9. 1Neurological Content for quiz.docx

9. 1Neurological Content for quiz.docx - 1 Neurological...

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1 Neurological Content Review prior to coming to class – information to be quizzed over 1. Low Back Pain a. Acute low back pain : lasts 4 weeks or less i. Causes: undue stress (hyperflexion) b. Chronic Low Back Pain : lasts more than 3 months i. Causes: degenerative disk disease, lack of physical exercise, prior injury, obesity, structural and postural abnormalities, and systemic disease. 2. Herniated Intervertebral Disk – What is it? Where does it most commonly occur? a. Causes of herniated disks? a. age or repeated trauma/stress to the spine. b. Clinical manifestations of herniated disks in the lumbar area? a. Back pain with radicular pain b. Depressed/absent reflexes c. Paresthesia/muscle weakness d. Bowel or bladder incontinence in Caude Equina i. What is Cauda Equina and why does it occur? a. multiple nerve root damage e. Specifics for herniated disks in the cervical area/Neck pain i. Causes: hyper reflexion and extension injury, cervical nerve root compression d/t stenosis, DDD, herniation ii. Clinical manifestations : stiffness, neck pain and possible pain radiating into the arm and hand; may also radiate to head, anterior chest, thoracic spine and shoulders 3. Spinal Cord Injuries a. Disrupts individual growth and development b. Alters family dynamics c. Economic impact d. High cost of rehabilitation and long term care e. Etiology: Who is most likely to experience a spinal cord injury? 1. 42%: car crash, 27%: falls, 15% violence; 7%: sports f. Causes of spinal cord injury? 1. See Above g. Pathophysiology of spinal cord injuries – Fig. 61-4 1. Injury to the spinal cord is caused by: i. Bone displacement causing compression of the cord ii. Interrupted blood supply to the cord iii. Traction resulting from pulling on the cord iv. Penetrating trauma causing tearing or transaction from gun shots or knife 2. What is the primary injury? i. initial mechanical disruption of axons d/t stretch or laceration 3. What is the secondary injury? How does it differ from the primary injury? What happens: i. Within 1 hour of initial injury hemorrhagic areas in the center of spinal cord appear ii. By 4 hours after injury infarction in the gray matter (inside) iii. By 24 hours or less permanent damage r/t edema! iv. Ischemia, hypoxia, microhemorrhage, edema damage! v. 72 hours after injury prognosis is determined 4. Spinal shock vs. Neurogenic shock vs. Autonomic Dysreflexia i. What is spinal shock? 1. When does it happen? WHEN YOU HAVE A COMPLETE SPINAL CORD INJURY. About 50% of patients with a complete injury will get spinal shock. 2. How long can it occur? ????? 3. Clinical manifestations include: decreased reflexes, loss of sensation, and flaccid paralysis below the level of injury
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2 4. How do you know it is resolving? Return of reflexes 5. What are the clinical manifestations of spinal shock : see above ii. What is neurogenic shock? How does neurogenic shock differ from spinal shock?
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