7313/7333 Bringman > 2.24 SCI > Flashcards

2.24 SCI Flashcards

(44 cards)

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1
Q

SCI causes due to trauma in order of most to least prevalent

A
  1. MVA
  2. falls (esp in elderly)
  3. acts of violence/passion
  4. sports act
  5. other
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2
Q

percentage of SCI causes: MVA

A

38%

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3
Q

percentage of SCI causes: falls

A

30%

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4
Q

percentage of SCI causes: acts of violence/passion

A

14%

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5
Q

percentage of SCI causes: sports act

A

9%

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6
Q

percentage of SCI causes: other

A

9%

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7
Q

What are some of the “other” causes of SCI?

A
  • surgical
  • transverse myelitis
  • infection
  • spinal stroke
  • bone growths
  • stenosis
  • cancer
  • Down syndrome
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8
Q

If someone presents like a SC injury, how should it be treated?

A

treat it like a SC injury

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9
Q

spinal stroke

A

artery blocked that supplies te spine

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10
Q

Why would pts with Downs be likely to get SCI?

A

alar ligament laxity

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11
Q

spinal nerves 3, 4, and 5…

A

keep the diaphragm alive

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12
Q

Living through initial injury with SCI

A
  • most important thing initially is that they live through it
  • Most people who live do so because there was immediate healthcare provided
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13
Q

Which region of SC injury carries with it a high risk of death?

A

upper cervical

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14
Q

Out of all the cervical vertebrae that could be fractured, which one could be considered ideal and why?

A
  • better to fracture C1 or C2 than any of the others
  • most with one of these either walk out of the hospital or die
  • more space between the two vertebrae
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15
Q

rehab issues for SCI pts

A
  • functional skills (ADLs, clear cut, etc.)
  • psychosocial
  • sexuality
  • equipment
  • home
  • job
  • recreation
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16
Q

Rehab for SCI PTs: Why would it be better for them to go to a place like Shepherd if it’s available to them?

A
  • Most places can do functional skills, equipment, home

- Shephard is the one that deals with EVERYTHING

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17
Q

Rehab for SCI PTs: length of time

A
  • looking at months and years

- every aspect of their lives has changed in a moment

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18
Q

typical SCI pts

Study These Flashcards
A
  • 18-30 y.o. white male

- because they do stupid stuff

19
Q

quadriplegic

Study These Flashcards
A

all four limbs involved (typically indicative of cervical injury)

20
Q

paraplegic

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A

arms are full functioning

21
Q

hand placement and SCI pts

Study These Flashcards
A
  • Hand touching a SCI pt at all time

- the only time hands should be off the patient is when they are supine on the bed

22
Q

most to least likely region to get a SCI

Study These Flashcards
A

cervical
lumbar
thoracic

23
Q

Why is c-spine more likely to get injured?

Study These Flashcards
A
  • more mobile

- less stability

24
Q

types of c-spine SCI mechanisms

Study These Flashcards
A
  • flexion injury
  • flexion rotation injury
  • extension injury
  • axial loading
25
With a flexion injury, what gets ruptured and how?
- PLL ruptured - c-spine flexed and pressure added (axial loading---football players) - allows for increased posterior separation and teardrop fx - can get anterior translation of vertebral body
26
teardrop fx
when a piece of prox vertebral body breaks out and moves anteriorly
27
What can happen to the spinal cord in a flexion injury?
- ruptured - stretched - pinched could also rupture an artery
28
burst fracture
get bone fragment that enters spinal canal
29
flexion rotation injury
lock down one side and the other side becomes hypermobile
30
Which types of injuries could lead to Brown sequard?
- flexion rotation injury | - shootings, stabbings
31
Brown sequard
half of spinal cord gets injured
32
example of extension injury
falling and hitting your chin on the tub
33
With extension injuries, get rupture of this
ALL
34
rupture of ALL in extension injury
- takes tremendous amount of force to rupture - get subsequent fracture of facets and posterior structures - head stays still and body keeps translating down » shear force
35
axial loading cervical injury
- often a diving injury - burst fracture of a vertebrae - no more stability, head wobbles around
36
major causes of lumbar SCI
falls: compression and vertebral wedging
37
Why is t-spine less likely to get SCI?
- ribs, abs, bigger vertebral bodies | - super stable
38
What is needed to create an SCI in the thoracic spine?
- requires a LOT of force - or an outside force penetrates T-spine, typically with enough force that it stays that way - typically what would be considered a complete injury
39
What type of injury does an MVA often produce?
SCI at interface between thoracic and lumbar where seatbelt locks us in - high likelihood of injury - pelvis stays still and the rest of us moves
40
What are the main ways to get a thoracic SCI?
- MVA - shootings, stabbings - elderly
41
Why are elderly people susceptible to SCI in thoracic spine?
- kyphotic - osteoporotic - falls, get vertebral wedging and compression fracture (often get domino effect » line of force anterior to spinal column)
42
transfers: assistance level
depends on how much the pt helps
43
max A
usu 1-20% pt help from the pt
44
dependent
100% assistance req
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