226 Introduction to Anatomy and Physiology
Several different types of cerebral palsy
exist, with some individuals having mixed
symptoms. The most common form is spastic CP,
with symptoms that include
• very tight muscles and joints;
• muscle weakness; and
• gait (manner of walking) in which the arms
are held close to the body with the elbows
in fl exion, the knees touch or cross, and the
individual walks on tiptoes.
With other types of cerebral palsy, motor
function degradation may include twisting or
jerking movements; tremors; unsteady gait;
impaired coordination; and excessive, fl oppy
movements.
Sensory and cognitive symptoms may
include learning disabilities or diminished
intelligence; problems with speech; problems
with hearing or sight; seizures; pain; and
problems with swallowing and digestion.
Other symptoms may include slowed growth;
drooling; breathing irregularities; and incontinence.
No cure for cerebral palsy exists, so the
goal of treatment in moderate to severe cases is
to promote quality of life and, when possible,
independent living. In some cases, surgical
intervention can improve gait, alleviate spasticity
or pain, or restore joint range of motion.
Spinal Cord Injury
Fractures or displacements of the vertebrae
can result in injury to the spinal cord. Such injuries
most commonly occur during automobile accidents
or participation in high-speed or contact sports.
Although injuries to the spinal cord can occur at
any level, these injuries most commonly develop
in the cervical region because of the fl exibility of
the neck compared to that of the trunk.
A complete severing of the spinal cord
produces permanent paralysis, with a total lack
of sensory and motor function below the point of
injury. The level of the spine at which the injury
occurs is a major factor in determining the extent of
injury:
• C
1
–C
3
—usually fatal
• C
1
–C
4
—quadriplegia (KWAH-dri-PLEE-
jee-a), characterized by loss of function
below the neck
• C
5
–C
7
—complete paralysis of the lower
extremities, partial loss of function in the
trunk and upper extremities
• T
1
–L
5
—paraplegia (PAIR-ah-PLEE-jee-ah),
characterized by loss of function in the trunk
and legs
Fortunately, most spinal cord injuries do not
completely sever the spinal cord. In an incomplete
injury, the ability of the spinal cord to transmit
sensory and motor impulses is not completely
lost. This allows some degree of sensory and/
or motor function to remain below the point of
injury. The prognosis in such cases is typically
uncertain; some patients achieve nearly complete
recovery, whereas others suffer complete paralysis.
Spinal cord injuries are medical emergencies.
Immediate, aggressive treatment and follow-up
rehabilitation can help minimize damage and
preserve function. Because motion of a fractured
or displaced vertebra can cause more damage to
the spinal cord after the injury, it is critical that
the head, neck, and trunk be immobilized before
the victim is moved (Figure 6.24). In severe neck
injuries of the spinal cord, breathing is affected
in about one-third of the cases, and respiratory
support is necessary. Surgery is often warranted
to remove bone fragments or realign vertebrae to
alleviate pressure on the spinal cord.
Ongoing research is aimed at developing
techniques for repairing injured spinal cords.
Corepics/Shutterstock.com
Figure 6.24 It is critically important that the head,
neck, and trunk are immobilized before transporting a
patient with a potential spinal cord injury. What might
happen if a patient’s head, neck, and truck are not
immobilized after a potential spinal cord injury?