spinal cord injury 7

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  1. 4 indidcations for laminectomy
    • ascending neurological deficit
    • progressive paralysis
    • dev of paralysis after free interval
    • pain due to irritation of a nerve root
  2. 4 reasons for surgical procedures in later stages after SCI
    • persistant or recurring instability
    • restitution of neural function
    • treatment of spasticity and contractures
    • treatment of pain
  3. methylprednisolone
    • a bit of a wonderdrug
    • an antiinflammatory
    • if given within 8 hours of trauma the results of injury are significantly lessened
    • no known downside to this one-time usage
  4. sygen
    drug used experimentally to aid in neural regeneration
  5. use of diuretics for SCI pts?
    to prevent inflam / fluid buildup
  6. most common site of c-spine injury, what happens here and how it'll look on x-ray
    3 things about how this can present
    • C5
    • rupture of vertebral plates and shattering of body
    • on x-ray - wedge fracture

    • can involve roots and/orcord
    • fragments can project into cord
    • ligaments can remain intact
  7. cervical flexion injuries - un/stable? dislocating which way? probably in/complete?
    • unstable due to disruption of post ligs
    • ant dislocation w cord compression & shearing
    • likely complete
  8. where are most cervical hyperextension injuries? typically caused by what?
    • C4-5
    • MVA accell injuries
  9. 4 characteristics of cervical hyperextension injuries
    • occult soft tissue injuries
    • cord involvement probable
    • central cord syndrome
    • more common in elderly due to cervical DJD
  10. main feature of central cord syndrome, and what type of injury inspires this?
    • UE > LE involvement
    • cervical hyperextension injury
  11. flexion rotation injuries - most common where?
  12. main anatomical features of flexion rotation injury
    • unilateral facet joint dislocation
    • vertebra is displaced on x-ray
    • spinal canal narrowing
    • interruption of disc, joints, ligs, w/o fx
  13. why is there often no neural involvement in flexion rotation injuries?
    and if there is cord damage, what kind is it?
    • insufficient canal narrowing
    • incomplete
  14. 3 main causes for complete lesions
    • bilateral facet joint dislocation
    • thoracolumbar flexion/rotation
    • transcanal gunshot/projectile wound
  15. 3 main causes for incomplete lesions
    • cervical spondylosis
    • unilateral facet joint dilocation
    • projectile injuries w/o canal penetration
  16. spondylosis
    degeneration of a vertebra
  17. 5 reasons for progressive surgical approach
    • anterior decompression
    • reduction of dislocation w locked facets
    • reduction of compression fractures
    • posterior element fractures
    • upper cervical spine fractures
  18. 5 basica aims of acute SCI management
    • prevent complications
    • prevent further damage to spinal cord
    • aid healing of damaged spine
    • relieve pressure on cord
    • achieve healing of compound injuries after proper wound debridement
  19. 5 additional medical problems in SCIs
    • labile BP
    • congested nasal passages
    • decreased blood sugar
    • difficulty swallowing
    • loss of heat control
  20. 5 basic findings w complete SCIs -- loss of...?
    • vol movement below the level
    • sensation below the level
    • bowel & bladder control
    • normal sexual function
    • contorl of symp nervous system
  21. primary causes of death in SCI (post acute)
    • acute respiratory failure (if diaphragm is involved) or pneumonia
    • heart disease
    • subsequent trauma
    • septicemia (infection)
  22. secondary causes of death in SCIs (post acute)
    • chrinic respiratory failure
    • bladder dysfunction
    • bowel dysfunction
    • cachexia / failure to thrive
  23. spinal shock - lasts how long, char by what, what do we think of early res?
    • period lasting hours to weeks or months
    • flaccid paralysis characterized by complete paralysis, arreflexia, and sensory loss below level of lesion
    • early resolution of spinal shock is considered an important pos prognostic sign
  24. 2 things that can prolong spinal shock
    • sepsis
    • malnutrition
  25. an early sign that spinal shock is resolving (ending)
    bulbocavernosus reflex - put a digit of probe in the rectum and stim the genitals, looking for a clenching of the rectum
  26. which way do symptoms progress as you enter and leave shock?
    they progress distally and as they recede they move proximally

Card Set Information

spinal cord injury 7
2013-02-18 20:51:25
spinal cord injury

rosen & karpatkin spring 2013
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