Creado por Jordan Jones
hace más de 6 años
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Pregunta | Respuesta |
Tetraplegia (quadriplegia) | Partial of full Paralysis of the four limbs and trunk musculature |
Paraplegia | Paralysis of the LEs with some involvement of the trunk and hips |
Complete lesions | Absence of motor or sensory function of the spinal cord below the level of the injury |
Incomplete lesions | May involve several neurological segments, and some spinal cord function may be in partially or completely intact |
Central Cord Syndrome | Cellular destruction occurring in the center of the spinal cord |
Affects of Central Cord Syndrome | Paralysis and sensory loss in the UEs d/t damage to centrally located nerve tracks |
Brown-Sequard Syndrome (Lateral Damage) | One side of the spinal cord is damaged, as in a stabbing or gunshot injury |
Ipsilateral side of Brown-Sequard Syndrome | Motor paralysis and loss of proprioception below the level of injury |
Contralateral side of Brown-Sequard Syndrome | Loss of pain, temperature, and touch sensation |
Cauda Equina (Peripheral) | Involves peripheral nerves, usually occurs with fractures below L2 level, flaccid-type paralysis typical |
Deficits of Cauda Equina injuries | Highly variable and asymmetrical sensory and motor deficits |
Anterior Spinal Cord Syndrome | Injury that damages the spinal artery or anterior aspect of the spinal cord |
Deficits of Anterior Spinal Cord Syndrome | Paralysis and loss of pain, temperature, and touch sensation. Proprioception is preserved. |
Conus Medullaris Syndrome | Injury of the sacral cord (conus) and lumbar nerve roots within the neural canal. |
Deficits of Conus Medullaris Syndrome | Areflexic bladder, bowel, and lower extremities. |
Prognosis for complete lesions | Motor function less likely to return if no sensation or return of motor function below level of lesion 24-48hrs after injury |
Prognosis for incomplete lesions | Progressive return of motor function possible; dependent on when recovery process begins |
Goals of early medical treatment of SCI | Restore normal alignment of the spine, maintain stabilization of the injured area, decompress neurological structures that are under pressure |
Goals of SCI surgery | Decompress the spinal cord, achieve spinal spinal stability and normal bony alignment |
Complications of Spinal Cord Injury | 1. Skin breakdown, pressure sores, or decubitus ulcers; 2. Decreased vital capacity; 3. Osteoporosis; 4. Orthostatic Hypotension; 5. Autonomic Dysreflexia; 6. Spasticity; 7. Heterotopic Ossification |
Areas to most likely develop skin breakdown | Bony prominences: sacrum, ishium, trochanters, elbows, heels, iliac crest, scapula, knees, toes, rib cage |
Signs of developing skins problems | 1. Skin reddens yet blanches when pressed 2. Reddened area does not blanch (death of tissue -necrosis) 3. Blister or ulceration appears in area |
Methods to prevent pressure sores | 1. Routinely turning in bed; 2. Use specialized mattresses & pressure relief w/c cushions; 3. Use padding to protect bony prominences; 4. weight shifts |
Decreased Vital Capacity | Limited chest expansion and decreased ability to cough d/t weakness/paralysis of diaphragm, intercostal, and latissimus dorsi muscles |
Common areas of pathological fractures d/t Osteoporosis | LEs: supracondylar area of the femur, proxmial tibia, distal tibia, intertrochanteric area of femur, neck of femur |
Causes of Orthostatic Hypotension | Lack of abdominal and LE muscle leads to blood pooling; rapid change in body position (supine to upright) |
Symptoms of Orthostatic Hypotension | Dizziness, nausea, loss of consciousness |
How to reduce Orthostatic Hypotension symptoms | 1. Recline Pt quickly; if in w/c, tipped back with legs elevated until symptoms subside 2. Dress with abdominal binders, compression garments, antiembolism stockings, meds |
Autonomic Dysreflexia | Typical in injuries above T6; reflex action of the autonomic nervous system in response to some internal stimulus |
Symptoms of Autonomic Dysreflexia | immediate pounding headache, anxiety, perspiration, flushing chills, nasal congestion, sudden onset of hypertension, bradycardia |
Treatment of Autonomic Dysreflexia | 1. Place Pt in upright position 2. Remove restrictions (abdominal binders, elastic stockings) 3. Drain bladder 4. Check leg bag tubing for obstruction |
Persons with injuries above T6 typically have this condition | Autonomic Dysreflexia |
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