Function Grading 2

active movement, full range of motion (ROM) with gravity eliminated

Muscle Function Grading 3

active movement, full ROM against gravity

Muscle Function Grading 4

active movement, full ROM against gravity and moderate resistance in a muscle specific position

Muscle Function Grading 5

normal active movement, full ROM against gravity and full resistance in a functional muscle position expected from an otherwise unimpaired person

Muscle Function Grading 5*

normal active movement, full ROM against gravity and sufficient resistance to be considered normal if identified inhibiting factors (i.e. pain, disuse) were not present

Muscle Function Grading NT=not testable

i.e. due to immobilization, severe pain such that the patient cannot be graded, amputation of limb, or contracture of >50% of the normal ROM

Sensory Grading 0

Absent

Sensory Grading 1

Altered, either decreased/impaired sensation or hypersensitivity

Sensory Grading 2

Normal

Sensory Grading NT

Not testable

ASIA Impairment Scale (AIS) B

Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-5 and no motor function is preserved more than three levels below the motor level on either side of the body

ASIA Impairment Scale (AIS) C

Motor function is preserved at the most caudal sacral segments for voluntary anal contraction or the patient meets the criteria for sensory incomplete status, and has some sparing of motor function more than three levels below the ipsilateral motor level on either side of the body

ASIA Impairment Scale (AIS) D

Motor incomplete status as defined above, with at least half (half or more) of key muscle functions below the single NLI having a muscle grade ≥ 3.