Spinal Cord Injuries Flashcards

Vocabulary flashcards reviewing core terminology, classifications, incomplete syndromes, complications, and management of spinal cord injuries.

Tetraplegia

Impairment or loss of motor and/or sensory function in the cervical segments of the spinal cord, resulting in impairment of function in the upper extremities, lower extremities, trunk, and pelvic organs.

Paraplegia

Impairment or loss of motor and/or sensory function in the thoracic, lumbar, or sacral segments of the spinal cord, sparing upper extremity function while causing varying impairment of lower extremities, trunk, and pelvic organs.

Neurologic Level

The most caudal segment of the spinal cord with intact sensation and antigravity ($3/5$ or more) muscle function strength, provided that sensory and motor function rostrally are normal.

Motor Level

The lowest key muscle segment with a manual muscle testing grade of fair ($3/5$), provided that key muscles above this level have intact ($5/5$) strength.

Zone of Partial Preservation

The most caudal segment with some sensory or motor function (or both) below the injury level in an individual with a complete spinal cord injury.

Sacral Sparing

Preservation of motor or sensory function in the lowest sacral segments ($S4-S5$), such as perianal sensation or voluntary contraction of the external anal sphincter, confirming an incomplete injury.

Spinal Shock

A period immediately following spinal cord injury characterized by flaccidity, areflexia, loss of bowel and bladder function, and autonomic deficits below the level of the lesion.

Brown-Séquard Syndrome

An incomplete spinal cord injury resulting from hemisection of the cord, causing ipsilateral loss of motor function, proprioception, and vibration, and contralateral loss of pain and temperature sensation.

Anterior Cord Syndrome

An incomplete spinal cord injury typically caused by hyperflexion, characterized by loss of motor function, pain, and temperature sensation bilaterally below the injury level, with intact position and vibration sense.

Central Cord Syndrome

The most common incomplete spinal cord injury, caused by hyperextension or progressive stenosis, where upper extremities are more severely involved than lower extremities.

Dorsal Column Syndrome

A rare incomplete spinal cord injury caused by compression of the posterior spinal artery, resulting in bilateral loss of proprioception and vibration sensation while motor function and pain perception remain intact.

Autonomic Dysreflexia

A pathologic autonomic reflex occurring in injuries above $T6$ in response to noxious stimuli below the lesion, causing severe hypertension, bradycardia, headache, and profuse sweating above the level of injury.

Orthostatic Hypotension

A decrease in systolic blood pressure of $20\,\text{mm Hg}$ or greater, or a decrease in diastolic blood pressure of $10\,\text{mm Hg}$ or greater, occurring when transferring to an upright position due to lack of muscle pump and loss of vasoresponse.

Heterotopic Ossification

Abnormal bone formation in the soft tissues below the level of injury, most commonly occurring adjacent to large lower extremity joints such as the hip or knee.

Tenodesis Grasp

A functional hand grasp mechanism in tetraplegia where active wrist extension causes passive flexing of the fingers and thumb, and wrist flexion allows passive opening.

Glossopharyngeal Breathing

A breathing technique used by patients with high-level tetraplegia in which air is trapped using the palate and forced into the lungs using the tongue.

Root Escape

The preservation or return of motor or sensory function in peripheral nerve roots at or near the site of spinal cord injury.

ASIA Impairment Scale Grade A

Complete spinal cord injury classification where no motor or sensory function is preserved in the sacral segments $S4-S5$.

Compensatory Approach

A rehabilitation approach guided by teaching new movement strategies, utilizing intact muscle groups, momentum, adaptive equipment, and muscle substitution to complete functional tasks.

Recovery Approach

A rehabilitation approach focusing on restoring original neural tissue function and relearning normal movement patterns to perform tasks in the same manner as prior to injury.