Question

In 5 paragraphs,discuss the impact of spinal cord injuries (SCI) on sensory/perception, and the cardiovascular, respiratory, integumentaey, musculoskeletal, and GI systems from varying levels of SCI injuries. identify priorities and associated actions to prevent future injuries or complications and/ or restore health.

Answer 1

First we should know about :- What happens when the spinal cord is injured?

Changes in blood flow cause ongoing damage.

Excessive release of neurotransmitters kills nerve cells.

An invasion of immune system cells creates inflammation.

Free radicals attack nerve cells.

Nerve cells self-destruct.

Scarring occurs.

IMPACT OF SPINAL CORD INJURIES WITH TREATMENT :-

Respiratory system:-

Breathing:-A spinal cord injury high in the neck can affect the nerves and muscles in the neck and chest that are involved with breathing. Respiratory complications are often an indication of the severity of spinal cord injury. About one-third of those with injury to the neck area will need help with breathing and require respiratory support via intubation,( which involves inserting a tube connected to a machine that pushes oxygen into the lungs and removes carbon dioxide) through the nose or throat and into the airway. This may be temporary or permanent depending upon the severity and location of injury. Any injury to the spinal cord between the C1-C4 segments, which supply the phrenic nerves leading to the diaphragm, can stop breathing. (The phrenic nerves cause the diaphragm to move and the lungs to expand.) People with these injuries need immediate ventilatory support. People with high cervical cord injury may have trouble coughing and clearing secretions from their lungs. Special training regarding breathing and swallowing may be needed.

Pneumonia:- Respiratory complications are the leading cause of death in people with spinal cord injury, commonly as a result of pneumonia. Intubation increases the risk of developing ventilator-associated pneumonia; individuals with spinal cord injury who are intubated have to be carefully monitored and treated with antibiotics if symptoms of pneumonia appear. Attention to clearing secretions and preventing aspiration of mouth contents into the lungs can prevent pneumonia.

Cardiovascular system:-

• Circulatory problems:- Spinal cord injuries can cause a variety of changes in circulation, including blood pressure instability, abnormal heart rhythms (arrhythmias) that may appear days after the injury, and blood clots. Because the brain’s control of the cardiac nerves is cut off, the heart can beat at a dangerously slow pace, or it can pound rapidly and irregularly. Arrhythmias are more common and severe in the most serious injuries. Low blood pressure also often occurs due to changes in nervous system control of blood vessels, which then widen, causing blood to pool in the small arteries far away from the heart. Blood pressure needs to be closely monitored to keep blood and oxygen flowing through the spinal cord tissue, with the understanding that baseline blood pressure can be significantly lower than usual in people living with spinal cord injuries. Since muscle movement contributes to moving blood back to the heart, people with spinal cord injuries are at triple the usual risk for blood clots due to stagnation of blood flow in the large veins in the legs. Treatment includes anticoagulant drugs and compression stockings to increase blood flow in the lower legs and feet.

Musculoskeletal system :-

• Spasticity and muscle tone:- When the spinal cord is damaged, information from the brain can no longer regulate reflex activity. Reflexes may become exaggerated over time, causing muscle spasticity. Muscles may waste away or diminish due to underuse. If spasms become severe enough, they may require medical treatment. For some, spasms can be as much of a help as they are a hindrance, since spasms can tone muscles that would otherwise waste away. Some people can even learn to use the increased tone in their legs to help them turn over in bed, propel them into and out of a wheelchair, or stand.

Nervous system:-

Autonomic dysreflexia:- The autonomic nervous system controls involuntary actions such as blood pressure, heartbeat, and bladder and bowel function. Autonomic dysreflexia is a life-threatening reflex action that primarily affects those with injuries to the neck or upper back. It happens when there is an irritation, pain, or stimulus to the nervous system below the level of injury. The irritated area tries to send a sensory signal to the brain, but the signal may be misdirected, causing a runaway reflex action in the spinal cord that has been disconnected from the brain's regulation. Unlike spasms that affect muscles, autonomic dysreflexia affects blood vessels and organ systems controlled by the sympathetic nervous system. Anything that causes pain or irritation can set off autonomic dysreflexia, including a full bladder, constipation, cuts, burns, bruises, sunburn, pressure of any kind on the body, or tight clothing. Symptoms of its onset may include flushing or sweating, a pounding headache, anxiety, sudden increase in blood pressure, vision changes, or goose bumps on the arms and legs. Emptying the bladder or bowels and removing or loosening tight clothing are just a few of the possibilities that should be tried to relieve whatever is causing the irritation. If possible, the person should be kept in a sitting position, rather than lying flat, to keep blood flowing to the lower extremities and help reduce blood pressure.

Integumentary :-

Pressure sores (or pressure ulcers):- Pressure sores are areas of skin tissue that have broken down because of continuous pressure on the skin and reduced blood flow to the area. People with paraplegia and tetraplegia are susceptible to pressure sores because they may lose all or part of skin sensations and cannot shift their weight. As a result, individuals must be shifted periodically by a caregiver if they cannot shift positions themselves. Good nutrition and hygiene can also help prevent pressure sores by encouraging healthy skin. Special motorized rotating beds may be used to prevent and treat sores.

Gastrointestinal system:-

Bladder and bowel problems:- Most spinal cord injuries affect bladder and bowel functions because the nerves that control the involved organs originate in the segments near the lower end of the spinal cord and lose normal brain input. Although the kidneys continue to produce urine, bladder control may be lost and the risk of bladder and urinary tract infections increases. Some people may need to use a catheter to empty their bladders. The digestive system may be unaffected, but people recovering from a spinal cord injury may need to learn ways to empty their bowels. A change in diet may be needed to help with control.