REHB 205 1st Edition Lecture 4 I. Spinal cord Injurya. “An injury to the spinal cord where there is a marked change in the person’s ability to perform peripheral movements and/or experience sensory stimulation in areas connected to the injured spinal cord” - (Johnson,Mowrey,&Bergman,2008)b. Affects 8,000-10,000 Americans each year i. Mostly malesc. The spinei. Spinal cord-1. Starts at the occipital bone and extends to the second lumbar vertebrae2. Shaped like an H with postier horns and anterior hornsi. Postier horns-i. Extends to the backii. Anterior horns-i. Extend forward3. Surrounded by cerebral spinal fluid 4. Function-i. Conduct impulses to and from the braini. Afferent nerves(outer columns)-1. Transfer information from sensory organs to the brainii. Efferent nerves ( inner columns)-1. Transfer signals to the peripheral system a. Examples motor movement 5. Processing: i. Many reflexes system are housed entirely within the spinei. Motor reflexesii. Internal organ reflexes6. Vertebrae-i. Boney coverings that surround the spinal cord from the spinal column7. Disks-i. Cartilaginous cushions that separate the vertebraeThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.II. Spinal cord injuries statistics7.615.126.742.18.6injuries in % of how spinal cord injuries happen Sports violence falls vehicular other/unkowna. Others includei. Compression due to tumors orherniated disksii. From a virus like polio iii. Neurodegenerative disorders like1. Multiple sclerosis 2. Birth defectsb. 259,000 people in the united stateshave a spinal cord injuryc. Average injury age is 40.2d. Most occur between ages of 16-30 yearsolde. 80.9% of spinal cord injuries are male III. Symptoms of spinal injurya. Vary on location of injuryb. If T4 injury the individual willexperience loss of motor ability belowthe nipple if injury is completec. Come will have limited sensationsand/or motor abilityIV. Secondary effectsV. Secondary effectsa. Physiological i. Pressure sores (decubitis ulcers)-1. Mechanical and biological breakdown of skin due to immobility i. Can lead to amputation or death ii. Urinary tract and bowel complications-1. Can’t feel or extremely voidi. Can lead to infection, kidney stones and renal failure iii. Spasticity-1. Exaggerated involuntary motionsiv. Osteoporosis1. Loss of bone density due to immobility v. Obesityvi. Sexual dysfunction1. Males-i. Can often get reflex erections but not from arousali. No ejaculation2. Females-i. Reduced lubrication during arousalii. Can still menstruate and become pregnant vii. PTSDviii. Depressionix. Substance abuse 1. Alcohol2. Pain killersVI. Amputation-i. Loss of all or part of the bodyb. Causesi. Accidentsii. Tumorsiii. Injuriesiv. 82% of amputations are due to vascular diseasev. 22% to traumavi. 4% are congenitalvii. 4% due to tumors c. Limb deficienciesi. Vascular diseaseii. Canceriii. Infectioniv. Birth defectsd. Why amputate?i. To save the rest of the body usually from 1. Cancer2. Necrosis3. Infection4. Mobility related issuesii. Usually last resort e. Examples of locationsi. Shoulder disarticulation-1. Arm at shoulder joint above elbowii. Elbow disarticulation1. At the jointiii. Hemipelvectomy1. Lower limb and pelvis f. Hip disarticulationi. Removal of leg at hip jointg. Symes amputation i. Removal of the foot at the ankleh. Transmetatarsali. Potion of the foot VII. Management a. Surgery-i. Actual removal b. Re-implantation-i. Body part is reattached or replacedc. Prostheses-i. Artificial assistive devices1. Proscribed by orthopedic surgeon2. Built by prosthetic specialistVIII. Secondary complicationsa. Edemai. Swellingb. Contracturesc. Phantom limb sensationi. Feeling in the missing partd. Phantom limb paini. Pain in the missing parte. Psychosocial issuesIX. Treatment a. Activities to help promote motor skillsb. Exercises to promote muscle strengthc. Fitting and use of artificial limbsd. Pain managementi. Post-operative painii. Phantom pain X. Drawfisma. Achnondroplasiai. Most common formb. Affects growth of long bonesc. 1 in 7500 birthsd. 500 cases a