SpinalCord_Care of the PatientStu.pdf

SpinalCord_Care of the PatientStu.pdf - Spinal Cord...

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11/20/2015 1 Care of the Patient with Spinal Cord Injuries NURN 236 Nursing Concepts III Concept Synthesis Spinal Cord Injuries Definition : Damage to the spinal cord that results in loss of function which can include mobility and sensation. The Incidence of SCI } Around 262,000 individuals in the US live with Spinal Cord Injuries. } Estimated 12,000 Americans develop SCI per year } Cost: average cost with a cervical injury is $829,000 for the first year and $148,000 each year following (2/10 ). Risk Factors } MVA: 35% (C-spine most often when shoulder and lap restraints not used) } Sports: 8% (diving) } Falls: 22% } Violence: 24% } Other: 3% (tumors, infections)
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11/20/2015 2 Demographics } Males: 82% } Females: 18% } Age: } Most common 16-30 years of age (account for more than half of new injuries). } African Americans higher risk than Caucasian Spinal Column } Provides support and protection for spinal cord } Vertebrae are cushioned by discs, supported by muscles, tendons and ligaments } Divided into } Cervical } Thoracic } Lumbar-sacral Nervous System CNS: } Brain } Spinal Cord } PNS Somatic NS } Sensory Nerves } Motor Nerves } Autonomic NS } Sympathetic } Parasympath etic
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11/20/2015 3 The Motor Pathways of the CNS } Lower Motor Neurons Cell bodies located in the gray matter of the cord. Branch out between each vertebrae to become the spinal nerves Lower Motor Neurons } 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. Damage to the Lower Motor Neurons can cause: } Weakness } Paralysis } Denervation } Atrophy } Hypoflexia or areflexia (absence of reflex) } < muscle tone (flaccidity) The Motor Pathways of the CNS } Upper Motor Neurons Located in gray matter of the brain Axons travel down spinal cord to connect with Lower Motor Neurons
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11/20/2015 4 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) 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 Upper Motor Neurons } Influence skeletal muscle movement } Lesion located in UMN areas cause weakness or paralysis, disuse atrophy, hyper-reflexia and spasticity Types of Injuries Flexion Injuries Excessive forward motion of the spine such as chin to chest, for example backward fall, with the head being the point of impact.
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11/20/2015 5 Hyperextension Injury } Excessive backward motion of the spine such as a forward fall with chin or face as point of impact causing hyperextension Axial Loading Injury } Vertical compression injury of the cervical spine or the lumbar spine.
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  • Spring '14
  • Brinkley
  • Spinal cord injury

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