Ch. 27 Spinal Cord Injury

classification of spinal cord Injury: A

complete: no motor or sensory function is preserved in the sacral segments s4-s5

classification of spinal cord Injury: B

incomplete: sensory but not motor function is preserved below the neurological level and includes the sacral segments s4-s5

classification of spinal cord Injury: C

incomplete: motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade

classification of spinal cord Injury: D

incomplete: motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of greater than 3

classification of spinal cord Injury: E

normal: motor and sensory function are normal

how many vertebrae in spinal cord

33

Vascular supply comes from...

one anterior and two posterior spinal arteries at each vertebral level

MVA mechanism of injury classification

high fall (tree/building), low fall (elderly), sports and rec

Mechanism of injury classification

Primary:

damage to neural tracts, cell bodies, vascular structure within the cord

Mechanism of injury classification

Secondary:

due to hemorrhage, blood clot, and local edema within the cord -- can lead to ischemia

Spinal cord injury: complete

no nerve communication below the level of injury resulting in permanent paralysis -- loss of sensation and functional movement

spinal cord injury: incomplete

some nerve communication remains past the level of injury allowing possibility of feeling and function -- can result in partial or full recovery

type of spinal cord injury: tetraplegia

caused by damage to the spinal cord in the cervical region, affecting paralysis in all 4 limbs

- C1-4 loss of respiratory function, C5-8 loss of tricep and hands

- loses ability to regulate blood pressure and body temperature

types of spinal cord injury: paraplegia

caused by damage to T1-S5, loss of core from roughly T1-T9

both tetraplegia and paraplegia

loss of bowel, bladder, digestion, sensation, including tough and hot/cold

SCI results in ______ , not progressively spreading like MS,PD, etc

static lesion

many SCI occur in..

young, healthy, and active individuals

pressure wound management

rotate every 2 hours at least

other hindering factors for spinal cord injury

orthostatic hypotension, autonomic dysreflexia, UTIs, impaired thermoregulation, spasticity, osteoporosis, bowel/bladder dysfunction, mental barriers

Reflections from Heidi and rob: mental barriers

loss of control, "desperate to get any control back can look like anger, frustration, exhaustion"

Reflections from Heidi and rob: how'd they get guidance proceeding forward?

coordinated with project walk

Reflections from Heidi and rob: what was a big factor

nutrition and recovery

Reflections from Heidi and rob: what was used for visual feedback

mirror

Reflections from Heidi and rob: what's key?

communication is key

Reflections from Heidi and rob: time mark

2 year for SCI, 3 month for stroke, etc. can be a mental burden and limitation factor for some

reflections from Heidi and rob: called gyms not...

not clinics, liability is a issue

reflections from Heidi and rob: have to be..

creative

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