Spinal Objectives

Question 1

what is the function of the spinal cord?

Answer 1

• carries sensory signals and motor innervation to most of the skeletal muscles

Question 2

what is the difference between paraplegic and tetraplegic?

Answer 2

• Paraplegic = loss of/or impairment of motor +- sensory function in the thoracic, lumbar or spinal segments (not cervical) of the spinal cord
• Tetraplegic= paralysis of all four limbs, motor +- sensory function in the cervical spinal segments

Question 3

what is the difference between incomplete and complete SCI?

Answer 3

• Complete SCI = they have a complete loss of motor and sensory function below the SCI
• Incomplete SCI = they have partial random preservation of motor or sensory function below SCI

Question 4

what are the implications for a patient with confirmed high cervical cord damage?

Answer 4

• the higher the SCI (C1-C4) the more severe the loss of respiratory function, therefore require ventilation support
• a loss of all muscle function resulting in tetraplegia
• C6-C8 still will have diaphragm, and accessory muscle function and may be able to move neck, shoulders, and chest = quadriplegic

Question 5

why are spinal patients arms positioned in a crucifix position?

Answer 5

• prevention of shoulder pain in tetraplegics

- prevent adhesive capsulitis of the shoulders and contractures

Question 6

what are hand splints and when are they indicated?

Answer 6

-hand splints keep the hand in a neutral position and help prevent contractures

Question 7

what bowel care is required for a spinal patient?

Answer 7

• regular diet -not high in fibre, fat or dairy
• establish bowel regime
• encourage fluids

Question 8

what body points should you check to see if a pt is in alignment whilst supine?

Answer 8

• shoulders in alignment with hips
• legs are in alignment with hips
• head centred

Question 9

list 4 ways to minimise the development of pressure areaa in the acute spinal cord injured pt.

Answer 9

• gel pad for occipital
• ensure bed is crease free when rolling pt
• ensure lines aren’t pressing into the pt, rotate is possible
• heel bolsters