SPINAL INJURY

MANALI H SOLANKIF.Y.M.SC.NURSING STUDENTJ G COLLEGE OF NURSING

ANATOMY AND PHYSIOLOGY

DEFINITION

Spinal cord injury (SCI) is damage to the spinal cord that results in a loss of function such as mobility or feeling.

TYPES OF SPINAL CORD INJURY

Complete Spinal Cord Injuries

Complete paraplegia is described as permanent loss of motor and nerve function at T1 level or below, resulting in loss of sensation and movement in the legs, bowel, bladder, and sexual region. Arms and hands retain normal function.

INCOMPLETE SPINAL CORD INJURIES

Anterior cord syndrome

CENTRAL CORD SYNDROME

POSTERIOR CORD SYNDROME

BROWN-SEQUARD SYNDROME

CAUDA EQUINA SYNDROME

RISK FACTORS

Men

Young adults and seniors

People who are active in sports

People with predisposing conditions

CAUSES:

Bullet or stab wound

Traumatic injury

Electric shock

Extreme twisting of the middle of the body

Landing on the head during a sports injury

Fall from a great height

SIGNS AND SYMPTOMS

CERVICAL (NECK) INJURIES

Breathing difficulties

Loss of normal bowel and bladder control

Numbness

Sensory changes

Spasticity (increased muscle tone)

THORACIC (CHEST LEVEL) INJURIES

Loss of normal bowel and bladder control

Numbness

Sensory changes

Spasticity (increased muscle tone)

Weakness, paralysis

LUMBAR SACRAL (LOWER BACK) INJURIES

Loss of normal bowel and bladder control (you may have constipation, leakage, and bladder spasms)

Numbness

Pain

Sensory changes

Weakness and paralysis

ASSESSMENT

DIAGNOSTIC TESTS

Complete blood count (e.g. Hb, RBC, WBC)

Arterial blood gas level

PaO2:85-95 mm of Hg

PaCO2:35-45 mm of Hg

X- RAYS:

COMPUTERIZED TOMOGRAPHY (CT) SCANS

MAGNETIC RESONANCE IMAGING (MRI):

MYELOGRAPHY:

POSSIBLE COMPLICATIONS

Blood pressure changes - can be extreme (autonomic hyperreflexia)

Chronic kidney disease Complications of immobility:

Deep vein thrombosis

Pulmonary infections

Skin breakdown Contractures

Increased risk of urinary tract infections

Loss of bladder control

Loss of bowel control

Loss of sensation

Loss of sexual functioning (male impotence)

Muscle spasticity

Paralysis of breathing muscles

Paralysis (paraplegia, quadriplegia)

Pressure sores

Shock

MEDICAL MANAGEMENT:

Whole blood

NS

RL

Hydrocortisone:

Action : steroids

Nor epinephrine

action: adrenergic drug

Epinephrine

action: α and β adrenergic drug

Dopamine

action: adrenergic, anti shock drug

SURGICAL MANAGEMENT

NURSING MANAGEMENT:

Impaired physical mobility related to loss of motor function

Fluid volume deficit related to decrease LOC

Risk for injury related to loss of

motor function

Urinary retention related to level of injury

Risk for Impaired skin integrity related to trauma

Knowledge deficit regarding the treatment modalities and current situation.

Anxiety related to outcome of diseases as evidenced by poor concentration on work, isolation from others, rude behaviour

DIET PLAN

REHABILITATION

Cognitive Rehabilitation Therapy Speech Therapy Mental Rehabilitation Physical Exercise Occupational Therapy

THANK YOU