HSC3502 Spinal Cord Injury

traumatic spinal cord injury def

damage to vertebrae that could sever, contuse, crush, or compress the spinal cord

non-traumatic reasons for SCI

arthritis, spinal stenosis, cancer, inflammation, infection

traumatic reasons for sci

MVAs, falls, sports injuries, violence

most common type of sci

incomplete tetraplegia

complete injury

no sensation or motor activity below level of injury

• plegia

incomplete injury

spared sensation or motor activity below level of injury

• paresis

cervical vertebra responsible for

head, upper chest, shoulders, and arms

thoracic vertebra responsible for

mid-chest down to groin area

lumbar vertebra responsible for

front of legs and feet

sacral vertebra responsible for

back of legs and feet, butt, genitals

grade a asia scale

complete lack of motor and sensory function below level of injry

grade b asia scale

some sensation below level of injury

grade c asia scale

some muscle movement below injury is possible, but not against gravity

grade d asia scale

most muscle movement below injury is possible against gravity

grade e asia scale

all neurologic function has returned

cervical injuries complete

quadriplegia

cervical injuries incomplete

quadriparesis

christopher reeve’s fracture

c1-c2

cervical injuries

breathing could be impacted, personal attendant, reflexic bowel/bladder

thoracic injury categorized as

paraplegia or paraparesis

T1-T3

trunk paralysis

thoracic injury

wheelchair will most likely be needed, reflexic bowel/bladder

lumbar injuries

lower extremities and sexual functioning impacted

• assistive devices help walking

• areflexic bladder/bowl

sacral injuries

likely able to walk, sexual functioning impacted, areflexic bowel/bladder

stabilizing sci

spinal board, neck collar, surgical intervention

early stages of sci

scans to determine cord damage, urinary catheter inserted, ventilator if needed

psychosocial sci problems

loss/depression, role change, coping style

cardiopulmonary systems and sci

greater risk for blood clots, coronary artery disease, pulmonary embolism, orthostatic hypotension, autonomic dysreflexia

autonomic dysreflexia

lethal rise in BP triggered by acute pain in patients w/ sci in T6+

• pounding headache, stuffy nose, profuse sweating, tight chest, flushed face

autonomic dysreflexia treatment

determine and remedy cause, raise head/lower legs, monitor BP

sci and integumentary implications

abnormal thermoregulation and pressure sores

• change positions often, dress in loose fitting clothes

sci and renal implications

UTIs and kidney stones

• sufficient hydration, healthy diet, exercise, and established bladder routine

bladder and bowel program

catheter for bladder and retrain bowel habits

sexual functioning/fertility

males: may have erections, fertility is questionable

females: lubrication decreased, fertility is intact, delivery could be troublesome

neuropathic chronic pain

atypical response to sensory messages

musculoskeletal chronic pain

poor posture or overuse of structures

power wheelchair

motorized

manual wheelchair

non-motorized

body-weight supported treadmill training

suspends a patient’s body so they can walk easier

standing frame

assistive medical device that helps people transition from standing to sitting

lokomat

helps patient’s regain the feeling of walking