JOAN M' PINOTALBOT RN MSN APN CS

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JOAN M. PINO-TALBOTRN MSN APN CS

• SPINAL CORD INJURY
• FALL 2005

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Signs and symptoms of a spinal cord injury
depend on two factorsThe location of the
injuryThe higher in the spinal cord produces
more paralysis The severity of the
injurySpinal cord injuries are classified as
partial or complete, depending on how much of the
cord width is damaged.
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LEVEL OF SPINAL NEREVES

• BREAKFAST AT EIGHTCervical (8) controls
  diaphragm, chest wall muscles, arms, shoulders
• LUNCH AT TWELVE Thoracic (12) controls upper
  body, gastro-intestinal function
• DINNER AT FIVE
• Lumbar(5)
• Sacral (5) both control lower body, bowel and
  bladder

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PARALYSIS

• QUADRIPLEGIA (tetraplegia) all four limbs
• PARAPLEGIA lower limbs
• HEMIPLEGIA one side of the body

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•      Pain or an intense stinging sensation caused
  by damage to the nerve fibers in the spinal cord
•      Loss of movement
• Loss of sensation, including the ability to
  feel heat, cold and touch
•   Loss of bowel or bladder control
•   Exaggerated reflex activities or spasms
• Changes in sexual function, sexual
  sensitivity and fertility
• Difficulty breathing, coughing or clearing
  secretions from the lungs

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Emergency signs and symptoms of spinal cord
injury after a head injury or accident may
include

•     Fading in and out of consciousness
• Extreme back pain or pressure in the neck,
  head or back
•  Weakness, in coordination or paralysis in any
  part of the body
•   Numbness, tingling or loss of sensation in
  the hands, fingers, feet or toes
•    Loss of bladder or bowel control
• Difficulty with balance and walking
• Impaired breathing after injury
• An oddly positioned or twisted neck or back

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The most common causes of spinal cord injury in
the United States are

•   Motor vehicle accidents. Auto and motorcycle
  accidents are the leading cause of spinal cord
  injuries, accounting for approximately 50 percent
  of new spinal cord injuries each year.

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•       Acts of violence. Since 2000, 11 percent of
  spinal cord injuries have resulted from violent
  encounters, primarily involving gunshot wounds.

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•       Falls. Spinal cord injury after age 65 is
  often caused by a fall. Overall, falls make up
  approximately 24 percent of spinal cord injuries.
  

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• Sports and recreation injuries. Athletic
  activities such as impact sports and diving in
  shallow water cause about 9 percent of spinal
  cord injuries.
• Diseases. Cancer, infections, arthritis and
  inflammation of the spinal cord also cause spinal
  cord injuries each year. The exact number isn't
  known, but some estimates suggest that the number
  could equal or exceed the number of people with
  traumatic spinal cord injuries each year.

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Risk factorsAlthough a spinal cord injury is
usually the result of an unexpected accident that
can happen to anyone, some groups of people have
a higher risk of sustaining a spinal cord injury.
These include

• Men. Spinal cord injury affects a
  disproportionate amount of men. In fact, women
  account for only about 20 percent of spinal cord
  injuries in the United States.
• Young adults and seniors. People are most often
  injured between ages 16 and 35. But there is
  another peak in people older than 60. Motor
  vehicle crashes are the leading cause of spinal
  cord injury for young people, while falls cause
  most injuries in older adults. However, in some
  cities, acts of violence such as gunshot
  wounds, stabbings and assaults are a major
  cause of spinal cord injury.

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People who are active in sports. Sports and
recreational activities cause up to 9 percent of
the 11,000 spinal cord injuries in the United
States each year. High-risk athletic activities
include football, rugby, wrestling, gymnastics,
diving, surfing, ice hockey and downhill skiing.

• People with predisposing conditions.
• A relatively minor injury can cause spinal cord
  injury in people with conditions that affect
  their bones or joints, such as arthritis or
  osteoporosis.

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TESTS

• X-RAYS
• CT SCAN
• MRI
• MYELOGRAPHY

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EFFECTS OF SPINAL CORD INJURIES

• CENTRAL CORD SYNDROME
• ANTERIOR CORD SYNDROME
• BROWN-SEQUARD SYNDROME (lateral cord syndrome)

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COMPLICATIONS

• URINAARY TRACT PROBLEMS
• BOWEL MANAGEMENT DIFFICULITIES
• PRESSURE SORES
• DVT AND PULMONARY EMBOLISM
• LUNG AND BREATHING PROBLEMS
• AUTONOMIC DYSREFLEXIA
• SPASTICITY
• WEIGTH CONTROL ISSUES
• SEXUAL DYSFUNCTION
• PAIN
• NEW INJURIES

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TREATMENTS

• MEDICATION
• IMMOBILIZATION
• SURGERY
• ON GOING CARE PT/OT RESP
• REHABILITATION

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NEW TECHNOLOGIES

• MODREN WHEELCHAIRS
• COMPUTER DEVICES
• ELECTRICAL STIMULATION DEVICES AND PROSTHESES

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PREVENTION

• DRIVE SAFELY
• BE SAFE WITH FIREARMS
• PREVENT FALLS
• TAKE PRECAUTIONS WHEN PLAYING SPORTS OR WITH BIG
  BOY TOYS
• THIS INCLUDES YOU JOHN!!!!!!!