ABPMR SCI Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

ASIA Impairment Scale A

AIS A indicates a complete spinal cord injury: no sensory or motor function is preserved in the sacral segments S4-S5, including no anal contraction or deep anal pressure.

Neurological level of injury

The most caudal spinal cord segment with normal sensory and motor function on both sides of the body, determined by ASIA key sensory points and key muscle testing.

Sacral sparing

Presence of perineal sensation, anal contraction, or deep anal pressure in a patient with SCI; it distinguishes incomplete from complete injury and predicts better prognosis.

Zone of partial preservation

In complete SCI, the dermatomes and myotomes below the neurological level that retain some sensory or motor function; it is recorded only for AIS A injuries.

Upper extremity motor score

Sum of manual muscle test scores (0-5) for five key upper-limb muscles on each side; maximum is 50 per side and 100 total, used to track motor recovery.

Central cord syndrome

An incomplete SCI syndrome with greater weakness in upper limbs than lower limbs, often after hyperextension in a narrowed canal; sacral sensation is usually preserved and lower-limb function recovers first.

Brown-Séquard syndrome

An incomplete SCI syndrome from hemisection of the cord, causing ipsilateral motor and proprioceptive loss with contralateral pain and temperature loss below the lesion.

Neurogenic shock

Hypotension with bradycardia after cervical or high thoracic SCI due to loss of sympathetic vascular tone; treat with fluids, vasopressors such as norepinephrine, and atropine for symptomatic bradycardia.

Autonomic dysreflexia

A life-threatening syndrome in SCI at T6 or above with sudden hypertension, headache, sweating, and bradycardia triggered by noxious stimuli such as bladder distension or fecal impaction.

Acute SCI mean arterial pressure

Guidelines suggest maintaining mean arterial pressure at 85-90 mm Hg for about 5-7 days after acute SCI to optimize spinal cord perfusion, while avoiding prolonged severe hypertension.

Methylprednisolone in acute SCI

High-dose methylprednisolone is not routinely recommended for acute SCI because evidence of benefit is limited and risks include infection, hyperglycemia, and gastrointestinal bleeding.

DVT prophylaxis in SCI

Acute SCI carries high venous thromboembolism risk; guidelines recommend pharmacologic prophylaxis with low-molecular-weight heparin or unfractionated heparin plus mechanical prophylaxis when not contraindicated.

Respiratory failure in cervical SCI

Cervical SCI above C5 can impair diaphragm and intercostal function, causing hypoventilation, weak cough, atelectasis, and pneumonia; monitor vital capacity and consider noninvasive ventilation or intubation.

Heterotopic ossification in SCI

Abnormal bone formation in soft tissues, often around hips or knees after SCI, presenting with swelling, warmth, limited range, and elevated alkaline phosphatase; bone scan confirms early disease.

C6 tetraplegia functional goal

With preserved wrist extension, a person with C6 tetraplegia can use tenodesis grasp for feeding and grooming, drive with adaptive equipment, and assist transfers with a sliding board.

C7 tetraplegia functional goal

Preserved triceps in C7 tetraplegia enables independent transfers, pressure relief, manual wheelchair propulsion, and self-catheterization for many patients.

Body-weight-supported treadmill training

A locomotor training approach using harness support and treadmill stepping; evidence for walking recovery in incomplete SCI is mixed, and it is best used as part of individualized gait training.

Intrathecal baclofen

A pump-delivered GABA-B agonist used for severe generalized spasticity after SCI; it reduces tone and spasms but can cause withdrawal or overdose, so refill and alarm systems require monitoring.

Upper limb tendon transfer

Reconstructive surgery for tetraplegia that rebalances paralyzed muscles to restore grasp, pinch, or elbow extension; candidates need stable neurologic status and motivated rehabilitation participation.

Functional electrical stimulation cycling

An intervention using electrical stimulation of paralyzed leg muscles to drive cycling; it can improve cardiovascular fitness, muscle bulk, and bone density but does not restore walking.

Clean intermittent catheterization

The preferred bladder emptying method for many people with neurogenic bladder; a catheter is inserted every 4-6 hours to drain urine, reducing infection and pressure risk compared with indwelling catheters.

Neurogenic bladder upper motor neuron

After suprasacral SCI, the bladder shows detrusor overactivity and poor compliance with sphincter dyssynergia; management includes antimuscarinics, botulinum toxin, and intermittent catheterization.

Pressure injury stage 1

Intact skin with a localized area of non-blanchable erythema, indicating pressure injury; it may be painful, firm, soft, warmer, or cooler than adjacent tissue and should prompt immediate pressure relief.

Pressure injury stage 3

Full-thickness skin loss with visible subcutaneous fat, but not exposed bone, tendon, or muscle; slough or eschar may be present, and depth varies by anatomical site.

Bowel program in SCI

A scheduled regimen using diet, fluids, digital stimulation, suppositories, or manual removal to produce predictable bowel emptying; it should be individualized to the patient's level and bowel pattern.

Deep tissue pressure injury

Intact or non-intact skin with persistent deep bruising or discoloration that does not blanch, indicating damage to deeper tissues; it can deteriorate rapidly despite intact surface skin.

Depression after spinal cord injury

Depression is common after SCI and is associated with pain, functional loss, and social isolation; routine screening with tools such as the PHQ-9 and early treatment improve rehabilitation outcomes.

Sexual function after SCI

Sexual desire and orgasm may be preserved, but erection, lubrication, and ejaculation are often impaired; treatments include PDE5 inhibitors, vibratory stimulation, and counseling for both men and women.

Fertility in men with SCI

Men with SCI often have erectile dysfunction and anejaculation, but fertility can be assisted with penile vibratory stimulation, electroejaculation, and assisted reproductive technology; sperm quality may be reduced.

Return to work after SCI

Employment rates after SCI are low but improve with early vocational rehabilitation, workplace accommodations, assistive technology, and education; higher functional independence and younger age predict return to work.

Caregiver burden in SCI

Family caregivers of people with SCI face physical, emotional, and financial strain; respite care, skills training, counseling, and peer support reduce burden and improve community participation.

Aging with spinal cord injury

People aging with SCI experience earlier functional decline, osteoporosis, cardiovascular disease, and pressure injuries; preventive care, exercise, and periodic reassessment of equipment and function are important.