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Spinal Cord Injury - Ch 24 Week 4

Terms in this set (101)

How many pairs of spinal nerves?
31
The spinal cord ends just below which vertebrae?
L1
What is a collection of spinal nerves below the end of the spinal cord?
Cauda equina
What is the site where diagnostic of therapeutic lumbar punctures, like spinal taps, are performed?
CSF-filled meningeal space between L2-L4
The terms tract, pathway, lemniscus, and fasciculus all refer to what?
bundles of nerve fibers that have a similar function and travel through the spinal cord in a particular area
What type of nerve tissue is located centrally and resembles a butterfly in cross sections of the cord?
Gray matter
What is gray matter composed of?
cell bodies and synapses
What type of nerve tissue encompasses most of the periphery of the cord and contains the ascending and descending pathways?
white matter
_______ nerves carry afferent and efferent impulses for the head, neck, diaphragm, arms and hands
cervical
_______ nerves serve the chest and upper abdominal musculature
thoracic
______ nerves carry info to and from the legs and a portion of the foot
lumbar
______ nerves carry impulses for remaining foot musculature, bowel, bladder, and the muscles in sexual functioning
sacral
What is a reflex arc?
the nerve pathway involved in a reflex action including at its simplest a sensory nerve and a motor nerve with a synapse between.
What is the leading cause of SCI in the US?
Motor vehicle accidents
C1- C7 nerves exit ____ the corresponding vertebrae
above
C8-S5 spinal nerves exit ______ the corresponding vertebrae
below
Where are spinal taps performed?
between L2 and L4
What is the space between L2 and L4 referred to as?
lumbar cistern
What condition is a congenital neural tube dysfunction resulting in an incomplete closing of the VC and spinal cord agenesis?
spina bifida
What type of SCI injury occurs with a complete transection of the cord and all ascending and descending pathways are interrupted, causing a total loss of motor and sensory function below the level of injury?
complete sci
If a complete SCI has occurred and the reflex arc are intact below the level of injury, what is this referred to as?
UMN injury
What are UMN lesions characterized by?
loss of voluntary function below level of injury
spastic paralysis
no muscle atrophy
hyperactive reflexes
Complete injuries below the level of the conus medullaris are referred to as
LMN injury
In what type of injury can a reflex arc not occur because impulses cannot enter the cord to synapse?
LMN injury
What are LMN injuries characterized by?
loss of voluntary function below level of injury
flaccid paralysis
muscle atrophy
absence of reflexes
True or False
UMN and LMN injuries may be complete or incomplete
true
If damage to the SC does not cause a total transection, what type of injury is this?
incomplete
What results from damage to the anterior spinal artery or indirect damage to anterior spinal cord tissue?
anterior cord syndrome
What are the clinical signs of an anterior cord syndrome?
loss of motor function below level of injury
loss of thermal, pain, and tactile sensation below the level of injury
Light touch and proprioceptive awareness generally unaffected
What occurs when only one side of the spinal cord is damaged and is frequently a result of a stab or gunshot wound?
brown-sequards syndrome
What are the clinical signs of brown-sequard's syndrome?
Ipsilateral loss of motor function below level of injury
Ipsilateral reduction of deep touch and proprioceptive awareness
Contralateral loss of pain, temperature, and touch
Extremities with the greatest motor function have the poorest sensation
In what syndrome do the neural fibers serve the upper extremities are more impaired than those of the LE?
Central cervical cord syndrome
What occurs because the fibers that innervate the UE travel more centrally in the cord, and the central structures are the ones that are damaged?
central cervical cord syndrome
Hyperextension of the neck and narrowing of the spinal canal results in what type of injury?
central cervical cord syndrome
What are the clinical signs of central cord syndrome?
motor and sensory functions in the LE less involved than the UE
Improvements in intrinsic hand function
Potential for flaccid paralysis of UE
What injuries do not involve damage to the spinal cord itself, but rather to the spinal nerves that extend below the end of the spinal cord?
Cauda equina injuries
What type of injury involves structures of the PNS which allows for chance for nerve regeneration and recovery of function?
cauda equina
What injuries are usually the result of direct trauma from fracture dislocations of the lower thoracic or upper lumbar vertebrae?
cauda equina
What are the clinical signs of a cauda equina injury?
loss of motor function and sensation below level of injury
Absence of reflex arc
What refers to the lost or limited function of all extremities as a result of damage to cervical cord segments?
quadriplegia
What refers to the impairment or loss of motor or sensory function in the cervical segments of the spinal cord that is the result of damage of neural elements with the spinal canal?
tetraplegia
What causes impairment of function in the arms as well as in the trunk, legs, and pelvic organs and does not include brachial plexus lesions or injury to PNS?
tetraplegia
What refers to lost or limited function in the LE and trunk depending on level of injury?
paraplegia
What level of SCI involves no motor or sensory function is preserved in the sacral segments S4-S5?
level a complete
What level of SCI involves sensory but not motor function is preserved below the neurological level and extends through S4-S5
level B sensory incomplete
What level of SCI involves motor function is preserved below the neurological level, and the majority of the key muscles below the neurological level have a muscle grade <3?
Level C motor incomplete
What level of SCI involves motor function is preserved below the neurological level and the majority of key muscles below the neurological level have a muscle grade of > or equal to 3?
level d motor incomplete
What level of SCI involves motor and sensory function is normal?
level 3 normal
the period of altered reflex activity immediately after a traumatic SCI is known as
spinal shock
People with SCI at or below level of ___ generally have a normal respiratory status
T12
People with complete injuries above ____ typically require a respirator
C4
What involves an exaggerated response of the ANS?
autonomic dysreflexia
autonomic dysreflexia typically occurs in SCI above what level?
T6
Sudden pounding headache, diaphoresis, flushing, goose bumps, and tachycardia followed by bradycardia are signs of what?
autonomic dysreflexia
What are the 3 main reasons deep vein thrombosis could be a potential side affect in SCI?
reduced circulation caused by decreased tone
frequency of direct trauma to legs causing vascular damage
prolonged bed rest
Maintaining the appropriate body temperature is often a problem with injuries above what level?
T6
What is the term when the body tends to assume the temperature of the external environment the first year after injury?
poikilothermia
What refers to the abnormal formation of bone deposits on muscles, joints, and tendons?
heterotopic ossificiation
An injury affecting the UMN bladder is aka
reflex or spastic bladder
An injury affecting the LMN bladder is aka
nonreflex or flaccid bladder
People with ____ bladder require a catheter
LMN
The application of external pressure on the abdomen with their fists, starting at the umbilicus and pressing downward is called
credes maneuver
what is a process of muscle contractions resulting in the movement of food through the digestive track and a relaxation of the rectal sphincters?
peristalsis
What is stage 1 of a pressure sore?
clinical signs are reddened or darkened
damage is superficial
removing pressure can halt tissue breakdown
What is stage 2 of a pressure sore?
skin is red and open
blister or scap present
involves deep into adipose tissue
wound dressings may be involved
What is stage 3 of a pressure sore
wound draining
muscle may be visible
ulcer developing in necrotic tissue
wound dressings and surgical interventions
what is the function of the spinocerebellar pathway
nonconscious proprioception
what is the function of the lateral spinothalamic pathway
pain, temp
what is the function of the ventral spinothalamic pathway
touch, pressure
what is the function of the fasciculus gracilis/ cuneatus pathway
2 point tactile discrimination, vibration, conscious proprioception, stereognosis
what is the function of the spinocervicothalamic pathway
touch, proprioception, stereognosis, vibration
what is the function of the lateral corticospinal pathway
movement to extremities
what is the function of the ventral corticospinal pathway
movement of neck and trunk
what is the function of the vestibulospinal pathway
equilibrium
what is the function of the reticulospinal pathway
autonomic functions, motor respiratory functions
What are the primary muscle groups of C1-C3?
infrahyoid muscles
head/neck extension
rectus capitis
sternocleidomastoid
longus colli/capitis
scalene
primary movements of C1-C3
depression of hyoid
neck extension, flexion, rotation, and lateral flexion
what are the primary muscle groups of C4
trapezius and upper cervical paraspinals
diaphragm
what are the primary muscle groups of c5
rhomboids, deltoids, rotator cuff muscles, biceps, brachialis, brachioradialis
what are the primary muscle groups of c6
rotator cuff muscles, serratus anterior, pectoralis, supinators, extensor carpi radialis, flexor carpi radialis
what are the primary muscle groups of c7
lats
pec major
triceps
pronator teres
flexor carpi radialis
flexor digitorum superificalis
extensor digitorum
extensor pollicis longus and brevis
what are the primary muscle groups of C8
flexor carpi ulnaris
extensor carpi ulnaris
flexor digitorum profundus and superficialis
flexor pollicis longus and brevis
abductor pollicis longus
abductor pollicis
opponens pollicis
lumbricals
what are the primary muscle groups of T1
dorsal interossei
palmar interossei
abductor pollicis brevis
lumbricals
erector spinae muscles
intercostal muscles
what are the primary muscle groups of t4-t8
erector spinae group
intercostals
abdominals
what are the primary muscle groups of t9-t12
lower erector spinae muscles
lower intercostals
abdominals
quadratus lumborum
what are the primary muscle groups of L1-L3
quadratus lumborum
iliopsoas
erector spinae
what are the primary muscle groups of L4-L5
lumbar erector spinae
hip adductors
hip rotators
quads
hammies
tibialis anterior
what are the primary muscle groups of s1-s2
hip extensors and abductors
hammies
plantar flexors
invertors and evertors of ankle
what are the primary muscle groups of s2-s5
bladder
lower bowel
genital innervations
what are the primary movements of s2-s5
bowel functions
what are the primary movements of s1-s2
hip extension, abduction, and stability
knee flexion
ankle plantar flexion
ankle inversion and stability, and eversion
what are the primary movements of l4-l5
lumbar extension and stability
hip adduction and rotation
knee flexion and extension
ankle dorsiflexion
what are the primary movements of L1-L3
pelvic elevation
hip flexion and lumbar extension
what are the primary movements of T9-T12
thoracic spine extension
trunk flexion, extension, rotation, and stability
what are the primary movements of T4-T8
thoracic spine extension
respiratory function
thoracic flexion
trunk flexion
what are the primary movements of T1
finger abduction and adduction
thumb adduction
MCP flexion with IP extension
thoracic spine extension
respiratory function
what are the primary movements of c8
wrist extension, adduction, and abduction
finger flexion
thumb flexion, abduction, adduction, and opposition
flexion at MCP with IP extension
what are the primary movements of c7
elbow extension
wrist flexion
forearm pronation
finger flexion, extension
thumb extension
what are the primary movements of C6
shoulder rotation, adduction, flexion and extension
scapular abduction
horizontal shoulder adduction
wrist extension and flexion
what are the primary movements of C5
scapular downward rotation
shoulder external rotation, flexion, and extension
shoulder abduction and rotation
elbow flexion
what are the primary movements of C4
shoulder elevation
scapular adduction and depression
indpendent breathing
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