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ch 45 spinal cord
ch 45 spinal cord
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10/26/2013

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Term
where do most herniated disc often occur
Definition
4th and 5h vertebrea
Term
buldgin herniated nuicleus pupossus in the lumbosacral area can cause what
Definition
pressing on the sciatic nerve that can cause sever stabbing pain that radiates dwon the leg
Term
spondylolisthesis
Definition
occurs when one vertebrea slips forward on the one belwo it this can press of nerve roots leading to pain in the lower back and butt
Term
spinal stenosis
Definition
narrowing of the spinal cancal in those usually over 50
Term
what has beeen linked to back pain and deeneration
Definition
smoking
Term
egorninomics
Definition
applied science in the workplace to icrease the workers comfort and reduce injury o the back
Term
if the sciatic nerve is pressed where is the pain
Definition
when the persons leg is straight or lifted upward
Term
williams position for lower back pain
Definition
semi fowlers with apillow under the knees to keep them flexed
Term
why are opiods usually avoided in those with lower back pain
Definition
because they are no more effective then nonsteroidal analgesic and should be avoided
Term
phonophoresis
Definition
topicaldrug flollowed by continuous ultrasound
Term
iontrophoresis WHAT IS IT SIMILAR TO AND WHAT DO BOTH OF THESE PROCEDURES DO FOR BACK PAIN
Definition
similar to that of phonophoresis both of thesse procedures push the medicaitons deper sub Q AND PROVEID LONGER PAIN RELEIF
Term
diskitis
Definition
disc inflammation
Term
if csf is around the dressing after surgery what should be done
Definition
notify the surgeon- pt is usually kept on flat bed rest
Term
if a pt is unable to void following back surgery what could that mean
Definition
damge to the sacral spinal area and detrusor muscles
Term
what is the correct way to reposition a pt with back surgery
Definition
log rolling, pt is turned while back is striaght
Term
what are some techniques used for cervial neck pain with pt
Definition
shoulder shrugs
shoulder squeeze
seated row
Term
who usually cares for those with an acute spinal injury
Definition
icu
Term
what can a spinal cord injury lose funciton of
Definition
sensation reflexes bowel and bladder control
Term
what is a complete spinal cord injury what is an incomplete injury
Definition
the spinal cord is severly damged in a way that eliminates all innervations below the level of the injury

incomplete is when there is still some funciton left below the level of injury
Term
hyperflexion
Definition
head is suddenly accelerated forward
Term
hyperextension
Definition
when a vehicle is struck from behind and the head accelerates the decelerates
Term
axial loading
Definition
vertical compression when a jump occurs and the person lands on the feet or a blow to th top of the head
Term
rotation injuries
Definition
turning the head beond normal range
Term
secondary injuries with spinal injuries
Definition
worsent the primary injury
Term
spinal shock
Definition
occur suddenly as a cord response to an injury the pt has loss of motor and sensory reflex and it usually lasts 49 hrs but can go on for several weeks
Term
how can you test a spinal cord injured persons sensory
Definition
have them close their eyes and touch them with a cotton tipped and ask if they can feel it
Term
hypoestherisa/ hypertheisa
Definition
decresed sensation/ increased sensation
Term
what is the six point gradin scale and whats a 0- 5?
Definition
spinal scale to asess funciton/ 0 is no movement and a 5 is normal strength agaisnt resistance
Term
what injury does a pt have if they can flex their arms but can not extend them
Definition
5th or 6th cervical vertebrae
Term
cardiovascular dysfuntion from a disruption of the ans is especially true if there is an injury above what vertebrae
Definition
above the 6th
Term
what is a sing of loss of sympathetic input from an above 6th vertebrae injury
Definition
bradycardia hypotension and hypothermia
Term
a lack of sympathetic response can cause the pt to lose thermoregulatory functions why/ what temp does the body take over
Definition
lack of hypothalamic control causes the body to attempt to take the temperature of the enviroment around them
Term
why is a pt with a spinal injury at risk for breathing problems
Definition
there is an interruption from spinanl intervation to the respiratory muslces
Term
autonomic dysfunciton can cause areflexic bladder
Definition
no refelx for bladder contraction which can lead to urinary retention
Term
what are some complications from long term spinal injuries and prolonged immobility
Definition
muslce wasting
skin breakdown
heterotopic ossification
Term
heterotopic ossification
Definition
bony overgrwoth into muscle from prolonged immobility
Term
pt with a leve t6 are especially at risk for respiratory problems why
Definition
these are from complications of impaired funcitoning of the intercoastol muscles and decreased mobility
Term
what can you teach a pt who is tetrapalegic to do to cough
Definition
cough assis place both hand on eithere side of the rib cage below the diaphram and push upward to exapnd lungs and cough
Term
neurogenic shock usually will occur in 24 hrs with a pt with a t6 injury what will you monitor for
Definition
sever bradycardia
warm dry skin
sever hypotension
Term
halo fixation is used to fix a cervial spine injury it is worn for 8 week how is it place in th ept
Definition
four pins are inserted into the skull and attached to a special vest
Term
what are some common complications from a halo device
Definition
infection looses pins
scarring
osteomyletis
Term
what medicaiton is perscribed with spinal cord injuries
Definition
solumedrol (*methylpredisoe) to decrease inflammation
Term
what will be used if the pt becomes severly bradycardia
Definition
atropine
Term
decompression laminectomy
Definition
rmoval of one or more laminae to allow for cord expansion
Term
why does a person with a spinal injury at risk fro blackouts and syncope
Definition
because ther si a disruption in the psinal cord and it doesnt always allow the blood up to the brain
Term
how can you direct a pt with a flaccid bladder to empth=y bladder
Definition
valsalva maneuver or tightening ab muscles
Term
autonomic dysreflexia
Definition
excessive uncontrolled sympathetic output
headache
b\rady
nasal stuffiness and flushing
Term
emergency interventions for those with autonomic dysreflexia 4
Definition
sitting position
looses tight clothes
check bladder distention
give nitrates
Term
what does sexula funciton after a spinal injury depend on
Definition
level and extent of the injury
Term
expalin sexual function and diferent levels of lesions for spinal injuries
Definition
incomplete- control over some sensation
complete - no control
men above t6 injury can still have an erection, ejaculation may be less predicatable
Term
what areosme instructions for the pt with a halo device 4
Definition
use straws to drink\
bed baths or baths
do not drive
wrap pins with cloth before going in the cold
Term
what are the most common complication later with a spinal injury and what is done to prevent it
Definition
repiratory infections get a f lu shot
Term
what is the most common problem with a spinal tumor
Definition
pain
Term
radicular pain
Definition
stabbing or dull pain that increases during coughing or lying flat
Term
what are some sings of cortocospinal tract porblems
Definition
ataxia
hypotonia
babinskis sign
Term
multiple sclerosis what is it and whos it affect
Definition
affects the mylin sheath and condution of the path to the cns
young adults and has periods of exacterbation and remission
Term
what is the patho behind MS
Definition
inflammatory response with patchy areas of plaque in the white matter of the cns this dymelinates
impulses are still transmitted but not as well
Term
relapsing remitting ms
Definition
occurs in MS symptoms develop but then the pt retunrs to basline
Term
primary progressive ms
Definition
steady deteroation without remission
Term
secondary progressive ms
Definition
begins with a relapse that later becomes steadily progressive
Term
progressive relapsing MS
Definition
frequent relapses with partial recovrey but never returns to baseline
Term
what is the cause of mS
Definition
viruses
genes
enviroment
Term
MS symptoms 4
Definition
sensitivty to temps
flexor spasms
hyperactivedeep reflexes
positive babinskis
Term
intention tremor and dysmetria with MS
Definition
tremors when performing acitivy/ inability to direct movement
Term
what should you ask the pt during an assesment with ms
Definition
tinnitus
dizzyness
vertigo
Term
what are 5 typical findings in pupils with MS
Definition
double vision'decreased vision
blured vision
sctomas ( changesin visual field)
nystagmus ( involuntary rapid eye movemtn)
Term
pg 980
Definition
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