EFFECTS OF SPINAL CORD INJURY QUADRIPLEGIA :- injury occurring from C1 through C8. Paralysis involving all four extremities PARAPLEGIA :- injury occurring from T1 through L4 . Paralysis involving only the lower extremities Dependent on the level of the cord injury The level of spinal cord injury : the lowest spinal cord segment with intact motor and sensory function Respiratory status changes Motor and sensory changes below the level of injury Total sensory loss and motor paralysis below the level of injury

1. ASSESSMENT OF SPINAL
CORD INJURIES

2. • QUADRIPLEGIA :- injury occurring from C1 through C8. Paralysis involving
all four extremities
• PARAPLEGIA :- injury occurring from T1 through L4 . Paralysis involving only
the lower extremities
• Dependent on the level of the cord injury
• The level of spinal cord injury : the lowest spinal cord segment with intact
motor and sensory function
• Respiratory status changes
• Motor and sensory changes below the level of injury
• Total sensory loss and motor paralysis below the level of injury

3. • Loss of reflexes below the level of injury
• Loss of bladder and bowel control
• Urinary retention and bladder control
• Presence of sweat , which does not occur on paralyzed areas

4. CERVICAL INJURIES
• Injury at C2 to C3 is usually fatal
• C4is the major innervation to the diaphragm by the phrenic nerve
• Involvement above C4 causes respiratory difficulty and paralysis of all
four extremities
• Client may have movement in the shoulder if the injury is at C5 or
below

5. THORACIC LEVEL INJURIES
• Loss of movement of the chest, trunk, bowel, bladder, and legs may
occur , depending on the level of injury
• Leg paralysis (paraplegia) may occur
• Autonomic dysreflexia with lesions or injuries above T6 and in cervical
lesions may occur
• Visceral distention from a distended bladder or impacted rectum may
cause reactions such as sweating bradycardia , hypertension, nasal
stuffiness and goose flesh

6. LUMBAR AND SACRAL LEVEL INJURIES
• Loss of movement and sensation of the lower extremities may occur
• S2 andS3 center on micturation ; therefore below this level ,the
bladder will contract but not empty ( neurogenic bladder)
• Injury above S2 in males allows them to have an erection , but they
are unable to ejaculate because of sympathetic nerve damage
• Injury between S2 and S4 damages the sympathetic and
parasympathetic response , preventing erection or ejaculation

7. EMERGENCY INTERVENTION
• Emergency management is critical because improper handling can
cause further damage and loss of neurological function
• Maintain patent airway
• Always suspect spinal cord injury until this injury is ruled out
• Immobilize the client on a spinal backboard with the head in a
neutral position to prevent an incomplete injury from becoming
complete
• Prevent head flexion , rotation , or extension

8. • During immobilization , maintain traction and alignment on the head
by placing hands on either side of the head by the ears
• Maintain an extended position
• Logroll the client
• No part of the body should be twisted or turned and the client is not
allowed to assume a sitting position
• In the emergency room, a client who has sustained a severe cervical
injury should be placed immediately in skeletal traction via skull tongs
or halo traction to immobilize the cervical spine and reduce the
fracture and dislocation