12. Spinal Cord Injury Flashcards

Flashcards based on the lecture notes covering spinal cord injuries, medical management, classifications, and physiotherapy management.

What is the primary cause of SCI?

Trauma leading to neurological damage to the spinal cord.

Name three possible causes of SCI other than trauma.

Disease, infections, and congenital conditions

What are two age demographics that are more prone to SCI?

15-25 year old males and >60 year old males or females.

Name 5 possible causes of SCI

MVA and MBA, falls, work-related, water-related, sport-related

What are the two main categories of medical management for SCI?

Conservative and surgical.

What is a conservative treatment option for SCI

Bed rest for 6-12 weeks, mobilize with rigid bracing.

What does surgical treatment option do for SCI?

• decompression ± fusion

• bedrest - few days

• mobilise with soft bracing

Name three types of nerves affected by SCI

Motor, sensory, and autonomic nerves.

SCI can affect which of the autonomic nerves?

Parasympathetic and sympathetic.

Name 4 implications of SCI

Motor skills, respiratory function, exercise, bladder, bowel and sexual function, and skin

Describe the ASIA Impairment Scale (AIS) Grade A

A = Complete. No sensory or motor function is preserved in the sacral segments S4-5.

How to determine between AIS garde B, and C & D?

S4-5 motor, or S4-5 sensory and motor function more than 3 levels below motor level

How to determine between AIS grade C & D?

50% or more muscle below the neurological level are grade 3 or more

What does ZPP stand for?

Zone of Partial Preservation

What myotomes are tested for the ASIA motor upper limbs assessment?

C5 (elbow flexors), C6 (wrist extensors), C7 (elbow extensors), C8 (finger flexors), T1 (finger abductors)

What myotomes are tested for the ASIA motor lower limbs assessment?

L2 (hip flexors), L3 (knee extensors), L4 (ankle dorsiflexors), L5 (toe extensors), S1 (ankle plantarflexors)

What are the clinical syndromes of SCI?

Brown-Sequard, sacral sparing, central cord syndrome, anterior cervical cord syndrome

What is Brown-Sequard syndrome?

One side of the spinal cord is damaged -> loss of motor function and proprioception (same side) and loss of pain and temperature (opposite side).

What is sacral sparing?

Peripheral rim of the spinal cord is preserved -> motor and sensory sacral pathways intact

What is central cord syndrome?

Compression of the central section of the spinal cord -> ULs are impacted more than LLs

What is anterior cervical cord syndrome?

Anterior 2/3 of the spinal cord is damaged -> motor function, pain and temperature are impacted. Light touch and proprioception are intact.

What does SMART stand for in goal setting?

Specific, measurable, attainable, realistic, time-bound

What is the key muscle partially innervated at C3? (1)

Diaphragm

What muscles are innervated at C4? (2)

Rhomboids and trapezius

What muscles are innervated at C5? (2)

Deltoids and biceps

What muscles are innervated at C6? (4)

Pectoralis, latissimus dorsi, serratus anterior, wrist extensor

What muscles are innervated at C7? (3)

Triceps, wrist flexors, finger extensors

What muscle is innervated at C8? (1)

Finger flexors

What muscle is innervated at T1? (1)

Interossei

What muscle is innervated at L2?

Hip flexors

What muscle is innervated at L3?

Knee extensors

What muscle is innervated at L4?

Ankle dorsiflexors

What muscle is innervated at L5?

Toe extensors

What muscle is innervated at S1?

Ankle plantarflexors

Name 5 components of the ICF clinical framework

Health condition, impairment, activity, participation, environment factors and personal factors

What impairments do we assess after SCI?

• pain

• respiratory Fx

• CVS fitness

• spasticity

• sensation

• activity limitation

What are the determinants of tenodesis?

• passive finger flexion

• passive thumb flexion