Schizo Sci

8/14/2019 Schizo Sci

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SCHIZOPHRENIA

PERCEPTION PROBLEMS:

DEFINITION...

Schizophrenia( /skts fr ni/or /skts

fri ni /) is amental disorder!arateri"ed

#$ a disinte%ration of t!o&%!t 'roesses and

of emotional res'onsienessIt most

ommonl$ manifests itself as a&ditor$

!all&inations* 'aranoidor #i"arre

del&sions* ordisor%ani"ed s'ee! and

t!inkin%* and it is aom'anied #$

si%nifiant soial or o&'ational

d$sf&ntion T!e onset of s$m'toms

t$'iall$ o&rs in $o&n% ad&lt!ood* +it! a

%lo#al lifetime 'realene of a#o&t ,-.

,0 1ia%nosis is #ased on o#sered

#e!aior and t!e 'atient2s re'ortede3'erienes

BACKGROUND...

4enetis* earl$ enironment* ne&ro#iolo%$*

and's$!olo%ialand soial 'roesses

a''ear to #e im'ortant ontri#&tor$ fators5

some rereational and 'resri'tion dr&%s

a''ear to a&se or +orsen s$m'toms

C&rrent resear! is fo&sed on t!e role of

ne&ro#iolo%$* alt!o&%! no sin%le isolatedor%ani a&se !as #een fo&nd T!e man$

'ossi#le om#inations of s$m'toms !ae

tri%%ered de#ate a#o&t +!et!er t!e

dia%nosis re'resents a sin%le disorder or a

n&m#er of disrete s$ndromes 1es'ite t!e

et$molo%$of t!e term from t!e 4reek roots

skhizein(* 6to s'lit6) andphrn,

phren-(, -5 6mind6)* s!i"o'!renia

does not im'l$ a 6s'lit mind6 and it is not t!e

same as dissoiatie identit$ disorder7also

kno+n as 6m&lti'le 'ersonalit$ disorder6 or

6s'lit 'ersonalit$67a ondition +it! +!i! it

is often onf&sed in 'li 'ere'tion

T!e mainsta$ of treatment is anti's$!oti

mediation* +!i! 'rimaril$ s&''resses

do'amine (and sometimes serotonin)

ree'toratiit$ Ps$!ot!era'$and

oational and soial re!a#ilitation are also

im'ortant in treatment In more serio&s

ases7+!ere t!ere is risk to self andot!ers7inol&ntar$ !os'itali"ation ma$ #e

neessar$* alt!o&%! !os'ital sta$s are no+

s!orter and less fre8&ent t!an t!e$ one

+ere

T!e disorder is t!o&%!t mainl$ to affet

o%nition* #&t it also &s&all$ ontri#&tes to

!roni 'ro#lems +it! #e!aior and

emotion Peo'le +it! s!i"o'!renia are

likel$ to !ae additional (omor#id)

onditions* inl&din% ma9or de'ressionand

an3iet$ disorders5 t!e lifetime o&rrene of

sstane a#&seis almost ,0 Soial

'ro#lems* s&! as lon%;term

&nem'lo$ment* 'oert$ and !omelessness*

are ommon T!e aera%e life e3'etan$

of 'eo'le +it! t!e disorder is all&inations

are also t$'iall$ related to t!e ontent oft!e del&sional t!eme Positie s$m'toms

%enerall$ res'ond +ell to mediation

Ne%atie s$m'toms are defiits of normal

emotional res'onses or of ot!er t!o&%!t

'roesses* and res'ond less +ell to

mediation T!e$ ommonl$ inl&de flat or

#l&nted affetand emotion* 'oert$ of

s'ee! (alo%ia)* ina#ilit$ to e3'eriene
http://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Mental_disorderhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Neurobiologyhttp://en.wikipedia.org/wiki/Psychologyhttp://en.wikipedia.org/wiki/Etymologyhttp://en.wikipedia.org/wiki/Ancient_Greekhttp://en.wikipedia.org/wiki/Dissociative_identity_disorderhttp://en.wikipedia.org/wiki/Antipsychotichttp://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Receptor_(biochemistry)http://en.wikipedia.org/wiki/Psychotherapyhttp://en.wikipedia.org/wiki/Cognitionhttp://en.wikipedia.org/wiki/Comorbidityhttp://en.wikipedia.org/wiki/Major_depressive_disorderhttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Substance_abusehttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Suicidehttp://en.wikipedia.org/wiki/Hallucinationhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Persecutory_delusionshttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Schizophasiahttp://en.wikipedia.org/wiki/Emotionalhttp://en.wikipedia.org/wiki/Social_cognitionhttp://en.wikipedia.org/wiki/Social_cognitionhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Social_isolationhttp://en.wikipedia.org/wiki/Catatoniahttp://en.wikipedia.org/wiki/Symptomhttp://en.wikipedia.org/wiki/Tactilehttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Visualhttp://en.wikipedia.org/wiki/Olfactoryhttp://en.wikipedia.org/wiki/Gustatoryhttp://en.wikipedia.org/wiki/Blunted_affecthttp://en.wikipedia.org/wiki/Alogiahttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Wikipedia:IPA_for_Englishhttp://en.wikipedia.org/wiki/Mental_disorderhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Neurobiologyhttp://en.wikipedia.org/wiki/Psychologyhttp://en.wikipedia.org/wiki/Etymologyhttp://en.wikipedia.org/wiki/Ancient_Greekhttp://en.wikipedia.org/wiki/Dissociative_identity_disorderhttp://en.wikipedia.org/wiki/Antipsychotichttp://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Receptor_(biochemistry)http://en.wikipedia.org/wiki/Psychotherapyhttp://en.wikipedia.org/wiki/Cognitionhttp://en.wikipedia.org/wiki/Comorbidityhttp://en.wikipedia.org/wiki/Major_depressive_disorderhttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Substance_abusehttp://en.wikipedia.org/wiki/Life_expectancyhttp://en.wikipedia.org/wiki/Suicidehttp://en.wikipedia.org/wiki/Hallucinationhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Persecutory_delusionshttp://en.wikipedia.org/wiki/Thought_disorderhttp://en.wikipedia.org/wiki/Schizophasiahttp://en.wikipedia.org/wiki/Emotionalhttp://en.wikipedia.org/wiki/Social_cognitionhttp://en.wikipedia.org/wiki/Social_cognitionhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Social_isolationhttp://en.wikipedia.org/wiki/Catatoniahttp://en.wikipedia.org/wiki/Symptomhttp://en.wikipedia.org/wiki/Tactilehttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Visualhttp://en.wikipedia.org/wiki/Olfactoryhttp://en.wikipedia.org/wiki/Gustatoryhttp://en.wikipedia.org/wiki/Blunted_affecthttp://en.wikipedia.org/wiki/Alogia


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'leas&re (an!edonia)* lak of desire to form

relations!i's (asoialit$)* and lak of

motiation (aolition) Resear! s&%%ests

t!at ne%atie s$m'toms ontri#&te more to

'oor 8&alit$ of life* f&ntional disa#ilit$* and

t!e #&rden on ot!ers t!an do 'ositie

s$m'toms Peo'le +it! 'rominent ne%atie

s$m'toms often !ae a !istor$ of 'oor

ad9&stment #efore t!e onset of illness* and

res'onse to mediation is often limited

CAUSES...

GENETICS

EN4IRONENT

SUBSTANCE ABUSE

PRE5NATA6

TRE?TMENTS

EDICATIONS

PSYCHOSOCIA6 THERAPIES

ANTIPSYCHOTICS...

?n an%ip!'cho%ic(or ne*ro)ep%ic) is a

tran8&ili"in%'s$!iatri mediation'rimaril$

&sed to mana%e 's$!osis (inl&din%del&sionsor !all&inations* as +ell as

disordered t!o&%!t)* 'arti&larl$ in

s!i"o'!reniaand #i'olar disorder ? first

%eneration of anti's$!otis* kno+n as

t$'ial anti's$!otis*+as disoered in t!e


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C)open%hi(o) +Sor"ino)-

F)*pen%hi(o) +Depi(o) F)*an(o)-

Thio%hi(ene +Na,ane-

Z*c)open%hi(o) +Ci!or"ino) C)opi(o)

Ac*pha!e-

SECOND GENERATION...

Clo"a'ine (Clo"aril) ; Re8&ires +eekl$ to

#i+eekl$ om'lete #lood o&ntd&e to risk of

a%ran&lo$tosis

Olan"a'ine (A$'re3a) ; sed to treat

's$!oti disorders inl&din% s!i"o'!renia*

a&te mani e'isodes* and maintenane of

#i'olar disorder 1osin% = to =, m% 'er

da$

Ris'eridone (Ris'erdal) ; 1osin% ,= to

m% 'er da$ and is titrated &'+ard5 diided

dosin% is reommended &ntil initial titration

is om'leted* at +!i! time t!e dr&% an #e

administered one dail$ sed off;la#el to

treat To&rette s$ndrome and an3iet$

disorder

D&etia'ine (Sero8&el) ; sed 'rimaril$ to

treat #i'olar disorder and s!i"o'!renia*

and 6off;la#el6 to treat !roni insomnia and

restless le%s s$ndrome5 it is a 'o+erf&l

sedatie 1osin% starts at = m% and

ontin&es &' to ,, m% ma3im&m 'er da$*

de'endin% on t!e seerit$ of t!e

s$m'tom(s) #ein% treated

Ai'rasidone (4eodon) ; ?''roed in =,,FGFH

to treat #i'olar disorder 1osin% =, m% t+ie

dail$ initiall$ &' to , m% t+ie dail$ Side;

effets inl&de a 'rolon%edDT interalint!e !eart* +!i! an #e dan%ero&s for

'atients +it! !eart disease or t!ose takin%

ot!er dr&%s t!at 'rolon% t!e DT interal

?mis&l'ride (Solian) ; Seletie do'amine

anta%onist >i%!er doses (%reater t!an

F,, m%) at &'on 'ost;s$na'ti do'amine

ree'tors res&ltin% in a red&tion in t!e

'ositie s$m'toms of s!i"o'!renia* s&!

as 's$!osis Lo+er doses* !o+eer* at

&'on do'amine a&toree'tors* res&ltin% ininreased do'amine transmission*

im'roin% t!e ne%atie s$m'toms of

s!i"o'!renia Lo+er doses of amis&l'ride

!ae also #een s!o+n to !ae

antide'ressantandan3iol$tieffets in non;

s!i"o'!reni 'atients* leadin% to its &se in

d$st!$miaand soial '!o#ias ?mis&l'ride

!as not #een a''roed for &se #$ t!e ood

and 1r&% ?dministrationin t!e nited

States

?sena'ine (Sa'!ris) is a ;>T=?; and 1=;

ree'tor anta%onist &nder deelo'ment for

t!e treatment of s!i"o'!renia and a&te

mania assoiated +it! #i'olar disorder

Pali'eridone (Ine%a) ; 1eriatie ofris'eridone t!at +as a''roed in =,,

Ilo'eridone (ana't) ; ?''roed #$ t!e 1?

on Ma$ * =,,@

Aote'ine (Ni'ole't* Losi"o'ilon* Lodo'in*

Seto&s); ?n at$'ial anti's$!oti indiated

for a&te and !roni s!i"o'!renia It +as

a''roed in Ja'an ira

L&nd#ek Like t!e ot!er at$'ial

anti's$!otis* it is #elieed to !ae

anta%onistatiit$ at do'amine and

serotonin ree'tors in t!e #rain

T>IR1 4ENER?TION

?ri'i'ra"ole (?#ilif$) ; 1osin% < m% &' toma3im&m of -, m% !as #een &sed

Me!anism of ation is t!o&%!t to red&e

s&se'ti#ilit$ to meta#oli s$m'toms seen

in some ot!er at$'ial anti's$!otis T!e

e3tent to +!i! t!ese effets differ from

ot!er at$'ial anti's$!otis is de#ated

Partial a%onists of do'amine
http://en.wikipedia.org/wiki/Clopenthixolhttp://en.wikipedia.org/wiki/Clopenthixolhttp://en.wikipedia.org/wiki/Flupenthixolhttp://en.wikipedia.org/wiki/Flupenthixolhttp://en.wikipedia.org/wiki/Thiothixenehttp://en.wikipedia.org/wiki/Zuclopenthixolhttp://en.wikipedia.org/wiki/Zuclopenthixolhttp://en.wikipedia.org/wiki/Clozapinehttp://en.wikipedia.org/wiki/Complete_blood_counthttp://en.wikipedia.org/wiki/Agranulocytosishttp://en.wikipedia.org/wiki/Olanzapinehttp://en.wikipedia.org/wiki/Maniahttp://en.wikipedia.org/wiki/Bipolar_disorderhttp://en.wikipedia.org/wiki/Risperidonehttp://en.wikipedia.org/wiki/Tourette_syndromehttp://en.wikipedia.org/wiki/Tourette_syndromehttp://en.wikipedia.org/wiki/Tourette_syndromehttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Quetiapinehttp://en.wikipedia.org/wiki/Insomniahttp://en.wikipedia.org/wiki/Restless_legs_syndromehttp://en.wikipedia.org/wiki/Ziprasidonehttp://en.wikipedia.org/wiki/Antipsychotic_agentshttp://en.wikipedia.org/wiki/QT_intervalhttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Amisulpridehttp://en.wikipedia.org/wiki/Antidepressanthttp://en.wikipedia.org/wiki/Anxiolytichttp://en.wikipedia.org/wiki/Dysthymiahttp://en.wikipedia.org/wiki/Social_anxiety_disorderhttp://en.wikipedia.org/wiki/Food_and_Drug_Administration_(United_States)http://en.wikipedia.org/wiki/Food_and_Drug_Administration_(United_States)http://en.wikipedia.org/wiki/Asenapinehttp://en.wikipedia.org/wiki/Paliperidonehttp://en.wikipedia.org/wiki/Iloperidonehttp://en.wikipedia.org/wiki/Zotepinehttp://en.wikipedia.org/wiki/Sertindolehttp://en.wikipedia.org/wiki/H._Lundbeckhttp://en.wikipedia.org/wiki/H._Lundbeckhttp://en.wikipedia.org/wiki/Receptor_antagonisthttp://en.wikipedia.org/wiki/Aripiprazolehttp://en.wikipedia.org/wiki/Partial_agonisthttp://en.wikipedia.org/wiki/Clopenthixolhttp://en.wikipedia.org/wiki/Flupenthixolhttp://en.wikipedia.org/wiki/Thiothixenehttp://en.wikipedia.org/wiki/Zuclopenthixolhttp://en.wikipedia.org/wiki/Clozapinehttp://en.wikipedia.org/wiki/Complete_blood_counthttp://en.wikipedia.org/wiki/Agranulocytosishttp://en.wikipedia.org/wiki/Olanzapinehttp://en.wikipedia.org/wiki/Maniahttp://en.wikipedia.org/wiki/Bipolar_disorderhttp://en.wikipedia.org/wiki/Risperidonehttp://en.wikipedia.org/wiki/Tourette_syndromehttp://en.wikipedia.org/wiki/Tourette_syndromehttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Anxiety_disorderhttp://en.wikipedia.org/wiki/Quetiapinehttp://en.wikipedia.org/wiki/Insomniahttp://en.wikipedia.org/wiki/Restless_legs_syndromehttp://en.wikipedia.org/wiki/Ziprasidonehttp://en.wikipedia.org/wiki/Antipsychotic_agentshttp://en.wikipedia.org/wiki/QT_intervalhttp://en.wikipedia.org/wiki/Heart_diseasehttp://en.wikipedia.org/wiki/Amisulpridehttp://en.wikipedia.org/wiki/Antidepressanthttp://en.wikipedia.org/wiki/Anxiolytichttp://en.wikipedia.org/wiki/Dysthymiahttp://en.wikipedia.org/wiki/Social_anxiety_disorderhttp://en.wikipedia.org/wiki/Food_and_Drug_Administration_(United_States)http://en.wikipedia.org/wiki/Food_and_Drug_Administration_(United_States)http://en.wikipedia.org/wiki/Asenapinehttp://en.wikipedia.org/wiki/Paliperidonehttp://en.wikipedia.org/wiki/Iloperidonehttp://en.wikipedia.org/wiki/Zotepinehttp://en.wikipedia.org/wiki/Sertindolehttp://en.wikipedia.org/wiki/H._Lundbeckhttp://en.wikipedia.org/wiki/H._Lundbeckhttp://en.wikipedia.org/wiki/H._Lundbeckhttp://en.wikipedia.org/wiki/Receptor_antagonisthttp://en.wikipedia.org/wiki/Aripiprazolehttp://en.wikipedia.org/wiki/Partial_agonist


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PERCEPTION AND COORDINATION:

SPINAL CORD INJURY

Risk Factors for SCI

Each year, 11,000

people experience a SCI.

200,000 more people are living i!h

"pinal cor# in$%ry re"%l!"

S!a!i"!ic" "ho !ha! male" are highe"!

n%m&er. 'ge" 1( ) *0 y.o. +hy #o

yo% !hin !ha! i" "o-

Exampls of I!"#r$

'cci#en!" /

Car, van, coach 1(.

3o!orcycle 20

4icycle .

5e#e"!rian 1.

6elicop!er 1.

7ome"!ic 8 In#%"!rial 'cci#en!" */

Spor! In$%ry 1

7iving / 9ver!ical

compre""ion":

;%g&y 1

6or"e ;i#ing *

'""a%l! (

Sel> 6arm

'""a%l!e# 1

5ro>o%n# 6eal!h Care E>>ec!"

?i>elong @ee#" o> SCI

5hy"ical

5"ycho"ocial

Ainancial

Boca!ional

Social A%nc!ioning

CASE STUDY ONE

.+. i" a 22 yo male pa!ien! >ell 0>! >rom

a chairli>! hile "iing an# lan#e# on har#

"no. 6e a" >o%n# !o have a 10D11

>rac!%re i!h paraplegia. 6e a" a#mi!!e# !o

!he IC an# place on high #o"e" o> "!eroi#">or 2/hr". 6e a" !aen !o "%rgery >or

ex!ernal "pinal "!a&iliFa!ion. 6e "pen! !o

#ay" &ac in !he IC, #ay" on S!ep 7on,

an# i" no rea#y !o &e !ran">erre# !o yo%r

reha& %ni!. 6e con!in%e" !o have no

movemen! !o !he loer ex!remi!ie".

%& : 'oal of Tratm!t i! Ac#t P(as

5a!hophy"iologyG imme#ia!e

mechanical #i"r%p!ion o> axon" a" are"%l! o> a lacera!ion, "!re!ch, !ear, or

"ever

Primar$ I!"#r$ ) Sco!*ar$

O!+oi!+ I!"#r$

@ormal &loo# >lo i" #i"r%p!e#

!o area

Spinal cor# #eprive# o> %r!her #amage !o axon" H

&lee#ing appear" i!hin one

ho%r H !hi" can "prea# !he area

o> in$%ry an# #amage

he longer !hi" proce"", !he

more permanen! #amage H

C@S #oe" no! regenera!e

%&: Critical N#rsi!+ Car ) 'oals

Imme#ia!e S!a&iliFa!ion !o preven!

>%r!her in$%ry, !ra%ma, an# ca"ca#e o>

"econ#ary in$%ry

6o #o e #o !hi"-

S#r,i, t( I!"#r$

3ain!ain phy"iological "!a&ili!y

!hro%gh "pinal "hoc

ACUTE SPINAL FACTS

he ex!en! o> #amage re"%l!" >rom !he

primary an# "econ#ary in$%ry an# can


5/9

&e #eva"!a!ing i> "!a&iliFa!ion an#

early !rea!men! ere no! "!ar!e#

5rogno"i" 8 ;ecovery mo"! acc%ra!ely

#e!ermine# =2hr" or more a>!er in$%ry

%-: Stroi* T(rap$ .!fits

6igh #o"e IB "!eroi#" Sol%me#rolgiven i!hin >ri"! Jhr" o> in$%ry

;e#%ce #amage !o cell

mem&rane" an# #ecrea"e

in>lamma!ion.

Ao%n# in !he early J0" !o &e

highly e>>ec!ive !o re#%ce !he

leng!h o> !ime >or "pinal "hoc

an# !o re#%ce #egree o> in$%ry

Si#e E>>ec!"G #ecrea"e# imm%ne

re"pon"e, ri" >or in>ec!ion, increa"e

"er%m gl%co"e, in#%ce #epre""ion,

p"ycho"i", ri" >or KI &lee#

%/: 0(at is Spi!al S(ock1

2A3A N#ro+!ic S(ock4

emporary Con#i!ion 8 'c%!e 5ha"e

Sympa!he!ic >%nc!ion 8 comm%nica!ion

i" impaire# &elo !he level o> in$%ry )

Sympa!he!ic nerve" leave !he "pine a!

!horacic an# l%m&ar area"

5ara"ympa!he!ic >%nc!ion !ae" over

Ba"o#ila!ion , Beno%" 5ooling, 7ecrea"e#

Car#iac l%c!%a!ion", Al%"he#ex!remi!ie", 6ypoxia

?o"" o> Spinal ;e>lexe"

?o"" o> Sen"a!ion

Alacci# 5araly"i" &elo in$%ry

ime Arame ) one ee !o "ix mon!h"

3a"" !he ex!en! o> in$%ry

Spinal Shoc ;e"olve"G ;e>lexe"

re!%rn

L*G @%r"ing S%ppor!

4ra#ycar#iaG

'n!icholinergic 9'!ropine:

emporary 5acemaer

6ypo!en"ionG

Al%i#"

7opamine

Care>%l moni!or o> '4C". 'nyincrea"e o> vagal re"pon"e can

>%r!her increa"e &ra#ycar#ia

an# ca%"e car#iac arre"!.

%5 Post Ac#t P(as

S!a&iliFing !he "pine an# re"olving

"pinal "hoc ill allo >or early

mo&iliFa!ion.

Early mo&iliFa!ion preven!" >%r!her

complica!ion".

+ha! "y"!em &y "y"!em complica!ion"

are e concerne# i!h -

Car#iova"c%lar

;e"pira!ory

Ka"!roin!e"!inal 8 @%!ri!ion

Elimina!ion

3%"c%lo"ele!al

In!eg%men!ary

Rspirator$ Complicatio!s

3a$or ca%"e o> #ea!h in !he ac%!e

pha"e

5%lmonary "%ppor!

S%c!ioning 8 5o"!%ral 7rainage 8

%rning

Coor#ina!e i!h ;

66@


6/9

6igher !he level in$%ry, !he higher !he

ri"

'&ove C/ 8 4elo C/ 5hrenic nerve

a! #iaphragm. In!erco"!al m%"cle

impaire#

Car*io,asc#lar Complicatio!s

6ypo!en"ion

4ra#ycar#ia

7ecrea"e# Car#iac or Impac!ion 8 ;e!en!ion 8

Incon!inence 8 rinary rac! In>ec!ion"

3%"c%lo"ele!al Complica!ion"

;i" >or Con!rac!%re"

3%"cle "pa"!ici!y

Con!rac!%re" H.. ?o"" o>

>%nc!ion

4one lo""

3%"cle '!rophy

Sin Complica!ion"

Patients who do not have an ulcer state

that nurses in the ICU turned them every 2

hours after injury

;e"earch "ho" !ha! pa!ien!" go !o

reha& i!h

%lcer" alrea#y >orme# ) 7ISKSI@K n%r"ing

care

;i" >ac!or" >or "in &rea#on-

In!erven!ion"- Sin In"pec!ion"-

%7 Slf Car A6ilitis of T&89&&

?evel o> 2 ) 12 "ho%l# &e

in#epen#en! i!h !he heelchair

3ay even al "hor! #i"!ance"

i!h or!ho!ic" an# cr%!che"

3anage !heir on '7?"

3anage !heir 48 4 ro%!ine

LE;ELS OF INJURY arm"

Comple!e v". Incomple!e

Comple!e G o!al lo"" o>

"en"ory an# mo!or >%nc!ion

&elo !he level o> in$%ry

Incomple!eG 3ixe# lo"" o>

vol%n!ary an# invol%n!aryac!ivi!y an# "en"a!ion

Cervical In$%rie"

C1D2 G limi!e# hea# an# !r%n

con!rol , reM%ire" 8c i!h

&rea!h con!rol"


7/9

C*D/G 7epen#en! i!h '7?",

may "!ill nee# ven!ila!or "%ppor!

C/ an# a&oveG "ome "or! o>

li>elong ven!ila!ory "%ppor!

CG el&o >lexion

C(G ri"! ex!en"ion

C=G >inger con!rol

In#epen#ence increa"e" >rom

C( #on

%= .la**r F#!ctio!

SCI a&ove 12 ) Spa"!ic or ;e>lexic

4la##er

Charac!eriFe# &y invol%n!ary&la##er con!rac!ion" i!h

%ncon!rolle# voi#ing an#

incon!inence.

SCI &elo ?1 ) 're>lexic or Alacci#

4la##er

'&"en! &la##er con!rac!ion"

re"%l!ing in high vol%me" o>

re"i#%al %rine an# %rinary

re!en!ion

;i""G ;enal Calc%li , I"

Koal"G 'voi# &la##er in>ec!ion".

Increa"e >l%i#". 4la##er program

5! eachingG

"8 "x o> in>ec!ion

In!ermi!!en! ca!h program

3e#ica!ion" !o help &la##er

i!h !one

S!im%la!e %rine >lo

Increa"e >l%i#"

In#elling ca!he!er ) irriga!ion"

Cran&erry $%ice

3e#"G

'n!icholinergic" !o "%ppre""

con!rac!ion

'n!i"pa"mo!ic" !o #ecrea"e

"pa"!ici!y

%> .o?l Trai!i!+

he &oel ha" i!" on ne%ral con!rol

!ha! re"pon#" !o #i"!en!ion. hi" i"

ha! help" SCI pa!ien!" regain con!rol

o> emp!ying.

rain !he &oel a pre#ic!a&le pa!!ern

o> emp!ying

@*s:

S!ool So>!ener"

S!im%lan! ?axa!ive"

Dit:

Ai&er, >l%i#"

7igi!al "!im%la!ion avoi# enema"

5o"i!ioning

'ominal 3a""age

Bal"alva

CASE STUDY %-

/* yo male p! en!ere# !he ho"pi!al i!h a le>!

i"chial

pre""%re "ore "!age IB. 6e i" a Incomple!e

C ) C( level o>

in$%ry >or 20 year" a>!er "%>>ering a SCI a>!er

a #iving

acci#en!. 6e ha" a hi"!ory o> pre""%re

%lcer".

Bi!al Sign"G N(.0, 45 JJ8/2, 52, ;;20

6e al"o ha" a hi"!ory o> '%!onomic

7y"re>lexia

ae a loo a! hi" me#ica!ion regiman.

%&: INCO@PLETE1

SELF CARE A.ILITIES1

A%ll hea#, nec, an# "ho%l#er con!rol

7iaphragm con!rol

Sho%l# no! nee# re"pira!ory "%ppor!

El&o >lexion i!h "ome ri"!

ex!en"ion

'""i"!ive #evice" >or >ine mo!or "ill"

In#epen#en!G >ee#ing, grooming,

&a!hing, heelchair on even "%r>ace",

#rive i!h han# con!rol"


8/9

'""i"!anceG ran">er", #re""ing

%- ;S C(a!+s i! SCI

'%!onomic @ervo%" Sy"!em e>>ec!e#

i!h in$%rie" a&ove !he ( level.

here can &e a lo"" o> comm%nica!ion

i!hin !he &o#y i!h !he '@S.

Ina&ili!y !o a%!oreg%la!e ) par!ic%larly

BS

?o 45, ?o 5%l"e, 5oilo!hermia

!aing on !he !emp o> !he room i!h

perio#" o> >l%"hing an# ina&ili!y !o

"ea!

%5 @*icatio! R+im!

3%"cle Spa"!ici!yG

4aclo>en

Alexeril

Bali%m

Bi!amin"

5ain an# 3%"cle ;elaxa!ionG

@e%ron!in

4la##er Care

7e!rol

7i!ropan

4oel Care

Colace

S%ppo"i!ory

% A#to!omic D$srflxia

'&normal '@S re"pon"e in SCI p!" i!h

a ( or higher

5a!hoG '@S canno! #ecipher "!im%l%"

re"pon"e" rapi#ly coming %p !he

"pinal !rac! ca%"ing an a&normal '@S

re"pon"e flight and flight

5recipi!a!e# &y noxio%" "!im%li &elo

!he level o> in$%ry

9Conge"!e# comm%nica!ion: in "pinal

!rac!

Can &e ?i>e hrea!ening ) ca%"e

increa"e# IC5, hemorrhage, SeiF%re,

S!roe

3e#ic 'ler!

'7 i" %"%ally &ro%gh! on &y 4 8 4

#i"!en!ion, I, "pa"m", pre""%re

"ore", in>ec!ion, ingron !oenail,

in"ec! &i!e, #y"mennorhea, "%rgery

"i!e, con"!ric!ive clo!hing

Assss fastB

6ea#ache

Al%"hing

Sea!ing

6igh 45

4l%rre# vi"ion

@a%"ea

'c! >a"!

Eleva!e 6y noxio%"

"!im%li, !rea! ca%"e

L( ?e!O" al '&o%! Sex 4a&y

;e>lex erec!ion i" po""i&le i!h %pper

mo!or ne%ron le"ion"

>er "%ppor!,

"%gge"! co%n"eling, e#%ca!e

5SPC6


9/9

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