Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 344.1 Paraplegia ++ G82.20 Paraplegia, unspecified ++ 5H: Impaired Motor Function, Peripheral Nerve Integrity, and Sensory Integrity Associated With Nonprogressive Disorders of the Spinal Cord +++ Description ++ Complete paralysis of the trunk and bilateral lower extremitiesResult of damage to the spinal cord in the thoracic, lumbar, sacral spine or caudia equina +++ Essentials of Diagnosis2 ++ Complete neurological examMuscle strength testing of the upper extremity (UE), lower extremity (LE), core musculatureReflexes, deep tendon reflexes (DTRs)SensationCoordinationProprioceptionDiagnosis is made by level of injury, severity of injury, and use of the American Spinal Injury Association (ASIA) assessmentComplete loss of sensory and motor function due to damage in the thoracic or lumbar spineParaparesis is the partial loss of sensory or motor function due to damage in the thoracic or lumbar spineCommonly the result of trauma, but can also occur due to infarction or hemorrhageSpinal cord ends at or near the 1st lumbar vertebra (L1); damage at or above this level will produce upper motor neuron signs and symptomsDamage below L1 will produce lower motor neuron signs and symptoms +++ General Considerations ++ Damage to the spinal cord results in potential complications to many body systemsBe aware of wide range of complications in order to be safe and effective with patient care +++ Demographics ++ Men 4x as likely as womenMost common cause is motor vehicle accident (MVA)Second most common cause is falls +++ Signs and Symptoms ++ Upper motor neuron (UMN) signs present if the injury is above the conus medullarisLower motor neuron (LMN) signs present if the injury is in the conus medullaris or cauda equinaComplete injury is defined as no motor or sensory function spared in the lowest sacral segmentsIncomplete injury is defined as partial or full function spared in the lowest sacral segmentsAltered or lost trunk control and balanceAutonomic dysfunction if the injury is above the T6Orthostatic hypotensionLoss of bone densityDecreased ventilatory capability for paraplegics with damage in the mid- to upper-thoracic regionAltered or lost ambulation/locomotionAltered or lost bed mobilityAltered or lost transfer abilityAltered or lost muscle strengthAltered or lost sensationsAltered DTRsAltered or lost bowel and bladder functionAltered or lost autonomic controlAltered blood pressureSpasticityAltered thermoregulationChanges in muscle toneEdema of legs, ankles, feet Typically symmetrical and pitting in nature +++ Functional Implications ++ Impaired coordinationImpaired muscular strengthImpaired balanceGait abnormalitiesImpaired bed mobilityImpaired transfersDecreased endurance and energy efficiencyNeuropathic painUE and shoulder pain/over usePostural/orthostatic hypotensionBladder and bowel dysfunctionSexual dysfunctionPressure soresIncreased risk of deep vein thrombosisIncreased risk of contractureIncreased ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.