scorebuilders ch 2
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| show | A lesion to the spinal cord where there is no preserved motor or sensory function below the level of lesion |
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| show | A lesion to the spinal cord with incomplete damage to the cord. THere may be scattered motor function, sensory function or both below the level of lesion |
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| Anterior Cord Syndrome | show | the lesion due to the damage of the corticospinal and spinothalamic tracts. |
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| Brown-Sequard's Syndrome | An incomplete lesion usually caused by a stab wound, which produces hemisection of the spinal cord. There is paralysis and loss of vibratory sense on the same side as the lesion due to the damage to the corticospinal tract and dorsal columns. There is a | loss of pain and temperature sense on the opposite side of the lesion from damage to the lateralspinothalamic tract. Pure Brown Sequard's syndrome is rare since most spinal cord lesions are atypical | show 🗑
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| Cauda Equina Injuries | An injury that occurs below the L1 spinal level where the long nerve roots transcend. Cauda Equina Injuries can be complete, however, they are frequently incomplete due to the large number of nerve roots in the area. A cauda Equina Injury is considered | a peripheral nerve injury. Characteristics include flaccidity, areflexia, and impairmant of bowel and bladder function. Full rcovery is not typical due to the distance needed for axonal regeneration. | show 🗑
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| Central Cord Syndrome | show | The upper extremities present with greater involvement than the lower extremities and greater motor deficits exist as compared to sensory deficits. |
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| Posterior Cord Syndrome | A relatively rare syndrome that is caused by compression of the posterioor spinal artery and is characterized by loss of pain, perception, two-point discrimination, and sterognosis. Motor function is preserved. | show |
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| show | AD is perhaps the most dangerous complication of spinal cord injury and can occur in patients with lesions above T6. A noxious stimulus below the level of lesion triggers the autonomic nervous system causing a sudden elevation in BP. | Common causes can include distented or full bladder, kink or blockage in the catheter, bladder infections, pressure ulcers, extreme temperature changes, tight clothing, or even an ingrown toenail. |
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| Treatment of Autonomic Dysreflexia | The first reaction to this medical crisis is to cvheck the catheter for blockage. The bowel should also be checked for impaction. A patient should remain in a sitting position. Lying a patient down is contrainindicated and will only assist to further | show |
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| Deep Vein Thrombosis | DVT results from the formation of a blood clot that becomes dislodged and it is termed an embolus. This is considered a serious medical condition since the embolus may obstruct a selected artery. A patient with a SCI has a > risk of developing a DVT | show | schedule, range of motion, proper positioning to a void excessive venous stasis, and use of elastic stickings.
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| Symptoms of DVT | Swelling of the lower extremity, pain, sensitivity over the area of the clot, and warmth in the area. | show |
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| Treatment of DVT | Once a DVT is suspected there should be no active or passive movement performed to the involved LE. Bed rest and anticoagulant thereapy are usually indicated. Surgical procedures can be performed if necessary. | show |
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| show | Ecotopic bone or heterotrophic ossification refers to the spontaneous formation of bone in the soft tissue. It typically occurs adjacent to larger joints such as the knees or the hips. Theorys regarding etiology range from tissue hypoxia to abnormal | calcium metabolism |
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| show | Early sxs include edema, decreased ROM, and increased temperature of the involved joint. |
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| Treatment of Ecotopic Bone | Drug intervention usually involves disophoshates that inhibit ecotopic bone formation.PT and surgery are often incorporated into treatment. PT must focus on maintaining functional ROM and allowing the pt. the most independent functional outcome possible | show |
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| Orthostatic Hypotension | Orthostatic hypotension or postural hypotension occurs due to a loss of sympathetic control of vasoconstriction in combination with absent or severely reduced muscle tone. Venous pooling is fairly common during the early stages of rehabilitation. | show |
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| Symptoms of Orthostatic Hypotension | Complaints of dizziness, light-headedness, nausea, and "blacking out" when going from horizontal to a vertical position | show |
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| show | Monitoring vital signs assists with minimizing the effects of orthostatic hypotension. The use of elasticstockings, ace wraps to the LE's and abdominal binders are common. Gradual progression to a vertical position using a tilt table is often indicated | Drug intervention may be indicated in order to increase BP. |
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| Pressure Ulcers | A pressure ulcer is caused by sustained pressure, friction, and/or shearing to a surface. THe most common areas susceptible to pressure ulcers are the coccyx, sacrum, ischium, trochanters, elbows, buttocks, malleoli, scapulae, and prominent vertebrae. | Pressure ulcers require immediate medical intervention and can significantly delay the rehabilitation process. | show 🗑
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| Symptoms of Pressure Ulcers | show |
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| show | Prevention is of greatest importance. A patient should change position frequently, maintain proper skin care, sit on an appropriate cushion, consistently weight shift, and maintain proper nutrition and hydration. Surgical interverntion is often | necessary with advanced pressure ulcers |
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| Spasticity | Spasticity can occasionally be useful to a patient with a SCI, however, more oftenn serves to interfere with functional activities. Spasticity can be enhanced by both internal and external sources such as stress, decubiti, UTI, bowel or bladder | obstruction, temperature changes, or touch. | show 🗑
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| Spasticity Symptoms | show |
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| Spasticity treatment | Medications are usually administered to reduce the degree of spasticity. (Dantrium,Baclofen, Lioresal). Aggressive treatment includes phenol blocks, rhizotomies, myelotomies, and other surgical intervention. PT intervention includes positioning, aquatic | show |
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| Corticosteroid Agents | Administered within 8 hours after injury to prevent overall decline in white matter within the cord. Allows for enhanced blood flow and reduces post-traumatic ischemia | show |
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| show | reduces tension in the muscles | Examples: Baclofen, Lioresal, Valium |
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| show | treatment of neurogenic pain | Example: Gabapentin |
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| Tricyclic Antidepressants | treatment of neurogenic pain | Example: Amitriptyline, Pamelor, Sinequan | show 🗑
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| Parathyroid Hormone | show | Example: Teriparatide |
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| Biphosphonate Agents | Prevent demineralization and SCI-induced osteoporosis | Example: Didronel, Aredia | show 🗑
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| show | Example: Minipress, Ditropan |
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| Agents for Bowel Program | show |
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| Anti-bone Resorption Agents | show | Example: Didronel, Fosamax |
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| Anticoagulation Agents | prevents DVT | Example: Coumadin, Heparin | show 🗑
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| SCI Examination | -past medical history -History of current condition -Social history (caregiver support) -Medications -Living Environment -Systems Review -Cognitive Assessment -Skin Assessment -Sensory Examination -Motor Examination -ASIA impairment scale | -Respiratory Assessment -Cough -Chest Expansion -Accessory Muscle Use -Vital Capacity -ROM -Pain -Mobility skills | show 🗑
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| SCI Intervention | -Positioning -Family/caregiver teaching -Respiratory Training -Assisted cough and secretion cleaarance -Breathing Exercises -WC, cushion, and orthotic prescription -Pressure Releif -ROM -Motor function retraining -Mobility training | show |
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| SCI Goals | show | -Positioning -Range of Motion -Strengthening -WC management |
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| Cauda Equina Injury | Aterm used to describe injuries that occur below the L1 level of the spine. A cauda equina injury is considered to be a LMN lesion | show |
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| Dermatome | show |
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| Myelotomy | show |
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| show | Designated motor areas based on spinal segment innervation |
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| show | A surgiacla removal of a segment of a nerve in order to reduce spasticity and improve function |
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| Neurogenic Bladder | The bladder empties reflexively for a patient with an injury above the level of S2. The sacral reflex arc remains intact | show 🗑
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| show | THe lowest segment (most Caudal) of the spinal cord with intact strength and sensation. Muscle groups at this level must receive a grade of fair |
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| Nonreflexive Bladder | show |
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| Paraplegia | A term used to describe injuries that occur at the level of the thoracic, lumbar, or sacral spine | show 🗑
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| Rhizotomy | A surgical resection of the sensory component of a spinal nerve in order to decrease spasticity and improve function | show |
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| Sacral Sparring | show |
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| Spinal Shock | show |
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| Tenotomy | A surgical release of a tendon in order to decrease spasticity and improve function | show |
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| show | A term adopted by the American Spinal Cord Injury Association to describe injuries that occur at the level of the cervical spine |
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| show | A term used to describe poor or trace motor or sensory function for up to three levels below the neurlogic level of injury |
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| Autonomic Dysreflexia Symptoms | show |
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