Spinal Cord Injuries and Patient Transfers Quiz
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Questions and Answers

Which of the following is the MOST common type of incomplete spinal cord injury?

  • Central Cord Syndrome (correct)
  • Brown-Sequard Syndrome
  • Anterior Cord Syndrome
  • Posterior Cord Syndrome

A patient presents with greater motor and sensory deficits in their upper limbs, with relatively preserved function in their lower limbs. Bowel and bladder control is mostly intact. Which spinal cord syndrome is MOST likely?

  • Brown-Sequard Syndrome
  • Posterior Cord Syndrome
  • Central Cord Syndrome (correct)
  • Anterior Cord Syndrome

A patient has an injury to one side of the spinal cord. Which of the following deficits would you expect on the ipsilateral side?

  • Loss of motor function and proprioception (correct)
  • Loss of pain and temperature sensation
  • Loss of motor function only
  • Loss of pain and proprioception

A patient with Brown-Sequard Syndrome has lost motor control on the left side of their body, which side of their body will have lost pain and temperature sensation?

<p>The right side (B)</p> Signup and view all the answers

What is the MOST likely cause of Central Cord Syndrome?

<p>Hyperextension injury (A)</p> Signup and view all the answers

Before initiating a patient transfer, what is the MOST important action to ensure patient safety and cooperation?

<p>Ensuring the patient understands the transfer process. (A)</p> Signup and view all the answers

When setting up equipment for a patient transfer, which of the following is MOST crucial for preventing accidents?

<p>Applying brakes on the wheelchair and removing obstructions. (D)</p> Signup and view all the answers

Which posture MOST effectively enables a safe lift during a patient transfer?

<p>Feet shoulder-width apart, knees bent, and pelvic tilt. (D)</p> Signup and view all the answers

During a patient transfer, why is it important to use body weight and momentum?

<p>To minimize strain on the caregiver's muscles and avoid injury. (A)</p> Signup and view all the answers

When turning during a patient transfer, which movement technique is MOST recommended to prevent twisting injuries?

<p>Pivoting or stepping around while maintaining a stable base. (A)</p> Signup and view all the answers

What is the primary difference between a direct and an indirect spinal cord injury?

<p>Direct injuries involve trauma to the spinal cord itself, while indirect injuries are due to surrounding tissue or bone damage. (A)</p> Signup and view all the answers

Anterior cord syndrome primarily affects which of the following spinal tracts?

<p>Corticospinal and spinothalamic tracts (D)</p> Signup and view all the answers

Which of the following best describes a secondary spinal cord injury?

<p>Delayed damage resulting from complications after the initial trauma. (A)</p> Signup and view all the answers

A patient with a hyperflexion injury to the spine is MOST at risk of which spinal cord syndrome?

<p>Anterior Cord Syndrome (C)</p> Signup and view all the answers

What is the distinguishing characteristic of a 'complete lesion' in a spinal cord injury?

<p>Full lesion of the spinal cord leading to total loss of motor and sensory function below the lesion. (D)</p> Signup and view all the answers

A patient presents with bilateral loss of motor function, pain, and temperature sensation. Which spinal cord syndrome does this MOST likely indicate?

<p>Anterior Cord Syndrome (D)</p> Signup and view all the answers

According to the provided content, what is the most common cause of traumatic spinal cord injuries?

<p>Motor vehicle accidents (C)</p> Signup and view all the answers

Which of the following is a non-traumatic cause of spinal cord injury?

<p>Radiation (C)</p> Signup and view all the answers

Which of the following spinal regions is MOST vulnerable to injury due to its instability in favor of mobility?

<p>C4-C6 (B)</p> Signup and view all the answers

A patient with a spinal cord lesion at T2 is likely to have which of the following functional capabilities?

<p>Intact arm function (A)</p> Signup and view all the answers

What is a common outcome of a diving-related spinal cord injury?

<p>Quadriplegia or paraplegia (A)</p> Signup and view all the answers

What is the correlation between motor vehicle accidents and spinal cord injuries according to the provided information?

<p>They are the most common cause of traumatic spinal cord injury. (A)</p> Signup and view all the answers

A patient experiences paralysis in their left arm, left trunk, and left leg. Which term BEST describes this condition?

<p>Hemiplegia (B)</p> Signup and view all the answers

Which of the following is an example of a vascular complication that could cause a spinal cord injury?

<p>Aortic aneurysm (C)</p> Signup and view all the answers

At what level of spinal cord injury is a patient MOST at risk of developing autonomic dysreflexia?

<p>T6 and above (A)</p> Signup and view all the answers

Which of the following best describes paraparesis?

<p>Muscle weakness in legs (B)</p> Signup and view all the answers

During a standing pivot transfer, what should the patient do after gaining balance?

<p>Turn and sit into the chair. (A)</p> Signup and view all the answers

When performing a standing pivot transfer from a chair to a bed, how should the patient be positioned in relation to their destination?

<p>The patient's stronger side should be closest to the bed. (C)</p> Signup and view all the answers

In the standing step around technique, what is the therapist's initial foot position?

<p>One foot is placed on either side of the patient’s feet, in a walking stance. (B)</p> Signup and view all the answers

During the stand up phase of the step around technique, where should the patient position their hands?

<p>Around the therapist's shoulders. (A)</p> Signup and view all the answers

When moving a patient from a chair to a table using the described technique, where does one of the therapist's hands go?

<p>On the patient's shoulder and the other under their knees. (B)</p> Signup and view all the answers

During a bed mobility procedure, which of the following actions is NOT recommended?

<p>Pull on the patient's shoulders to shift their weight. (B)</p> Signup and view all the answers

When performing a lateral shift, where should the therapist’s hands be placed on the turning sheet?

<p>As close to the patient as possible, at hip and shoulder level. (A)</p> Signup and view all the answers

In a 'pull turn to side lying', what is the recommended position of the patient’s far leg (unless contraindicated)?

<p>Flexed and crossed over the near leg. (C)</p> Signup and view all the answers

During a 'push turn to side lying', what should the therapist ensure regarding the patient's arm?

<p>That it does not get caught up during the turn. (A)</p> Signup and view all the answers

When moving a patient over the side of the bed, in what position should the patient’s upper hand be?

<p>In a fist in front of their abdomen. (A)</p> Signup and view all the answers

When centering a patient in a chair, where does the therapist place one hand for support during the movement?

<p>Underneath the patient's buttocks. (D)</p> Signup and view all the answers

When moving a patient back in a chair, where is the therapist's hand initially placed?

<p>Behind the patient's low back. (A)</p> Signup and view all the answers

During a hemi transfer, where should the wheelchair be positioned relative to the table?

<p>At a 45-degree angle to the table on the patient's strong side. (B)</p> Signup and view all the answers

In a hemi transfer, what is the positioning of the patient's feet on the floor compared to each other?

<p>The weak leg is slightly further back. (D)</p> Signup and view all the answers

During a hemi transfer, what part of the patient does the therapist support?

<p>Around the patient's waist. (D)</p> Signup and view all the answers

Flashcards

Primary Spinal Cord Injury

Damage that happens immediately due to the initial trauma.

Secondary Spinal Cord Injury

Damage that occurs later due to complications after the initial injury.

Complete Spinal Cord Lesion

A complete break in the spinal cord, leading to total loss of movement and feeling below the injury.

Incomplete Spinal Cord Lesion

A partial break in the spinal cord, leading to partial loss of movement or feeling below the injury.

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Direct Spinal Cord Injuries

Injuries caused by direct impact or pressure to the spinal cord.

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Indirect Spinal Cord Injuries

Injuries to the spine caused by damage to surrounding tissues and bones, indirectly affecting the spinal cord.

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Traumatic Spinal Cord Injuries

Injuries caused by trauma such as accidents, falls, or violence.

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Non-traumatic Spinal Cord Injuries

Injuries caused by conditions like tumors, infections, or blood clots, not directly related to trauma.

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Central Cord Syndrome

A spinal cord injury where the center of the cord is damaged, but the outer parts are intact. It's the most common incomplete spinal cord injury.

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What causes Central Cord Syndrome?

Caused by hyperextension or arthritis in the cervical spine, leading to damage in the center of the cord.

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Brown-Sequard Syndrome

A spinal cord injury where one side of the cord is damaged. It's often caused by a stabbing or gun shot wound.

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What are the symptoms on the affected side of the body in Brown-Sequard Syndrome?

The affected side of the body experiences loss of movement (motor function), and senses like position and vibration. Pain and temperature sensation remain normal.

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What are the symptoms on the opposite side of the body in Brown-Sequard Syndrome?

The opposite side of the body experiences loss of pain and temperature sensation. However, motor function remains unaffected.

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Safety First: Patient Transfer

Before moving a patient, ensure their environment is safe by removing tripping hazards like rugs, furniture, and personal items.

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Communication is Key: Transfer

Make sure the patient fully understands the transfer process and feels comfortable with what will happen.

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Clothes for Comfort and Safety

When preparing for a patient transfer, make sure their clothing is loose enough to allow for movement but secure enough to prevent snagging on objects.

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Proper Body Mechanics in Transfers

During a patient transfer, maintain a proper posture with feet shoulder-width apart, knees bent for support, and a pelvic tilt throughout the maneuver.

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Teamwork and Efficiency: Patient Transfers

When lifting a patient, use your body weight and momentum to make the move efficient. Coordinate the lift by counting "1-2-3-LIFT" with your team.

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Anterior Cord Syndrome

Damage to the anterior spinal artery or anterior spinal cord, affecting the corticospinal and spinothalamic tracts. This injury is often caused by a hyperflexion injury.

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Symptoms of Anterior Cord Syndrome

A person with this condition will have loss of motor function and sensation, affecting both sides of the body below the level of the injury.

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Vulnerable Areas for Anterior Cord Syndrome

The most vulnerable parts of the spine for this type of injury are C4-C6 and T12-L1, due to their mobility and less stable structure.

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Muscle Function with Anterior Cord Syndrome

Depending on the severity and location of the lesion, different levels of muscle function may be retained. For example, a C6-C7 injury might allow some arm and chest muscle function.

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Autonomic Dysreflexia

A state of exaggerated sympathetic nervous system response, often occurring in individuals with a spinal cord lesion above T6. It can trigger dangerously high blood pressure.

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Triggers of Autonomic Dysreflexia

Causes of Autonomic Dysreflexia include a full bladder or bowel, skin irritation, or even a cold draft.

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Diplegia

Paralysis affecting both the upper or lower limbs.

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Quadriplegia

Paralysis affecting all four limbs.

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Standing Pivot Transfer

A safe transfer technique where the patient stands up with support, pivots to face their destination, and then sits down. It involves patient using their strong side to support themselves.

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Standing Step Around Transfer

A transfer technique used to move a patient from a chair to a bed or other surface, where the patient stands briefly before stepping to their destination. It involves a therapist assisting the patient and providing support.

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Chair to Table Transfer

A transfer technique where a patient is moved from a seated position to a surface like a table. The therapist provides support and guidance.

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Pull turn to Side Lying

A technique used to help patients move from lying to sitting, involving the therapist using a turning sheet and applying gentle pulling force to the patient's hip and shoulder, while the patient's leg is flexed and crossed over the other leg.

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Over Side of Bed Transfer

Involves a patient facing the edge of the bed, knees bent, feet clear of the bed. The therapist moves the patient into a seated position by applying pressure on the scapula and SI region, while the patient pushes down on their own fisted hand.

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Hemi Transfer

The patient's weaker leg is positioned further back, and the therapist blocks the weaker foot and knee to help with stability.

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Centering a patient in their chair

The therapist, facing the patient, crouches and uses their hands to place the patient's legs between their own. They then rock the patient forward while supporting the thorax and buttocks, then uses a sideways pressure to center the patient in the chair.

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Moving a patient back in their chair

The therapist crouches and stabilizes the patients knees between their own, then locks their hands behind the patient's low back. They tilt the patient forward, then rock them backward while supporting their weight, pushing them into a fully reclined position.

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Bed Mobility Technique

To achieve a coordinated movement, the therapist counts aloud and rocks the patient in the direction of the desired movement.

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Body Mechanics for Patient Movement

During any movement, the therapist should support the patient's shoulder and pelvic girdle while avoiding pulling on the shoulders, to ensure safety and prevent injury.

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Maximum Patient Participation

Ensuring that the patient is fully engaged in the movement and that the therapist utilizes whole body momentum, rather than just relying on arm strength.

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Pull turn to side lying

The patient is positioned with their far leg flexed and crossed over the near leg, unless contraindicated. The therapist then grasps the patient at the hip and shoulder and pulls them towards them on the count of three.

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Push turn to side lying

The patient is positioned with their far leg flexed and crossed over the near leg. The therapist, with a pillow for the patient's knee, grasps the hip and shoulder and pushes the patient towards their side on the count of three, ensuring the patient's arm doesn't get caught.

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Study Notes

Spinal Cord Injuries

  • Definition: Injuries from direct or indirect damage to the spinal cord, or surrounding tissues/blood vessels. This leads to paralysis and/or loss of sensation, partially or wholly.

Classifications

  • Direct vs. Indirect: Direct trauma affects the spinal cord directly, indirect occurs through surrounding tissue damage.
  • Primary vs. Secondary Damage: Immediate damage is primary, while delayed damage post-injury is secondary.
  • Complete vs. Incomplete Lesion: Complete means total motor and sensory loss below the injury point; incomplete means partial loss. Incomplete injuries are more common.

Etiology

  • Trauma: Often caused by motor vehicle accidents (most common - 97% are non-seatbelt related), diving, contact sports (American football, rugby), and violent trauma (gunshot/stab wounds).
  • Non-Traumatic: Spinal hematomas, infections, radiation, neoplasms (tumors), vascular complications (e.g., cardiac arrest, aortic aneurysm).

Specific Incomplete Spinal Cord Injuries

  • Central Cord Syndrome: Most common incomplete injury; damage to the central spinal cord with peripheral sparing. Typically from hyperextension or arthritis of the cervical spine. Affects upper limbs more than lower.
  • Brown-Séquard Syndrome: Damage to one side of the spinal cord, often caused by stabbing/gunshot wounds. Ipsilateral (same side) motor function/sensation loss. Contralateral (opposite side) pain/temperature loss.
  • Anterior Cord Syndrome: Damage to the anterior spinal artery/cord, affecting both corticospinal and spinothalamic tracts (pain, temperature, crude touch). Usually caused by hyperflexion. Results in bilateral motor and sensory loss.

Signs and Symptoms: Level of Injury

  • Vary based on the injured vertebral level and severity. Specific areas of the spine (e.g., C4-C6, T12-L1) are more vulnerable.

Types of Plegia

  • Monoplegia: One limb paralysis
  • Diplegia: Both (either upper or lower) limbs paralysis
  • Paraplegia: Both lower limbs paralysis
  • Paraparesis: Weakness in both lower limbs
  • Hemiplegia: One side of the body (including upper limb, trunk, and lower limb) affected.
  • Quadriplegia / Tetraplegia: All four limbs affected
  • Quadriparesis: Weakness in all four limbs

Autonomic Dysreflexia (AD)

  • An acute, exaggerated sympathetic response, potentially life-threatening. Common in injuries above T6. Painful stimuli in the abdomen or pelvic area (e.g., bladder distention) can trigger symptoms.
  • Symptoms: Severe hypertension, bradycardia, headache, vasospasms, skin changes (flushed/sweating), piloerection.

Massage & Spinal Cord Injuries

  • Adaptations: Modified techniques to accommodate the client's needs and limitations. Deep pressure and forceful stretching should be avoided to decrease risk of fractures or clots.

Transfer Techniques

  • General Guidelines: Respect, clear communication, leading role, planning, safety precautions, respect the individual.
  • Approaches: Client participation and understanding are crucial.
  • Equipment: Make sure brakes are engaged and unnecessary components are removed.
  • Positioning: Proper patient alignment to avoid risk of injury.
  • Techniques: Specific techniques (like over the side of bed, positioning in chair, hemi-transfer, standing pivot) are used depending on the situation.
  • Safety: Emphasis on preventing falls and maintaining stability at all times.

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Related Documents

Spinal Cord Injuries Class 3 Notes PDF

Description

Test your knowledge about spinal cord injuries and the appropriate procedures for patient transfers. This quiz covers various syndromes, their symptoms, and safety measures necessary during patient handling. Challenge yourself to see how well you understand these critical concepts in healthcare.

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