Spinal Cord Injury: Critical Care Course Jan 2022

Study Notes

The spinal cord primarily functions to transmit signals between the brain and the rest of the body, facilitating motor control and sensory perception.
Neurological level of injury refers to the specific segment of the spinal cord at which the injury occurs, influencing the extent of motor and sensory loss.
The sequence of spinal cord injury depends on the mechanisms of injury, including the type and direction of trauma, as well as individual physiological responses.

Secondary injuries in spinal cord trauma are primarily caused by inflammation and ischemia that occur after the initial injury, leading to further neuronal damage.
The cervical plexus functions to supply motor and sensory nerves to the neck, shoulders, and parts of the diaphragm.
A T1 spinal injury often results in a loss of movement and sensation in the arms and hands, leading to paraplegia or tetraplegia, depending on the exact level of injury.
An L4 spinal injury impacts lower limb function, resulting in potential loss of sensation and motor control in the legs and feet.

A C5 spinal injury indicates preserved shoulder movement but likely results in weakness in elbow flexion and hand function.
In cases of lumbar spinal injury, cauda equina syndrome or nerve root damage should be suspected due to the potential involvement of lower lumbar and sacral nerves.
Complete transection of the spinal cord above C3-5 produces immediate respiratory failure, requiring ventilation support due to loss of diaphragm control.

Intervertebral discs serve as shock absorbers between vertebrae, allowing for flexibility and reducing the impact on the vertebral bodies.
The vertebral body is the main weight-bearing component, responsible for supporting the body's weight and distributing load during activities.
The anterior longitudinal ligament provides major stability to the spinal column and resists hyperextension movements.

The spinal canal houses the spinal cord and protects it from mechanical damage, facilitating the safe passage of neural structures.
The lamina connects the vertebral body to the spinous and transverse processes, contributing to the structure and stability of the vertebrae.
The vertebral ligaments that prevent hyperflexion of the spine are located posteriorly, providing stability and limiting excessive movement.

The transverse processes extend bilaterally from the vertebrae, serving as attachment sites for muscles and articulation points for ribs.
The foramen of the vertebrae is formed by the vertebral arch and body, creating a protective passage for the spinal cord and exiting nerve roots.
Spine and spinal cord injuries are significant sources of morbidity and mortality, often resulting in lifelong disabilities.
Young adults, particularly males aged 16-30, have the highest frequency of spinal cord injuries, often related to accidents or sports-related incidents.