SCI adult barriers

what is the standout points of tetraplegia/quadriplegia?

injury to cervical spinal cord C1-C7, all four limbs are effected

what are the stand out points of paraplegia?

injury to thoracic, lumbar, or acral spinal cord areas T1-S4 where trunk, legs, and pelvic organs are impacted

what intervention approaches do you use for an incomplete SCI versus a complete SCI?

incomplete SCI you can remediate/restore but for complete SCI you can only modify/adapt

can a spinal cord be progressive?

yes similarly to like a stroke can evolve a SCI can and will do the same with progressive symptomology that can become better or worse with time

what is the most common cause of SCI in general

MVAs, followed by falls, gunshot wounds, sports injuries and tumors

why are the first 24 hours after a SCI so important?

85% of people with a SCI who survive the first 24 hours are still alive 10 years later

what are the leading causes of death for a SCI patient

pneumonia and spepsis

what are some acquired methods of getting a SCI

spinal or bone cancer that does not involve direct trauma, this is a medical issue

what is the hardest mechanism of injury to recover from with a SCI?

flexion with rotation as the combo of forces causes severe twisting resulting in torn ligs and ultimately dislocation

what is SC ischemia?

stroke in the spinal cord, this is rare and risky there must be a very risky surgery done to fix it that could sever the SC

what is transverse myelitis

inflammatory process of the SC that occurs in response to illness or infection

what occurs in the acute phase of SC management

worried about survival atp, there will be extreme pressure in the head or neck, tingling or lost sensation in hands/fingers, partial loss of control over any body part, impaired breathing, difficulty balancing or walking

what is neurogenic shock?

pts with SCI at T6 or above may develop this bc of a loss of sympathetic tone (extreme vasodilation), this results in bradycardia, temperature dysregulation

what is spinal shock?

happens in acute phase in particular, if pt has a bowel or bladder obstruction this can occur causing reflex activity below the level of injury to be absent

how is a halo brace different from a cervical collar?

a halo brace immobilizes cervical spine providing traction to restrict movement associated with really high SCIs (C1-T3) but cervical collars are only used post-cervical fusion surgery

when is the turtle shell orthoses used

for thoracic injuries (T1-T10)

what is the difference between a stable versus unstable SCI?

stable injuries occur when bone or ligs support the injured cord area, but in unstable injuries the bones and ligs are disrupted and are unable to support and protect the injured cord involving soft tissues

what is the anticipated level of function for cervical injuries (C1-C8)

paralysis of neck, arms, hands, and diaphragm with no bowel, bladder or sexual control

what is the anticipated level of function for someone with a thoracic injury (T1-T12)

affects control of the upper torso and some parts of the arms with little nor not voluntary control of bowel/bladder

what is the anticipated level of function for someone with a lumbar injury (L1-L5)

loss of function in the hips and LE but can slightly control signals to hip flexors, no voluntary bowel/bladder control

what is the anticipated level of function for someone with a sacral injury (S1-S5)

dependent on the injury if bowel/bladder/sexual functions are involved, but most pts are able to walk with some loss of function in the LE and hips

what are the standout points of a complete degree of impairment for an SCI pt

total loss of all motor and sensory function below injury level occurs bc nerve damage obstructs all the signals coming from brain below injury level on both sides of the body equally

what are the standout points of a zone of partial preservation degree of impairment for an SCI pt

consists of the dermatomes and myotomes that are caudal to the neurological level so kind of like affected hot spots, this can only exist with complete injuries

what are the standout points of an incomplete degree of impairment for an SCI pt

results in partial preservation of sensory or motor functional below level of injury with some preservation of function (aka sacral sparing), one side may be stronger than the other and motor function can be preserved more than three levels below lesion level

what is an upper motor neuron injury (UMN)

injury that is T12 or above, this causes loss of control over all reflex activity below level of lesion and spastic paralysis (including organs like bowel/bladder/sex)

what is a lower motor neuron injury (LMN)

T12 or below causing flaccid paralysis and non-reflexive organ functioning. associated with muscle weakness/atrophy because it occurs in the motor nerve after it has left the SC

what is central cord syndrome?

50% of incomplete injuries are this type bc it is caused by damage to the central part of the SC usually in cervical regions. this causes loss of motor power and sensation that impacts UE more than LE with sacral sparing

what is brown sequard syndrome?

damage to one side of the SC with same sided motor and position sense deficits, but opposite sided temperature, sensation, and light touch deficits

what is anterior cord syndrome?

damage to the anterior artery impacting 2/3 of SC, this produces paralysis and loss of pain, temperature, sensation below the lesion with having some positioning sense all from 2/3 of body down (so nipple down)

what is conus medullaris syndrome

caused by damage to conus and lumbar nerve roots, causing areflexia or flaccidity in the bladder/bowel and LE pretty much exclusively

what is cauda equina syndrome

caused by damage below conus and lumbar nerve roots, this causes loss of reflexes, sensation, strength in the LE with overflow incontinence in the bladder, and bowel and sex organ deficits