Spinal Cord injury Flashcards
What can the nervous system be divided into?
Afferent (Sensory)
Brings information into the nervous system
Efferent (Motor)
Carries information out of the nervous system and effects change
Define the autonomic nervous system
The autonomic nervous system controls involuntary responses to regulate physiological functions
Major components of the central nervous system
- Spinal Cord
- Brain Stem
- Cerebellum
- Cerebral hemispheres
Explain the spinal cord
- Facilitates transmission of neural impulses from the brain stem to the rest of the body
- Extends from the medulla oblongata
- 42-45 cm in length
- Divided into cervical, thoracic and lumbar regions
- Acts like a ‘switchboard’
- 31 pairs of spinal nerves both sensory and motor travelling along ascending and descending pathways
- Beyond the first lumbar vertebra the cord becomes a bundle of nerves
Extra information
- The spinal cord is the main pathway for information connecting the brain and peripheral nervous system.
- The length of the spinal cord is much shorter as compared to the length of the vertebral column.
- The human spinal cord extends from the foramen magnum and continues through to the conus medullaris near the second lumbar vertebra, terminating in a fibrous extension known as the filum terminale
Explain the nerves and where they go to in the body
-
Cervical Nerves (8 pairs) - damage = life-threatening (higher = worse)
- Head / neck
- Deltoids/Biceps
- Triceps
- Hands
-
Thoracic Nerves (12 pairs) - damage = affects legs, pelvic organs, BP
- Chest muscles
- Abdominal muscles
-
Lumbar (5 pairs) - damage affects both legs/incontinence
- Leg muscles
-
Sacral (5 pairs)
- Bowels
- Bladder
Give some examples of spinal cord pathology
- Infections such as Meningitis and polio
- Autoimmune diseases
- Osteoporosis/ arthritis
- Degenerative diseases – spinal muscular atrophy
- Tumours - Metastatic
- Can result in spinal cord compression (10% of patients with spinal cord metastases)
- Significant neurological consequences
What is spinal cord injury and the common types
- Compression (great force applied to top of skull e.g. jumping from height/diving into a pool), stretching or tearing of the spinal cord
- Common types of injury
- Cervical spine from hyperextension or hyperflexion of the neck
- Dislocation of the vertebrae may crush, compress or reduce blood supply to the neck
- Compression fractures
- Penetration injuries (stabbing or bullet wounds)
Explain spinal cord injury
- Damage can be temporary or permanent
- 80% of injuries occur in males
- Complete transection or crush will result in loss of motor and sensory functions at and below the level of injury.
- Partial transection or crush may allow some recovery of function
- Bruising can result in temporary loss of function when mild oedema and bleeding impair function
- Damage tends to lead to local bleeding and inflammation to develop – creating additional pressure.
- Also known as complete or incomplete complete = no sensation
Common causes of spinal cord injury
Progress of a spinal cord injury
Time = neurons
Permanent - complete severe (transection) or crushing of the cord
Temporary - bruising
Symptoms of spinal cord injury
- Limb control – depends on two factors: Injury location and severity
- The lowest part of the spinal cord that remains undamaged after an injury is referred to as the neurological level of injury
- Pale and numbness
- Inability to move
- Exaggerated reflex activities and spasms
- Changes in sexual function and fertility
- Inability to feel pain
- Muscle spasm
- Loss of bladder and/ or bowel control
- Difficulty breathing
Acute effects, secondary effects and chronic effects of spinal cord injury
Extra information
- Hypotension – trauma – vasodilation due to neurogenic shock
- Bleeding and swelling put extra pressure on the cord impairing function and reducing blood supply
- Spinal shock – first 24 hours – impaired oxygen to spinal cord
- Free radicals – breakdown lipid in cell membranes
- Too much calcium can damage the cell and
- Apoptosis – delayed calcium influx can trigger cell death – cell shrinks and is engulfed by other cells.
What are the stages of spinal cord injury?
- 2 Stages
- Early Stage (Spinal Shock)
- All neurological activity ceases at, below and slightly above the level of injury
- Recovery Stage
- Gradual return of reflex activity below the level of injury
- Early Stage (Spinal Shock)
What are the types of paralysis?
-
Paraplegia
- Paralysis of lower limbs (T1 & Below)
-
Hemiplegia
- Bilateral paralysis (Hemispheric brain damage)
-
Quadriplegia
- Paralysis of all four limbs (C4 & Above)
What does quadriplegic mean?
Quadriplegic (paralyzed from the neck down) dependent on ventilator
