Seizures/Spinal Cord Injuries
Terms
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- The age group most represented in spinal cord injuries is:
- 18-25
- The incidence of new spinal cord injuries per million population per year is:
- 25-30
-
Automobiles account for what percentage of spinal cord injuries
Falls
gunshot wounds
diving -
35%
15%
10%
6% - The spinal cord lies within the:
- vertebral canal formed by the vertebrae of the spinal column
- Where does the spinal cord end?
- L1
- What does the neural tissue within spinal cord consist of?
- nerve cells and nerve fiber tracts
- What carries movement, motor messages down the spinal cord from the brain to the grey matter?
- corticospinal tract/fiber tracts
- Sensory messages from the skin and other tissues enter the spinal cord how?
- via the posterior spinal roots and travel up spinal cord to brain
- When a complete spinal cord injury occurs, impulses cannot be transmitted either down or up fiber tracts past the point of injury. The extent of the resultant paralysis and senory loss is determined by:
- the level of injury
- What are the first important nerve roots?
- C3 & C4
- C3 & C4 travel via:
- the phrenic nerve to the diaphragm
-
The action of the C3 & C4 nerve roots account for what percentage of lung's breathing capacity?
The intercostal muscles between the ribs account for the remaining? -
75%
25% - Do injuries below C4 spare the respiratory function enabling breathing?
- yes
- The remaining nerve roots and the first thoracic nerve root (T1) innvervate/support what muscles?
- upper extremities
- Spinal cord injuries affecting any segment between C3 and T1 produces?
- impairment of function of upper extremities/quadraplegia
- Do the arms have to be completely paralyzed for quadriplegia to exist?
- no
- Is quadriplegia present if any of the segment of the spinal cord C5-T1 produces impairment of the arms?
- yes
- Injries to the spinal cord below T1 spares upper body and it is referred to as
- paraplegia
- sensory impulses carry information from the skin and other tissues via:
- peripheral nerves and the spinal roots into the spinal cord and then to the brain
- The degree of disruption of the vertebral column determines?
- how severe the injury to the spinal cord will be, and whether sensation and voluntary muscle movement below the level of the lesion will be completely or partially lost.
- Spinal shock:
- condition not only of paralysis and sensory loss, but absence of reflexes below the level of injury/lasts from several days to several weeks
-
If reflexes return________
voluntary function is present, it is likely that voluntary function will never develop - before
- Complications of spinal cord injury is caused by:
- Paralysis and anesthesia
- Acute (1 month)Phase of complications:
-
1.RESPIRATORY/pneumonia/pulmonary embolism
2.GASTROINTESTINAL/bleeding from ulcers/absence of intestinal movement
3.GENITOURINARY/kidney infection/distention of bladder from catheter
4. CARDIOVASCULAR/sudden increase of blood pressure with sweating and flushing caused by overdistention of bowel or bladder/lowered blood p;ressure when changing positions
5. SKIN/pressure sores/
6. MUSCULOSKELETAL/abnormal formation of calcium in muscles surrounding joints/loss of range of motion/vertebral column instability - Chronic Phase (after 1 month)
-
1.RESPIRATORY/pneumonia/collapsed lung
2.GENITOURINARY/pyelonephritis, calculi, and urethral fistulae/prostate infection/
urine flowing back
3. CARDIOVASCULAR/all complications listed in acute stage are more likely to develop in chronic stage
4. SKIN: pressure sores
5. MUSCULOSKELETAL/fractures of long bones (legs), osteoporosis
6. NEUROLOGIC/abnormal painful sensations below level of lesion/excessive sweating/spasticity - Functional disabilites:
- 1. PHYSICAL: bathing, personal hygiene, ambulation, eating, driving
- Adaptive techniques are based on:
-
1. INDEPENDENCE/function alone
2. NEEDS STANDBY ASSISTANCE/cannot consistently perform activity
3. NEEDS PARTIAL PHYSICAL ASSISTANCE/can perform but needs help
4. TOTAL DEPENDENCE/someone else needs to perform activity and task for him - Sexual impairment is on what levels of injury?
- all
-
Levels:
Sacral S2,S3,S4
Lumbosacral L5,S1,S2
Lumbar L1,L2,L3,L4
Thoracic T7 thru T12
Thoracic T2-T6
Cervical C7, C8, T1
Cervical C6
Cervical C5
Cervical ab -
bowel and bladder initially impaired
bowel, bladder and ambulation functions are impaired
Wheelchairs are used, bowel and bladder function can become dependent
personal hygiene, ambulation, transfers, dressing and driving are impaired initially/training is needed on other
same as above
same as above except independence is successful/wheelchair is used
all function are impaired initially/small amount achieve independence
all function are impaired initially/wheelchair/total physical dependence for hygiene, dressing, driving
Breathing function is compromised/totally physically dependent for all functions