Spinal Cord Injuries
\u2756 Primary spinal cord injury: initial mechanical trauma and immediate tissue
destruction
\u27a2 If not immediately mobilized
\u27a2 Longitudinal stretch of cord
Injury Description
Cord concussion Results in temporary disruption of cord-mediated functions
Cord contusion Bruising of neural tissue causes swelling and temporary loss of cord-mediated
function
Cord compression Pressure on cord causes ischemia to tissues; must be decompressed to prevent
permanent damage to spinal cord
laceration Tearing of neural tissue of spinal cord; may be reversible if only slight damage
sustained by neural tissues; may result in permanent loss of cord-mediated
functions of spinal tracts are disrupted
Transection Severing of spinal cord causes permanent loss of function
Complete All tracts in spinal cord are completely disrupted; all cord-mediated functions below
transection are completely and permanently lost
incomplete Some tracts in spinal cord remain intact, together with functions mediated by these
tracts; has potential for recovery although function is temporarily lost
Hemorrhage Bleeding into neural tissue as a result of blood vessel damage; usually no major
loss of function
Damage or
obstruction of spinal
blood supply
Causes local ischemia
\u2756 Secondary spinal cord injury
\u27a2 Cascade of vascular, cellular, and biochemical events beginning minutes
after injury and continuing for weeks
\u25a0 Hemorrhages- central gray matter
\u25a0 Inflammation
\u25a0 Edema-white matter impairs microcirculation of the cord
\u25a0 Ischemia
1 \/ 4
2
2
\u27a2 C1-C4
\u25a0 Swelling may be life-threatening because CV and respiratory
control functions can be lost
\u27a2 Vertebral Injuries
\u25a0 Acceleration, deceleration, deformation forces occurring at impact
2 \/ 4
3
3
Type of Injury Mechanism
Clinical findings : temporary loss of spinal cord functions below the lesion
\u2605 Develop immediately after injury
\u2756 Spinal shock: temporary loss of spinal cord functions below the lesion
\u27a2 Develops immediately after injury
\u27a2 Caused by cord hemorrhage, edema, or anatomic transection
\u27a2 Activity of cells AT and BELOW the level of injury cease
\u27a2 Complete loss of reflex function, flaccid paralysis, absence of sensation, loss of
bladder and rectal control, drop in BP, bradycardia, poor circulation
\u27a2 Damage to SNS results in loss of thermal control
\u25a0 Hypothalamus cannot regulate body heat through vasoconstriction
\u25a0 Assumes temp of air known as poikilothermia
\u25a0 Generally lasts 2-3 days
\u2756 Neurogenic shock\/vasogenic shock
\u27a2 Cervical or upper thoracic cord injury above T6
\u27a2 Absence of sympathetic activity
\u27a2 Symptoms
\u25a0 Vasodilation
\u25a0 Hypotension
\u25a0 Bradycardia
\u25a0 Failure of body temp regulation
\u27a2 Paraplegia: paralysis of lower half of body
\u27a2 Quadriplegia: paralysis of all extremities
\u25a0 Complete
\u25cf Level of injury is above C6
\u25a0 Incomplete
\u25cf Function at or above C6 preserved
\u25c6 Shoulder, upper arm, some forearm muscle control intact
\u2756 Autonomic hyperreflexia: syndrome of sudden massive reflex sympathetic discharge
r\/t spinal cord injury at level T6 or above
\u27a2 Manifestations
\u25a0 Flexor spasms
\u25a0 Severe HTN
\u25a0 Pounding headache
\u25a0 Blurred vision
\u25a0 Profuse sweating
\u25a0 Nasal congestion
\u25a0 Nausea
\u25a0 Piloerection
\u25a0 Bradycardia
\u27a2 Emergency medical management
3 \/ 4
4
4
PRIMARY BRAIN INJURY
FOCAL BRAIN INJURY Localized injury from impact
CLOSED BRAIN INJURY Blunt trauma
Coup Injury is directly below site of forceful impact
Contrecoup Injury is on opposite side of brain from site of forceful impact
Epidural hematoma Vehicular accidents, minor falls, sporting accidents
Subdural hematoma Forceful impact: vehicular accidents or falls, especially in
elderly persons or persons with chronic alcohol abuse
Subarachnoid hemorrhage
*worst headache of my life
Bleeding caused by forceful impact, usually vehicular accidents
or long distance falls
OPEN INJURY Penetrating trauma: missiles, bullets, sharp objects i.e. knives,
ice picks
Compound fracture Objects strike head with great force or head strikes object
forcefully; temporal blows, occipital blows, upward impact of
cervical vertebrae
DIFFUSE AXONAL INJURY Traumatic shearing forces, tearing of axons from twisting and
rotational forces with injury over widespread brain areas;
moving head strikes hard, unyielding surface or moving object
strikes stationary head; torsional head motion without impact
SECONDARY BRAIN INJURY
SYSTEMIC PROCESSES Hypotension, hypoxia, anemia, hypercapnia, hypocapnia
INTRACEREBRAL PROCESSES Inflammation, cerebral edema, ICP, brain herniation, decreased
cerebral perfusion pressure; ischemia
Cellular processes Release of excitatory neurotransmitters (glutamate); failure of
cell ion pumps, mitochondrial failure, disruption of blood brain
barrier
\u2794 \u00b7 Types of traumatic brain injury: alteration in brain function or other evidence of brain
pathology caused by an external force such as MVA or falls
\u25c6 Primary: direct impact
\u25cf Focal Brain Injury 2\/3rds head injury deaths
\u25cb Observable bain lesion
\u25cb Force of impact typically produces
\u25c6 Contusions
\u25c6 Subdural hematomas<\/p>\n","protected":false},"excerpt":{"rendered":"
Spinal Cord Injuries\u2756 Primary spinal cord injury: initial mechanical trauma and immediate tissuedestruction\u27a2 If not immediately mobilized\u27a2 Longitudinal stretch of cordInjury DescriptionCord concussion Results in temporary disruption of cord-mediated functionsCord contusion Bruising of neural tissue causes swelling and temporary loss of cord-mediatedfunctionCord compression Pressure on cord causes ischemia to tissues; must be decompressed to preventpermanent […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117358","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117358","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117358"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117358\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117358"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117358"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}