Carried up same side of spinal cord as side where touch is applied o Tested by

Carried up same side of spinal cord as side where

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Carried up same side of spinal cord as side where touch is applied oTested by applying light touch to same side of patient Common Mechanisms of Spinal InjuryMost common cause = automobile crashes (48%), falls (21%), gunshot wounds, recreational activities (diving, football)Only 14-15% of patients w spinal column fractures/dislocations have spinal cord injuries that result in neurologic deficits (motor/sensory dysfunction)o85-86% of patients w spinal fracture/dislocation do not present w neurologic deficit (couldbe walking/moving); does not mean spinal injury not presentC1 and C2 dislocations more common in elderly (rheumatoid arthritis) and Down syndrome patients (abnormal development of odontoid/C2) Spine particularly susceptible to injury from following mechanisms:oCompression: weight of body driven against head Common in falls, diving accidents, motor vehicle crashes, other accidents where person impacts object head firstoFlexion: severe forward movement of head (chin meets chest), or when torso excessively curled forward oExtension: severe backward movement of head (neck stretched), or when torso severely arched backwardoRotation: lateral movement of head/spine beyond normal rotationoLateral bending: body or neck is bent severely from the sideoDistraction: vertebrae/spinal cord are stretched and pulled apart (common in hangings)oPenetration: injury from gunshots, stabbings, other penetrating trauma that involve cranium or spinal column
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Spine motion restriction (SMR): steps taken to keep spine in anatomic alignment and restrict movement of spine to prevent further injury when existing spinal injury suspectedSpinal Column vs. Spinal Cord InjurySpinal column injury = injury to one/more vertebrae (bone injury)oPain/tenderness somewhere along spineSpinal cord injury = damage to nervous tissueoDisruption of one or more motor/sensory tracts likely; experience loss of motor/sensory function(s)Complete spinal cord injury: results in complete loss of motor, sensory, and autonomic function below the level of injurySpinal shock: temporary, concussion-like insult to spinal cord causing paralysis and loss of sensation below level of injury; usually occurs high in cervical regionoLoss of muscle tone (disrupts temperature regulation), sensation, motor function, and bladder/bowel control (and priapism); vasodilation (decreased BP, neurogenic shock)oUsually resolves within 24 hours but can last for several daysoSkin = warm, dry, flushed/red; pulse = 60-80bpm (not rapid)Neurogenic hypotension from spinal shock: condition associated w injury to spinal cord that results in vasodilation and relative hypovolemia; spinal-vascular shock/neurogenic shockoSpinal shock- SNS impulses to adrenal glands = lost (prevents release of nor/epinephrine); causes vasodilationPresents as red/flushed skin, lack of sweat gland stimulation (skin remains dry)oSMR; keep patient warm (increased heat loss from peripheral vasodilation)
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