I know the following is a long read..but I wanted to explain to you all more in detail what I am dealing with. The spinal cord is about 18 inches long and extends from the base of the brain, down the middle of the back, to about the waist. The nerves that lie within the spinal cord are upper motor neurons (UMNs) and their function is to carry the messages back and forth from the brain to the spinal nerves along the spinal tract. The spinal nerves that branch out from the spinal cord to the other parts of the body are called lower motor neurons (LMNs). These spinal nerves exit and enter at each vertebral level and communicate with specific areas of the body. The sensory portions of the LMN carry messages about sensation from the skin and other body parts and organs to the brain. The motor portions of the LMN send messages from the brain to the various body parts to initiate actions such as muscle movement. The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the Central Nervous System. Motor and sensory nerves outside the central nervous system constitute the Peripheral Nervous System, and another diffuse system of nerves that control involuntary functions such as blood pressure and temperature regulation are the Sympathetic and Parasympathetic Nervous Systems. With the injury I had, some of these nerve systems are not working properly on a daily basis or not at all. The spinal cord is surrounded by rings of bone called vertebra. These bones constitute the spinal column (back bones). In general, the higher in the spinal column the injury occurs, the more dysfunction a person will experience. The vertebra is named according to their location. The eight vertebra in the neck are called the Cervical Vertebra. The top vertebra is called C-1, the next is C-2, etc. Cervical spinal cord injuries usually cause loss of function in the arms and legs, resulting in quadriplegia. The twelve vertebra in the chest are called the Thoracic Vertebra. The first thoracic vertebra, T-1, is the vertebra where the top rib attaches. Injuries in the thoracic region usually affect the chest and the legs and result in paraplegia. Paraplegia is impairment of motor or sensory function of the lower extremities. It is usually caused by spinal cord injury that affects the neural elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. Over time, if only one limb is affected, the correct term is monoplegia. Tetraplegia is paralysis caused by illness or injury that results in the partial or total loss of use of all their limbs and torso. The loss is usually sensory and motor, which means that both sensation and control are lost. Currently I am in between Tetraplegia and Paraplegia due to 2 limbs; my right arm/ hand and right leg / foot. Putting me into a sub category of Brown-Séquard syndrome which is a loss of sensation and motor function. Spinal cord injuries can be divided into two types of injury - complete and incomplete. I am classified as an incomplete. An incomplete injury means that there is some functioning below the primary level of the injury. A person with an incomplete injury may be able to move one limb more than another, may be able to feel parts of the body that cannot be moved, or may have more functioning on one side of the body than the other. In an incomplete injury there will be some variation in prognoses. C-5 injuries often result in shoulder and biceps control, but no control at the wrist or hand. C-6 injuries generally yield wrist control, but no hand function.Individuals with C-7 and T-1 injuries can straighten their arms but may have dexterity problems with the hand and fingers. Injuries at the thoracic level and below result in paraplegia. At T-1 to T-8 poor trunk control as the result of lack of abdominal muscle control. Lumbar and Sacral injuries yield decreasing control of the hip flexors and legs.Besides a loss of sensation or motor functioning, individuals with spinal cord injuries also experience other changes. For example, they may experience dysfunction of reduced control of body temperature, inability to sweat below the level of injury, loss of sensation to temperature, and chronic pain, only to name a few. Currently there is no cure for spinal cord injuries. There are researchers attacking this problem, and there have been many advances in the lab. When a spinal cord injury occurs, there is usually swelling of the spinal cord. This may cause changes in virtually every system in the body. After days or weeks, the swelling begins to go down and people may regain some functioning. With many injuries, especially incomplete injuries, the individual may recover some functioning as late as 18 months after the injury. In very rare cases, people with spinal cord injury will regain some functioning years after the injury. However, only a very small fraction of individuals sustaining spinal cord injuries recover all functioning. Low-Cervical Nerves (C5 – C8) • Corresponding nerves control arms and hands. • Person can raise his or her arms and bend elbows. • Can speak and use diaphragm, but breathing will be weakened • Nerves affect wrist extension. • Paralysis in hands, trunk and legs, typically • Should be able to bend wrists back • Nerves control elbow extension and some finger extension. • Most can straighten their arm and have normal movement of their shoulders. • Can do most activities of daily living by themselves, but may need assistance with more difficult tasks • May also be able to drive an adapted vehicle • Little or no voluntary control of bowel or bladder, but may be able to manage on their own with special equipment Thoracic Nerves (T1 – T12) • Nerves affect muscles of the trunk (abdominal and back muscles) depending on the level of injury • Usually results in paraplegia. • Fair to good ability to control and balance trunk while in the seated position • Little or no voluntary control of bowel or bladder but can manage on their own with special equipment • Can learn to drive a modified car • Some can stand in a standing frame, while others may walk with braces, walker, or cane Lumbar (L1 – L5) and Sacral Nerves (S1 – S5) • Injuries generally result in some loss of function in the hips, legs, and feet. • Most likely will be able to walk – with or without assistance
Posted on: Sun, 02 Nov 2014 23:46:32 +0000
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