NUR 2115 COLLEGE OF SOUTHERN
MARYLAND
1. Spinal Cord Injury RISK
motor vehicles accidents, falls, and gunshot wounds
2. Mechanism of injury
Hyperflexion Hyperextension Compression Rotation Pen- etrating Injury
3. Hyperflexion
sudden deceleration .C5-C6. results in ( cord compression frac- tured disolocated vertebrae
rupture or tearing of the posterior muscles and ligament
4. Hyperextension( downward, backward. eg diving)
Spinal cord stretched and distorted .No significant bony involvement Whiplash - mild form
Most often associ- ated with central cord syndrome Neuron deficits due contusion & ischemia
5. compression
vertical force along the cord (Fall from height)- lands on feet or buttocks. cause burst fractures
,of the vertebral body which sends bony fragments into spinal canal or cord
6. Rotation
Occur in conjunction with flexion/extension injuries Severe rotation - turning head beyond
normal range Tearing of posterior ligaments and displace- ment/dislocations of the spinal
column
7. penetrating
Bullet, knife or object that penetrates the cord Causes permanent damage - anatomically
transects the spinal cor
8. initial injury
results in disruption of neurons and protective layers
9. secondary
Inflammatory response causes further damage Hypoperfusion from systemic or local
hemorrhage Stress response causes vasoconstriction and leads to further reduced circulation to
spinal cord. Inflammation,edema, compression
10. priorities immobilization
Initiated in the field and continued in the emergency room• Patient immobilized on a back
, board, head and neck in neutral position, and cervical immobilization device placed (e.g. cervical
collar). • Avoid twisting or turning movements • Patient should not sit up • Use spinal
precautions
11. Strategies to maintain spinal precautions
HOB at or less than 30 degrees 2 people to reposition collar and log roll to move patient as one
unit Bed rest. Patient will not be placed on an air bed (used to prevent ulcers) Prevent accidental
rotation Watch your position when you talk to your patient Remind patient to not turn head side
to side or up and down Stabilize neck to prevent lateral rotation of cervical spine. A blanket or
towel Hard cervical collar Backboard
12. Cervical (C1-C8)
Motor movement of arms, hands, neck, and respiratory mus- cles C3-C5 keeps that diaphragm
alive.
13. Thoracic (T1-T12)
Motor control parts of the arm, respiratory muscles, and torso Autonomic nervous system
(sympathetic)
14. Lumbar (L1-L5)
Motor control of hips, knees, legs, and feet
15. sacral (S1-S5)
MARYLAND
1. Spinal Cord Injury RISK
motor vehicles accidents, falls, and gunshot wounds
2. Mechanism of injury
Hyperflexion Hyperextension Compression Rotation Pen- etrating Injury
3. Hyperflexion
sudden deceleration .C5-C6. results in ( cord compression frac- tured disolocated vertebrae
rupture or tearing of the posterior muscles and ligament
4. Hyperextension( downward, backward. eg diving)
Spinal cord stretched and distorted .No significant bony involvement Whiplash - mild form
Most often associ- ated with central cord syndrome Neuron deficits due contusion & ischemia
5. compression
vertical force along the cord (Fall from height)- lands on feet or buttocks. cause burst fractures
,of the vertebral body which sends bony fragments into spinal canal or cord
6. Rotation
Occur in conjunction with flexion/extension injuries Severe rotation - turning head beyond
normal range Tearing of posterior ligaments and displace- ment/dislocations of the spinal
column
7. penetrating
Bullet, knife or object that penetrates the cord Causes permanent damage - anatomically
transects the spinal cor
8. initial injury
results in disruption of neurons and protective layers
9. secondary
Inflammatory response causes further damage Hypoperfusion from systemic or local
hemorrhage Stress response causes vasoconstriction and leads to further reduced circulation to
spinal cord. Inflammation,edema, compression
10. priorities immobilization
Initiated in the field and continued in the emergency room• Patient immobilized on a back
, board, head and neck in neutral position, and cervical immobilization device placed (e.g. cervical
collar). • Avoid twisting or turning movements • Patient should not sit up • Use spinal
precautions
11. Strategies to maintain spinal precautions
HOB at or less than 30 degrees 2 people to reposition collar and log roll to move patient as one
unit Bed rest. Patient will not be placed on an air bed (used to prevent ulcers) Prevent accidental
rotation Watch your position when you talk to your patient Remind patient to not turn head side
to side or up and down Stabilize neck to prevent lateral rotation of cervical spine. A blanket or
towel Hard cervical collar Backboard
12. Cervical (C1-C8)
Motor movement of arms, hands, neck, and respiratory mus- cles C3-C5 keeps that diaphragm
alive.
13. Thoracic (T1-T12)
Motor control parts of the arm, respiratory muscles, and torso Autonomic nervous system
(sympathetic)
14. Lumbar (L1-L5)
Motor control of hips, knees, legs, and feet
15. sacral (S1-S5)
