Spinal Cord Injuries Overview

Damage to the spinal cord, resulting in loss of motor function, sensory function, reflexes, and control of elimination.

Paralysis/paresis of all four extremities and the trunk, caused by cervical SCI.

Paralysis/paresis of the lower extremities, caused by SCI below T1.

Loss of all voluntary movement and sensation below the injury level.

Varying losses of voluntary movement and sensation below the injury level.

Conditions or activities increasing the chance of spinal cord damage.

Physical changes indicating potential spinal cord damage, including numbness, pain, and reflex loss.

Area of skin supplied by a specific spinal nerve.

Temporary loss of reflexes and function below the injury site after spinal cord damage.

Physical examination indicators of spinal cord damage, such as loss of sensation, reflexes, and muscle tone.

The condition of a person's breathing, including rate, depth, and effort.

A nerve that controls the diaphragm, the main muscle for breathing.

Patients may have involuntary respirations affected due to swelling or a lesion at or above the phrenic nerve.

Patients may not be able to voluntarily take a deeper or faster breath due to impaired movement of muscles used in respiration.

Encourage the client to perform coughing and deep breathing exercises regularly.

A life-threatening complication of spinal cord injury (SCI) where the sympathetic nervous system is disrupted, leading to widespread vasodilation, decreased cardiac output, and a drop in blood pressure.

Common signs of neurogenic shock include hypotension (low blood pressure), bradycardia (slow heart rate), dependent edema (swelling in lower extremities), and temperature dysregulation.

Because it can lead to venous pooling in the extremities, decreased cardiac output, and a life-threatening drop in blood pressure.

Patients with neurogenic shock are at higher risk for developing venous thromboembolism (VTE), a blood clot in a vein.

SCI above L1/L2 will lead to spastic muscles, while SCI below L1/L2 will lead to flaccid paralysis.

Damage to the cauda equina nerve roots can cause patchy motor and sensory deficits.

Encourage active range of motion (ROM) exercises when possible to prevent muscle contractures.

Spasticity can be severe, leading to pressure injuries and difficulty with sitting.

Clients with complete spinal cord injuries (SCI) will not regain mobility. They may benefit from braces for some function, but a wheelchair remains the primary mode of mobility.

Clients with incomplete SCI can regain some mobility through braces and adaptive equipment, but a wheelchair will likely remain essential for functional movement.

Individuals with high-level SCI may experience a drop in blood pressure when transitioning to an upright position, potentially causing dizziness.

Clients with SCI should be transferred slowly, in stages, to minimize risk of postural hypotension. Use a reclining wheelchair and monitor for dizziness.

Clients with upper motor neuron SCI develop spastic bladder, where the bladder contracts involuntarily, leading to unpredictable urine release.

Clients with lower motor neuron SCI have a flaccid bladder, meaning the bladder cannot contract effectively, leading to urine retention.

Clients with SCI may require regular bowel management, including stool softeners and manual stimulation to achieve bowel regularity.

Clients with SCI are at increased risk for skin breakdown due to impaired sensation. Use pressure-relieving surfaces in beds and wheelchairs.