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Condition/Disorder Synonyms

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  • Tetraplegia

  • Quadriplegia

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ICD-9-CM-Code

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  • 344.0 Quadriplegia unspecified

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ICD-10-CM Code

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  • G82.50 Quadriplegia unspecified

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Preferred Practice Pattern1

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  • 5H: Impaired Motor Function, Peripheral Nerve Integrity, and Sensory Integrity Associated with Nonprogressive Disorders of the Spinal Cord

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Key Features

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Description

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  • Loss of motor and/or sensory function due to damage in the cervical spinal cord

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Essentials of Diagnosis

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  • Diagnosis is made by level of injury, severity of injury, and use of the American Spinal Injury Association (ASIA) assessment.

  • Quadriplegia is complete loss of sensory and motor function due to damage in cervical spine.

  • Quadriparesis is the partial loss of sensory or motor function due to damage in the cervical spine.

  • Quadriplegia is most commonly the result of trauma but can also occur due to infarction, hemorrhage, spinal stenosis.

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General Considerations

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  • Damage to the cervical spinal cord results in complications to many body systems.

    • The individual will likely experience most of the following:

      • Loss of motor and/or sensory function

      • Neurogenic bowel and bladder

      • Autonomic dysfunction

      • Orthostatic hypotension

      • Loss of bone density

      • Decreased ventilatory capability

      • Cardiac deconditioning

  • Working with this population requires the PT to be aware of this wide range of complications in order to be safe and effective with patient care

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Demographics

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  • Men 4 times as likely as women2

  • Most common cause is motor vehicle accident (MVA), second is falls.2

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Clinical Findings

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Signs and Symptoms

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  • Upper motor neuron signs present

  • Complete injury is defined as no motor or sensory function spared in the lowest sacral segments; incomplete injury is defined as partial or full function spared in the lowest sacral segments.

  • Altered or lost trunk control and balance

  • Altered or lost head/neck control

  • Altered or lost ambulation/locomotion

  • Altered or lost bed mobility

  • Altered or lost transfer ability

  • Altered or lost muscle strength

  • Altered or lost sensations

  • Altered deep tendon reflexes (DTRs)

  • Altered or lost bowel and bladder function

  • Altered or lost autonomic control

  • Altered blood pressure

  • Spasticity

  • Altered thermoregulation

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Functional Implications

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  • Impaired bed mobility

  • Impaired upright tolerance

  • Impaired sitting balance

  • Impaired w/c mobility

  • Impaired movement of upper extremity (UE)/lower extremity (LE), trunk, head, and neck

  • Respiratory impairment

  • Impaired coordination

  • Impaired muscular strength

  • Gait abnormalities

  • Impaired transfers

  • Decreased endurance and energy efficiency

  • Neuropathic pain

  • Postural/orthostatic hypotension

  • Bladder and bowel dysfunction

  • Sexual dysfunction

  • Increased risk of pressure sores

  • Increased risk of deep vein thrombosis

  • Increased risk of contracture

  • Increased risk of heterotopic ossification

  • Dysesthesias

  • Osteoporosis and renal calculi

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Possible Contributing Causes

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  • Traumatic

    • Most frequent cause in adults

    • MVA 45.6%2

    • Fall 19.6%2

    • Acts of violence, including gun ...

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