Spinal Cord Injuries.docx - Care of the Patient with Spinal...

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Care of the Patient with Spinal Cord Injuries Definition: Damage to the spinal cord that results in loss of function which can include mobility and sensation. Risk Factors o MVA: 35% (C-spine most often when shoulder/lap restraints not used) o ? Sports: 8% (diving) o Falls: 22% o Violence: 24% o Other: 3% (tumors, infections) Demographics ? o Males: 82% // Females: 18% o Age: Most common 16-30 years of age (account for more than half of new injuries). o ? African Americans higher risk than Caucasian Spinal Column o Provides support and protection for spinal cord o Vertebrae are cushioned by discs, supported by muscles, tendons and ligaments o Divided into: Cervical Thoracic Lumbar-sacral Nervous System o CNS: Brain Spinal Cord
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o PNS Somatic NS Sensory Nerves Motor Nerves Autonomic NS Sympathetic Parasympathetic o o o The Motor Pathways of the CNS o Lower Motor Neurons Cell bodies located in the gray matter of the cord. Branch out between each vertebrae to become the spinal nerves ? LMN innervate the skeletal muscles of the arms, trunk, legs, eyes, face, mouth and throat. ? LMN make up the somatic motor components of the spinal nerves. Implications for Injury Lower Motor Neurons 1. Breaks communication between LMN and muscles they innervate 2. If completely severed: paralysis 3. Reflex arcs are interrupted resulting in flaccidity and muscle wasting Damage to the Lower Motor Neurons can cause: Weakness Paralysis Denervation Atrophy Hypoflexia or areflexia (absence of reflex) ? < muscle tone (flaccidity) o o Upper Motor Neurons Located in gray matter of the brain Axons travel down spinal cord to connect with Lower Motor Neurons Influence skeletal muscle movement Lesion located in UMN areas cause weakness or paralysis, disuse atrophy, hyper-reflexia and spasticity Implications for Injury Upper Motor Neurons 1.Break communication between brain and lower motor neurons below injury site 2.Reflexes continue except in the injury area 3.Since there is no longer UMN regulation, reflexes are exaggerated (spasticity & hyperreflexia) o Types of Injuries Flexion Injuries o Excessive forward motion of the spine such as chin to chest, for example backward fall, with the head being the point of impact. Hyperextension Injury o Excessive backward motion of the spine such as a forward fall with chin or face as point of impact causing hyperextension
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Axial Loading Injury o Vertical compression injury of the cervical spine or the lumbar spine. This injury often occurs with dives into shallow water, or falling from great heights onto one’s bottom. Compression Injuries o Causes the vertebral bones to shatter, compress, or burst from high velocity below or on the top of the head or when landing forcefully on the feet.
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  • Spring '14
  • Brinkley
  • Spinal cord injury, Spinal shock,  �LMN

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