Spinal Cord Injury (Accident)

Question 1

Spinal cord injury/disorder

Answer 1

Motor, sensory and autonomic dysfunction caused by insult to the spinal cord

Question 2

Etiology (disease’s cause)

Answer 2

trauma: from motor vehicle accident (MVA), falls; most common
nontraumatic: infection, tumors, inflammation

Question 3

pathophysiology (changes in body structure/function produced by the disease)

Answer 3

trauma causes fracture and/ dislocation of vertebrae (bone) which damages the spinal cord (nerve) inside the spinal column. Injury increase edema (swelling) -> incr. compression to nerves & further decrease blood flow & oxygenation (lack of oxygen -> necrosis -> infarction)

Question 4

Quadriplegia (neurological damage), define and name damage from C1-C8

Answer 4

-paralysis (loss of voluntary motion & sensation) of 4 limbs & trunk

C1-2 (damage @ cervical vertebra) = probable death
C1-4 = respiratory paralysis (trunk & legs)
C5-8 = paralysis of various arm/hand muscles (trunk & legs)

Question 5

paraplegia

Answer 5

damage to thoracic level T1 & below -> paralysis of lower extremities (L.E/legs) & trunk (can move arms)

Question 6

Spinal shock

Answer 6

acute immediate temporary paralysis 3-12 days then gradual incre. reflexes

Question 7

Diagnosis

Answer 7

MRI (magnetic resonance imaging), CT

Question 8

Paralysis - Signs & Symptoms

Answer 8

paralysis - quadriplegia/paraplegia

Question 9

Respiratory - Signs & Symptoms

Answer 9

respiratory

• possible damage to nerves of diaphragm, high-risk death from phenomena
• above C3 need a ventilator
• above C4 sip & puff wheelchair

Question 10

autonomic nerve dysfunction - Signs & Symptoms

Answer 10

causes bradycardia (low heart rate) & postural hypotension (reduced blood pressure)-watch for dizziness

Question 11

neurogenic B&B - Signs & Symptoms

Answer 11

may need urinary catheter, Risk urinary tract infection (UTI) if don’t empty catheter bags regularly

Question 12

sexuality - Signs & Symptoms

Answer 12

reflex erections possible

Question 13

Treatment (4 points)

Answer 13

1. immediate care and use backboard when moving victims to prevent further damage
2. Immediate Corticosteroidsreduce acute swelling
3. ICU, might need surgery to take out broken bones
4. nursing care prevent urinary & pulmonary skin infections

Question 14

Rehabilitation (5 points)

Answer 14

1. OT - ADL, splints, wheelchair fitting, positioning
2. PT - strengthening, ROM, transfers
3. Patient education +++, B&B training, prevent complications
4. Drugs control spasticity
5. Counseling - emotional care, treat depression, career counseling, sex ed

Question 15

prognosis (outcome &course of the disease)

Answer 15

1. spinal cord totally severed-no recovery
2. death risk from pneumonia & infection from decubitus ulcers
3. prognosis varies w/ level, first yr most dangerous but long lifespan possible

Question 16

prevention

Answer 16

prevent accidents, seat belts, education on responsible intoxication ectc

Question 17

Problems (5points)

Answer 17

1. Blood clots -> reduced mobility (deep vein thrombosis=cerebral embolism in calves)
2. skin breakdown -> decubitus ulcers -> lack of sensations & immobility
3. infections in lungs/bladder
4. Contractures – abnormally reduced joint movement due to shortened muscles
5. depression, suicide, substance abuse

Question 18

Issues:

Answer 18

1. home support
2. income
3. transportations