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Flashcards in Spinal Symposium Deck (20)
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1
Q

Which myotomes supply which upper arm muscles?

A

Shoulder Abduction - Deltoid - C5

Elbow flexion & Wrist extension = C6

Elbow extension = C7

Finger flexion (FDS/P) = C8

Finger Abduction (interossei) = T1

2
Q

Which myotomes supply the lower limbs?

A

Hip flexion - Iliopsoas - L2

Knee Extension - Quads - L3/4

Ankle Dorsiflexion - Tib Ant - L4

Hallucis Extension - EHL - L5

Ankle Plantar Flexion - Gastroc - S1

3
Q

Peak demographic for a spinal cord injury?

A

Males 20-29yrs

Majority caused by falls or RTAs

4
Q

How do we grade spinal injuries?

A

ASIA grading A–>E

A = complete (no sensory/motor function preserved)

B-D = Incomplete

E = Normal function

5
Q

Define Quadraplegia and how it happens?

A

Partial/total loss of use of all 4 limbs & trunk

Due to damage in cervical cord (Phrenic keeps you alive)
May present with spasticity

6
Q

Define Paraplegia?

A

Partial/total loss of use of lower limbs +/- bladder/bowel

Thoracic/lumbar/sacral injury

7
Q

What type of injury is likely to occur in an elderly patient who falls and hyperextends their neck?

A

A central Cord Syndrome

Damage to the central cervical tracts in older people with arthritic necks who hyperextend, typically when falling

8
Q

How does a central cord syndrome look?

A

Weakness greater in arm than legs

Perianal sensation & lower limb power largely preserved

9
Q

What happens in anterior cord syndrome?

A

Hyperflexion injury

You damage everything but the dorsal columns –> Profound weakness but retaining fine touch and proprioception

10
Q

How could an anterior cord syndrome be caused?

A
  • Hyperflexion
  • Ant Compression fracture
  • Ant Spinal art damage
11
Q

What is brown-sequard syndrome?

A

Hemi-section of the cord due to a penetrating injury

12
Q

How does brown-sequard syndrome present?

A
Ipsilateral Paralysis (CST damage)
Ipsilateral loss of proprioception & fine touch (dorsal columns)
Contralateral loss of pain & temp (STT)
13
Q

How do you manage an acute Spinal cord injury?

A

ABCD incl:

  • C-spine control
  • Ventilation & O2
  • Fluids
  • Vasopressors for neurogenic shock
  • Log rolling
  • Assess neuro function incl. PR & perinanal sensation
14
Q

How can you spot neurogenic shock in a SCI?

A

Injury above T6 with -hypothermia

  • bradycardia
  • hypotension (due to symp outflow damage)
15
Q

How can you differentiate spinal shock from neurogenic

A

Spinal shock is:

  • Transient (hrs to days)
  • Flaccid paralysis (vs spastic)
  • Areflexia (vs hyperreflexic)
16
Q

What’s the preferred method for fixing a spinal injury?

A

If it’s an unstable fracture –> Pedicle screw

17
Q

What can we provide long term for a SCI patient?

A
  • Transfer to SCI unit
  • Physio
  • OT
  • Psychological support
  • Urological & sexual counselling
18
Q

What would you see in brown -sequard syndrome?

A
  • Paralysis of affected side
  • Loss of proprioception and fine discrimination on affected side
  • Pain and temperature loss on the opposite side of the lesion.
19
Q

what is spasticity?

A
  • Increased muscle tone
  • Upper motor neuron lesion
  • Spinal cord and above (CNS)
  • Injuries above L1
20
Q

Difference between a complete and an incomplete SCI?

A

Complete

  • no motor/ sensory function distal to lesion
  • no anal squeeze
  • no sacral sensation
  • ASIA grade A
  • No chance of recovery

Incomplete

  • Some function present below the site of injury
  • more favourable prognosis overall