Question

Option 1

G. H. is a 26-year-old male who was involved in a serious motorcycle accident that fractured his vertebrae and compressed his spinal cord at the level of T8. Answer the following questions:

1. What is spinal shock? How long can it last? Why is it difficult to determine the degree of injury and impairment during this time frame?
2. Immediately after this injury, what should you expect to occur for each of the following:
   1. Range of movement for his arms? For his legs? Why?
   2. Spastic or flaccid paralysis? Why?
   3. Bowel and/or bladder dysfunction? Why or why not?
   4. Breathing difficulties? Why or why not?
3. After the period of spinal shock, what changes should you expect to see (if any) in the manifestations listed in #2 above?
4. What type of rehabilitative treatments might G. H. need to promote his recovery and return to function?
5. If G. H. has mild-to-moderate chronic back pain one year after his accident, explain the pain management medications you would suggest to improve his quality of life and why you selected those particular medications.

Answer 1

1.# Spinal shock

Loss of all neurological activity below the level of the injury. It

includes loss of motor, sensory, reflex and autonomic FN (flaccid paralysis, areflexia and anesthesia below the level of injury) Causes neurometabolic cascade.

It is a short term temporary.

Starts between 30-60 minutes following a SC injury

Lasts up to 6 weeks post injury

The return of reflexes indicates the end

#. Degrees of injury :-

1. complete: total loss of sensory & motor function below level of injury

2. incomplete: mixed loss of voluntary motor activity & sensation with some still intact

---central cord syndrome

---anterior cord syndrome

---posterior cord syndrome

---Brown-Sequard syndrome

#. Rehabilitation team members will begin to work with you while you're in the early stages of recovery. The team may include a physical therapist, an occupational therapist, a rehabilitation nurse, a rehabilitation psychologist, a social worker, a dietitian, a recreation therapist, and a doctor who specializes in physical medicine (physiatrist) or spinal cord injuries.

During the initial stages of rehabilitation, therapists usually emphasize maintenance and strengthening of existing muscle function, redeveloping fine motor skills, and learning adaptive techniques to accomplish day-to-day tasks.

Patient will be educated on the effects of a spinal cord injury and how to prevent complications, and you'll be given advice on rebuilding your life and increasing your quality of life and independence.

They will be taught many new skills, and you'll use equipment and technologies that can help you live on your own as much as possible. You'll be encouraged to resume your favorite hobbies, participate in social and fitness activities, and return to school or the workplace.

Medications

Medications may be used to manage some of the effects of spinal cord injury. These include medications to control pain and muscle spasticity, as well as medications that can improve bladder control, bowel control and sexual functioning.

New technologies :-

Inventive medical devices can help people with a spinal cord injury become more independent and more mobile. Some devices may also restore function. These include:

Modern wheelchairs. Improved, lighter weight wheelchairs are making people with spinal cord injuries more mobile and more comfortable. For some, an electric wheelchair may be needed. Some wheelchairs can even climb stairs, travel over rough terrain and elevate a seated passenger to eye level to reach high places without help.

Computer adaptations. For someone who has limited hand function, computers can be very powerful tools, but they're difficult to operate. Computer adaptations range from simple to complex, such as key guards or voice recognition.

Electronic aids to daily living. Essentially any device that uses electricity can be controlled with an electronic aid to daily living. Devices can be turned on or off by switch or voice-controlled and computer-based remotes.

Electrical stimulation devices. These sophisticated devices use electrical stimulation to produce actions. They're often called functional electrical stimulation systems, and they use electrical stimulators to control arm and leg muscles to allow people with spinal cord injuries to stand, walk, reach and grip.

Robotic gait training. This emerging technology is used for retraining walking ability after a spinal cord injury.