(a) Flexion-extension injuries are commonly located at C - C
4
7
("whiplash").
(b) T , T , and L are frequent sites of spinal cord injury resulting
1
11
12
from falls.
(3)
Mechanisms of spinal cord injury.
(a) Flexion-extension: whiplash, seen with rapid deceleration injuries.
(b)
Subluxation: incomplete or partial dislocation.
(c)
Torsion: twisting of the spinal cord.
(d) Compression.
(4)
Pathophysiological changes associated with spinal cord injuries.
(a) Damage to the cord may be a concussion, contusion, laceration,
compression, or complete transection of the cord.
(b) Cord's response to injury includes hemorrhage, ischemia, and
edema.
b. Signs and Symptoms.
(1)
Patient's symptoms will mirror the level of the cord injury.
(2)
There will be total sensory loss and motor paralysis below level of the
injury.
(a) Cervical spinal cord injuries will produce quadriplegia--loss of
function of all four extremities.
(b) Injuries to the thoracic spinal cord below the level of T1 will produce
paraplegia--paralysis of the lower extremities.
(3)
Loss of bowel and bladder control; usually urinary retention and bladder
distention.
(4)
Loss of sweating and vasomotor tone below the level of the cord injury.
(5)
Marked reduction of blood pressure due to loss of peripheral vascular
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