SPINAL CORD INJURY GLOSSARY:

*Information from http://www.sci-info-pages.com/glossary.html

 

Abdominal Binder – Wide elastic binder use to help prevent a drop in blood pressure or used for cosmetic purposes to hold in abdomen. A rigid (non-elastic) binder is used to help empty the bladder in some patients.

Aces – Elastic bandage used to wrap extremities to help support and prevent blood pressure from lowering.

Acute rehabilitation program – Primary emphasis on the early rehabilitation phase which usually begins as soon as a person is medically stable. The program is designed to be comprehensive and based in a medical facility with a typical length of stay of 2-3 months. Treatment is provided by and identifiable team in a designated unit.

Adipose tissue – Fatty tissue.

ADL – Activities of daily living: eating, dressing, grooming, shaving, etc. Nurses, occupational and physical therapists are the main coaches for ADL, which is sometimes called DLS or daily living skills.

Afferent – Sensory pathway proceeding toward the central nervous system from the peripheral receptor organs.

Ambulation – “Walking” with braces and/or crutches.

Ankylosis – Fixation of a joint leading to immobility, due to ossification or bony deposits of calcium at joints.

Anterior – The front of anything. Before or toward the front.

Anterior Cord Syndrome -An incomplete spinal injury in which all functions are absent below the level of injury except proprioception and sensation.

Anterior Spinal Artery Syndrome – (also known as Anterior Cord Syndrome) Anterior spinal artery syndrome refers to the anterior spinal artery that originates from the vertebral arteries and basal artery at the base of the brain and supplies the anterior two-thirds of the spinal cord to the upper thoracic (chest) region. The lesion produces variable loss of motor function and of sensitivity to pinprick and temperature, while preserving proprioception (position sense).

Anterio-lateral – To the front and to the side.

Antero-posterior – To the front and to the back.

Antibody – A protein, carried in the blood, produced by the immune to system which will attack germs, viruses, and other invading agents.

Anticholinergic – A drug often prescribed for those with indwelling catheters to reduce spasms of smooth muscle, including the bladder. Anticholinergics block certain receptors (acetylcholine), resulting in inhibition of certain nerve impulses (parasympathetic). Brand names include Daricon, ProBanthine, Urispas, Ditropan, and Cystospaz. Side effects may include constipation, nausea, dry mouth, and blurred vision. Caution: combined with alcohol, anticholinergics can cause extreme drowsiness.

Antidepressant – A drug prescribed to treat depression; standard tricyclic antidepressants include Tofranil, Imvate, Elavil, Norpramin, and Adapin.

Aphasia – The change, or loss, in language function due to an injury.

Apraxia – The inability to produce voluntary speech due to a deficit in motor (muscle) programming caused by brain damage.

Arachnoid Membrane – The middle of three membranes protecting the brain and spinal cord.

Arachnoiditis – Inflammation and scarring of the membranes covering the spinal cord.

ASIA Score – A measure of function after spinal cord injury, used by physicians. “A” means complete injury; “E” means full recovery.

Astrocyte – Star-shaped glial cells which provide the necessary chemical and physical environment for nerve regeneration.

Ataxia – Failure or irregularity of muscle coordination.

Atelectasis – Loss of breathing function characterized by collapsed lung tissue.

Atrophy – A wasting away or decrease in size of a cell, tissue, organ, or part of the body due to lack of nourishment.

Augmentative and Alternative Communication (AAC) – Forms of communication that supplement or enhance speech or writing, including electronic devices, picture boards, and sign language.

Autoimmune Response – The body produces a response against itself.

Autonomic Dysreflexia (Hyperreflexia) – A syndrome attributed to interruption of spinal cord sympathetic pathways. It is a condition that can occur in anyone who has a spinal cord injury at or above the T6 level. It is related to disconnections between the body below the injury and the control mechanisms for blood pressure and heart function. It causes the blood pressure to rise to potentially dangerous levels.

Autonomic Nervous System – The part of the nervous system that controls involuntary activities, including heart muscle, glands, and smooth muscle tissue. The autonomic nervous system is subdivided into the sympathetic and parasympathetic systems.

Axon – The nerve fiber that carries an impulse from the nerve cell to a target, and also carries materials from the nerve terminals back to the nerve cell. A long, slender part of a neuron that carries the electrochemical signal to another neuron. It’s the main or core nerve fiber which generally conducts impulses away from the cell body.

Bacterial infection – Infection by minute, one-celled organisms which multiply by dividing in one or more directions.

Balkan Frame – A rectangular frame which may be placed over a hospital bed to position or increase mobility. Loops or a trapeze are often hung from the Balkan frame to assist a patient in bed activities and wheelchair transfers to and from the bed.

Bilateral – Refers to using both sides of the body or extremities on both sides.

Bilateral sensory stimulation – Stimulation of both sides of the body simultaneously, using touch, hearing, or vision, in order to determine whether an individual imperceives the stimulus on one side or the other.

Bilateral transfer – Facilitation of performance of a task by one hand as a result of having practiced the task with the other hand.

Biofeedback – A process that provides sight or sound information about functions of the body, including blood pressure, muscle tension, etc. The use of sensory feedback to help provide some self-control over autonomic functions, such as blood pressure.

Biotechnology – In the most general terms, biotechnology describes guiding natural occurrences to develop useful products. More specifically, it involves using living organism to make products and solve problems.

Bladder Training – Method by which the bladder is trained to empty (micturition) without the use of an indwelling catheter. Involves drinking measured amounts of fluid, and allowing the bladder to fill and empty at timed intervals. See intermittent catheterization.

Body Jacket (TLSO) – A support made of plastic that fits over the chest, abdomen and upper pelvis, used to support an unstable or recently fused spine.

Bowel program – The establishment of a “habit program” or a specific time to empty the bowel – also known as a “dil” – so that regularity can be achieved.

Bradycardia – Slow pulse (< 60 beats per minute)

Brain stem – Composed of midbrain, pons and medulla.

Brown-Sequard Syndrome – An incomplete spinal cord injury where half of the cord has been damaged. The Brown-Sequard syndrome is caused by a functional section of half of the spinal cord. This results in motor loss on the same side as the lesion and sensory loss on the opposite side. This syndrome is very often associated with fairly normal bowel and bladder function and does not prevent the person from being able to walk, although some functional bracing or ambulatory device such as a cane or crutch may be necessary.

Calculi – Stones that may form in either kidney or bladder.

Carpal Tunnel Syndrome – A painful disorder in the hand caused by inflammation of the median nerve in the wrist bone.

Catheter – A flexible rubber or plastic tube for withdrawing or introducing fluids into a cavity of the body, usually the bladder.

CT Scan – Computerized axial Tomography is a cross-sectional X-ray enhancement technique that greatly benefits diagnosis with high-resolution video images.

Cauda Equina – The collection of spinal roots descending from the lower part of the spinal cord.

Cauda Equina Syndrome – Injury to the nerves still within the spinal cord as they form a “horse’s tail” to exit the lumbar and spinal regions. This usually occurs with fractures below the L2 level and results in flaccid-type paralysis. The type of bladder and bowel impairment that results from such an injury depends on the level of the injury and can be problematic, particularly for women, who may have difficulty with urinary drainage and incontinence.

Central Cord Syndrome – A lesion, occurring almost exclusively in the cervical region, that produces sacral sensory sparing and greater weakness in the upper limbs than in the lower limbs. A central cord syndrome indicates there is an injury to the central structures of the spinal cord. This is most commonly seen in older patients with cervical arthritis and may occur in the absence of spinal fracture.

Central Nervous System (CNS) – The CNS includes the brain and spinal cord.

Cerebrospinal Fluid (CSF) – A colorless solution similar to plasma protecting the brain and spinal cord from shock. A lumbar puncture (spinal tap) is used to draw CSF.

Cervical – The upper spine (neck) area of the vertebral column. Cervical injuries often result in quadriplegia (tetraplegia).

Collateral sprouting – Intact axons located near damaged areas may sprout to reestablish connections with, and in place of damaged areas; cannot be assured that the new connections function exactly as their damaged neighbors did.

Complete Lesion – An injury with no motor or sensory function below the area of the spinal cord that was damaged.

Contracture – The stiffening of a body joint to the point that it can no longer be moved through its normal range.

Condom Catheter – External urine collecting device used by males.

Conus Medullaris Syndrome – Injury of the sacral cord (conus) and lumbar nerve roots within the neural canal, which usually results in an areflexic bladder, bowel and lower limbs. Sacral segments may occasionally show preserved reflexes with higher lesions.

Creatinine Clearance – A 24-hour urine collection test to assess how the kidneys are functioning.

Crede – A technique of pressing down and inward over the bladder to facilitate voiding. Pronounced “cruh-day.”

Cyst (post traumatic cystic myelopathy) – A collection of fluid within the spinal cord, which may increase pressure and lead to increased neurological deterioration, loss of sensation, pain, and dysreflexia.

Cystogram (CG) – X-ray taken after injecting dye into bladder.

Cystometric Examination – An exam measuring the pressure of forces to empty, or resisting to empty, the bladder.

Decubitus Ulcer – See pressure sore.

Demyelination – The loss of nerve fiber “insulation” due to trauma or disease, which reduces the ability of nerves to conduct impulses (as in multiple sclerosis and some kinds of SCI).

Denial – Avoiding physical or emotional conflict or loss; many rehab professionals over-ascribe denial to their patients. Hoping for functional improvement should not be misunderstood as denying disability.

Dendrite – Microscopic tree-like fibers extending from a nerve cell (neuron). They are receptors of electrochemical nervous impulse transmissions. A fine branching process of the nerve cell which conducts a nerve impulse from the cell body to the structure(s) supplied by the nerve, or toward the cell body.

Depression (dysthymia) – An abnormal lowering of mood of psychologic or physiologic origin which is more prolonged than mourning and is time-limited and related to a specific loss.

Dermatome – A map that shows typical function for various levels of spinal cord injury. May also refer to the area of the skin innervated by the sensory axons with each segmental nerve (root).

Derotational Splints – Long splints on legs and feet used to prevent foot drop and external rotation of the hips. These splints are used when a patient is supine.

Disability – Any restriction or lack (resulting from an impairment) of ability to perform an activity in a manner or within the range considered normal for a human being.

Discharge Planning – Planning and preparation for life rehab. has been completed.

DLS (Daily Living Skills) – See ‘ADL”.

Dorsal Root – The collection of nerves entering the dorsal section (on the back) of a spinal cord segment.

Dura Mater – The outermost of three membranes protecting the brain and spinal cord, it is tough and leather-like. The fibrous outer sheath surrounding the brain and spinal cord.

Dysphagia – Difficulty in swallowing.

Edema – Swelling; most commonly present in legs and feet. Edema occurs when the body tissues contain an excessive amount of fluid (plasma), increasing skin sensitivity and risk of pressure sores.

Egg-crate Mattress – Foam mattress, resembling egg cartons, that helps distribute pressure and prevent pressure sores.

Effector neuron – The output nerve component of the reflex arc which transmits a reaction to the end of the organ to which the effector neuron connects.

Efferent – Motor pathway proceeding from the central nervous system toward the peripheral end organs.

Electromyogram (EMG) – A test that records the responses of muscles to electrical stimulation.

Environment – The context in which development takes place, including physical properties of stimuli.

Exacerbation – A recurrence or worsening of symptoms.

Extension – Movement which brings the body or limbs into straight position. Outward movements of body parts away from the center of the body (straightening).

External Continence Device (ECD) – Male external urine control device that attaches to tip of penis.

Fairley Test – A urine test to determine the site of infection. For instance, it can determine whether infection exists in the bladder only or in a kidney as well.

FES (Functional Electric Stimulation) – The application of low-level, computer-controlled electric current to the neuromuscular system, including paralyzed muscle.

Flaccidity – A form of paralysis in which muscles are soft and limp.

Flexion – Movement which brings body or limbs into a bent position. Inward movements of body parts toward the center of the body (bending).

Foley Catheter – A rubber tube placed in the urethra, extending to the bladder, in order to empty the bladder. It is held in place with a small fluid-filled balloon.

Functional – The ability to carry out a purposeful activity.

Gait Training – Instruction in walking, with or without equipment.

Ganglioside – Complex, carbohydrate-rich lipids found in cell membranes, most concentrated at the surface of brain cells.

Glial Cells – From the Greek for “glue,” glial cells are supportive cells associated with neurons. Astrocytes and oligodendrocytes are central nervous system glial cells. In the peripheral nervous system the main glial cells are called Schwann cells.

Glossopharyngeal breathing (GPB) – A means of forcing extra air into the lungs to expand the chest and achieve a functional cough. Also called “frog breathing.”

Halo Traction – The process of immobilizing the upper body and cervical spine with a traction device. The device consists of a metal ring around the head, held in place with pins into the skull. A supporting frame is attached to the ring and to a body jacket or vest to provide immobilation.

Hand Splint – See “tenodesis”.Handicap – A disadvantage that limits or prevents fulfillment of a role that is normal (depending on age, sex, and social and cultural factors).

Handicap dimensions – Physical independence, mobility, roles and activities, social integration, and economic self-sufficiency.

Harrington Rods – Metal braces fixed along the spinal column for support and stabilization.

Hemiparesis – Partial paralysis of loss of movement on one side of the body.

Heterotopic Ossification (HO) – The formation of new bone deposits in the connective tissue surrounding the major joints, primarily the hip and knee. A disorder characterized by the deposition of large quantities of calcium at the site of a bone injury. Often the result of prolonged immobilization. [heterotopic bone].

Hubbard Tank – A large full-body tank of water used for wound care and range of motion.

Hydronephrosis – A kidney distended with urine to the point that its function is impaired. Can cause uremia, the toxic retention of blood nitrogen.

Hyperreflexia – See “autonomic dysreflexia”.

Hyperesthesia – Grossly exaggerated tactile stimuli.

Hypothermia – An extreme lowering of the body temperature. A technique used to cool the spinal cord after injury.

Hypoxia – Lack of blood oxygen due to impaired lung function.

Immune Response – The body’s defense function that produces antibodies to foreign antigens. It is important in organ and tissue transplantation since the body is likely to reject new tissues.

Impairment – Any loss or abnormality of psychological, physiological, or anatomical structure or function.

Incomplete Injury – Some sensation or motor control preserved below spinal cord lesion.

Incomplete Lesion – A spinal cord lesion in which some sensation or muscle function below the level of injury is preserved.

Incontinence – Lack of bowel and/or bladder control.

Indwelling Catheter – A flexible tube retained in the bladder, used for continuous urinary draining to a leg bag or other device.

Informed Consent – A patient’s right to know the risks and benefits of a medical procedure.

Intermittent Catheterization (ICP) – Using a catheter for emptying the bladder on a regular schedule. See self-catheterization.

Intrathecal Baclofen – Administration of the anti-spasm drug Baclofen directly to the spinal cord by way of a surgically implanted pump.

Intravenous Pyelogram (IVP) – An X-ray of the kidney to determine function.

Ischemia – A reduction of blood flow that is thought to be a major cause of secondary injury to the brain or spinal cord after trauma.

KUB – An X-ray of the abdomen, showing the kidneys, ureters, and bladder.

Laminectomy – An operation used to relieve pressure on the spinal cord, or used to examine the extent of damage to the cord.

Late Anterior Decompression – Surgical procedure to reduce pressure on the spinal cord by removing bone fragments.

Lateral – Side.

Leg Bag – External bag which is strapped to the leg for collection of urine.

Lesion – An injury or wound, any pathologic or traumatic injury to the spinal cord.

Lipid Peroxidation – Lipids are the backbone of nerve cell membranes.

Lithotripsy – A non-invasive treatment for kidney stones. Shock waves, generated under water by a spark plug, crumble stones into pieces that will pass with urine.

Log Roll – Method of turning a patient without twisting the spine, used when a person’s spine is unstable.

Lower Motor Neurons – These nerve fibers originate in the spinal cord and travel out of the central nervous system to muscles in the body. An injury to these nerve cells can destroy reflexes and may also affect bowel, bladder and sexual function.

Lower Motor Neuron Lesion – Any damage to the lower motor neuron or its axon (peripheral nerve) that separates the lower motor neuron from control of its muscle fibers. This type of lesion leads to flaccidity and muscle atrophy.

Lumbar – Pertaining to that area immediately below the thoracic spine; the strongest part of the spine, the lower back.

Malingering – Faking or conscious deception; voluntary production of symptoms for a rationally considered goal, such as financial recompense, avoidance of responsibility, etc.

Medicaid – A state-funded insurance program that varies by state, and may vary within a state if a managed care product is present. Individuals are eligible and can receive the insurance for free if they meet maximal income limits, are pregnant, are <21 years of age, or have sufficient enough medical bills. Pays for all rehabilitation care, equipment, custodial and skilled nursing home care, home personal care services, and medications (a co-pay is usually needed for medications). All Medicaid in Virginia is managed care (as of 4/99).

Medicare – A Federally-funded insurance program that offers standard services nationwide, that may vary if a managed care product is present. Individuals are eligible and can receive for free Part A (pays for inpatient care, all rehabilitation care, equipment) if they have been employed for 10 or more years and are either 65 and older, disabled for 2 years or more, or have end-stage renal disease. Individuals are eligible for Part B (pays for physician services) if they have Part A, but must pay a monthly fee (around $50). Medicare does not pay for medications, personal care services at home, or custodial nursing home care, but does provide for skilled nursing facility (rehabilitation or medical) in a nursing home for 100 days (per each medical or rehabilitation incident separated by 60 days).

Molecular genetics – The study of how genes function to control cellular activies. (Genetic engineering involves the application of knowledge about molecular genetics in order to change living things by modifying their DNA, so they will produce desired strains).

Motoneuron (motor neuron) – A nerve cell whose cell body is located in the brain and spinal cord and whose axons leave the central nervous system by way of cranial nerves or spinal roots. Motoneuron supply information to muscle. A motor unit is the combination of the motoneuron and the set of muscle fibers it innervates.

Motor– Referring to nerves that give signals to muscles or glands in the body.

Motor development – The gradual acquisition of full control of all voluntary motor movements common to the species.

MRI (Magnetic Resonance Imaging) – A high-tech diagnostic tool to display tissues unseen in X-rays or by other techniques.

Multiple Sclerosis (MS) – A chronic disease of the central nervous system where myelin, the insulation on nerve fibers, is lost. MS is thought to be an autoimmune dysfunction in which the body turns on itself for some unknown reason.

Myelin – A white, fatty insulating material for axons which produced in the peripheral nervous system by Schwann cells, and in the central nervous system by oligodendrocytes. Myelin is necessary for rapid signal transmission along nerve fibers, ten to one hundred times faster than in bare fibers lacking its insulation properties. It insulates axons giving the “white matter” of the central nervous system its characteristic color.

Myelogram – A diagnostic test in which an opaque liquid is injected into the spinal canal, producing an outline of it on X-rays or fluoroscope.

Myoclonus – Involuntary, sharp, jerking muscular contractions, often painful.

Myotome – The collection of muscle fibers innervated by the motor axons within each segmental nerve (root).

Neurapraxia – The first level of nerve injury. The large motor fibers are predominately affected and anatomic continuity of the nerve is preserved. The prognosis for recovery is excellent and usually complete within a few days to weeks.

Nerve Growth Factor (NGF) – A “vitamin” for nerve cells. NGF, a protein, supports survival of embryonic neurons, and regulates neurotransmitters.

Nerve Impulse – An electrical current is carried along the plasma membrane (outer skin) nerve, and it may “start” in one of three ways: a) spontaneous “ignition” of the nerve cell body, b) removal of a suppressor impulse, and c) reception of an electrical impulse from other nerve cells.

Neurogenic Bladder – Any bladder disturbance due to an injury of the nervous system.

Neurological Level – Refers to the lowest segment of the spinal cord with normal sensory and motor function on both sides of the body. In fact, the segments at which normal function is found often differ by side of body and in terms of sensory vs. motor testing. Thus, up to four different segments may be identified in determining the neurological level. In cases such as this, generally each of these segments is separately recorded and a single “level”.

Neurolysis – Destruction of peripheral nerves by radio frequency, heat, cutting or by chemical injection. Used to treat spasticity.

Neuron – A nerve cell that can receive and send information by way of synaptic connections consisting of the cell body and extensions of the nerve called axons and dendrites.

Neuropathic / Spinal Cord Pain – Neuropathic (nerve-generated) pain is a problem experienced by SCI patients. A sharp, almost electrical shock, type of pain will be felt to the left of the injury and is the result of damage to the spine and soft tissue surrounding the spine. Phantom limb pain or radiating pain from the level of the lesion is related to the injury or sysfunction at the nerve root or spinal cord.

Neurotmesis – The most severe form of nerve injury. There is complete disruption within the nerve and/or an actual severing of the nerve. This injury needs surgical repair. There is wallerian degeneration of the nerve distal to the site of the injury and the prognosis for recovery is far poorer than in the case of neurapraxia or axonotmesis (the other 2 classes of nerve injuries). A nerve may not always have only one type of injury. It is possible to have combined types of injuries within a given nerve.

Neurotransmitter – A chemical released from a neuron ending, at a synapse, to either excite or inhibit the adjacent neuron or muscle cell. A chemical synthesized within the nerve cell body, characteristic for this type of nerve, and stored at the nerves in pods as granules. Release of these chemicals into the synaptic cleft between axons facilitates nerve transmissions.

Nucleic acid – Complex organic acids found in the nucleus of all living cells that contain the genetic code essential to life.

Occupational Therapist (OT) – The member of the rehabilitation team who helps maximize a person’s independence.

Occupational Therapy (OT) – Structured activity focused on activities of daily living skills (feeding, dressing, bathing, grooming), arm flexibility and strengthening, neck control and posture, perceptual and cognitive skills, and using adaptive equipment to facilitate ADL’s.

Oligodendrocyte – A central nervous system glial cell. Oligodendrocytes are the site of myelin manufacture for central nervous system neurons (the job of Schwann cells in the peripheral nervous system).

Omentum – Well-vascularized tissue of the gut.

Osteoporosis – Loss of bone density, common in immobile bones after SCI.

Ostomy – An opening in the skin to allow for a suprapubic cystostomy (catheter drainage), for elimination of intestinal contents (colostomy or ileostomy) or for passage of air (tracheostomy).

Papavarine – A drug injected into the penis to produce an erection which acts by increasing blood flow.

Paralytic Ileus – Loss of movement in the small intestine, resulting in gas and fluid build-up. It usually lasts a few days after injury.

Paraplegia – Refers to impairment of loss of motor and/or sensory function in the thoracic, lumbar or sacral (but not cervical) segments of the spinal cord, secondary to damage of neural elements within the spinal canal. WIth paraplegia, arm functioning is spared, but, depending on the level of injury, the trunk, legs, and pelvic organs may be involved. There are some types of paralysis involving the legs that are described by the impairment they cause (see Clinical Syndromes).

Paraplegic – One who has loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation.

Paresis – Weakness in voluntary muscle or slight paralysis.

Passive Standing – Standing on one’s feet while being propped up in a standing frame or other device. It is said to benefit bone strength.

Percussion – Forceful tapping on congested parts of the chest to facilitate postural drainage in persons with people with high-level tetraplegia.

Peripheral -Nerve tissue not found in the brain or spinal cord.

Peripheral Nervous System – Nerves outside the spinal cord and brain (not part of the central nervous system). If damaged, peripheral nerves have the ability to regenerate.

Personal Care Services – Non-skilled assistance (bathing, dressing, light housework) provided to individuals in their homes.

Phrenic Nerve Stimulation – Electrical stimulation of the nerve that fires the diaphragm muscle, facilitating breathing in people with injury at the C1 or C2 level.

Physiatrist – A doctor whose specialty is physical medicine and rehabilitation.

Physical Therapist (PT) – A key member of the rehabilitation team.

Physical Therapy (PT) – Structured activity focused on mobility skills (bed, transfers, wheelchair use, walking), leg flexibility and strengthening, trunk control and balance, endurance training, and using adaptive equipment to facilitate mobility.

Piloerection – “goose bumps”

Plasticity – Long-term adaptive mechanism by which the nervous system restores or modifies itself toward normal levels of function.

Posterior – Back.

Postural Drainage – Using gravity to help the clear lungs of mucus by positioning the head lower than chest.

Postural Hypotension – The reduction of blood pressure resulting in light-headedness.

Preservation – The repetition of an idea or activity without an appropriate stimulus.

Pressure Release – Relieving pressure from the ischial turberosities (bones on which we sit) every 15 min. in order to prevent pressure sores.

Pressure Sore – Also known as decubitus ulcer. A potentially dangerous skin breakdown due to pressure on skin resulting in infection, tissue death.

Priapism – A dangerous condition where the penis remains erect due to retention of blood.

Prone – Lying on stomach.

Proprioception – The sense of movement and position.

Prosthesis – Replacement device for a body part, for example an artificial limb.

PVR (Post Void Residual) – The volume left in bladder after the patient voids (urinates).

Quad – Generally, a high quad is someone with an injury at C1, C2, and C3. some doctors also group c4 quads into this category. Mid-level quads are those injured at C5. Low-level quads are those injured at C6 & C7. This isn’t written in stone, and some doctors consider C4, C5, and C6 all as mid-level, with C7 being low-level.

Quad Cough – A method of helping a patient with tetraplegia cough by applying external pressure to diaphragm, thus increasing the force and clearing the respiratory tract.

Quadriparesis – Partial loss of function all four (4) extremities of the body.

Quadriplegia – Loss of function of any injured or diseased cervical spinal cord segment, affecting all four body limbs. Outside the U.S. the term tetraplegia is used (which is etymologically more accurate, combining tetra + plegia, both from the Greek, rather than quadri + plegia, a Latin/Greek amalgam).

Range of Motion (ROM) – The normal range of movement of any body joint. Range of Motion also refers to exercises designed to maintain this range and prevent contractures.

Receptor (afferent) neuron – The input nerve component of the reflex arc which conducts stimuli from the environment toward the CNS.

Reciprocating Gait Orthosis (RGO) – A type of long-leg brace used for ambulation by paralyzed people. Uses cables across the back to transfer energy from leg to leg, thereby simulating a more natural gait.

Reflex – An involuntary response to a stimulus involving nerves not under control of the brain.

Reflex arc – In its simplest form, three components. Receptor, association, and effector (efferent) neurons facilitate one-way transmission of nerve impulses in a repetitive manner.

Reflux – The backflow of urine from the bladder into the ureters and kidney.

Regeneration – The regrowth of a cell or nerve fiber.

Rehabilitation – Retraining to normal functionality or training for new functionality.

Residual Urine – Urine that remains in the bladder after voiding. Too much left can lead to a bladder infection.

Restorative Nursing (NRS) – Replication of activities initiated by PT, OT, and SLP performed by nursing staff (range of motion, dressing, hygiene, walking, feeding).

Retrograde Pyelogram (RP) – Insertion of contrast material directly into the kidney through an instrument.

Rhizotomy – The cutting, or interruption, of spinal nerve roots.

Sacral – The fused vertebrae and spinal cord below the lumbar level.

Schwann Cells – Responsible in the peripheral nervous system for myelinating axons they also provide trophic support in injury situation.

Secondary Injury – The biochemical and physiological changes that occur in the injured spinal cord after the initial trauma has done its damage.

Self-Catheterization – Intermittent catheterization, the goal of which is to empty the bladder as needed, on one’s own, minimizing risk of infection.

Sensory Level and Motor Level – When the term “sensory level” is used, it refers to the lowest segment of the spinal cord with normal sensory function on both sides of the body; the motor level is similarly defined with respect to motor function. These “levels” are determined by neurological examination of (1) a key sensory point with in each of 28 dermatomes on the right and 28 dermatomes on the left side of the body, and (2) a key muscle within each of 10 myotomes on the right and 10 myotomes on the left side of the body.

Shunt – A tube used to drain a cavity. In the spinal cord, a shunt is used to treat a syrinx by equalizing pressures between the syrinx and the spinal fluids. In spinal bifida, it is used to reduce pressure of hydrocephalus.

Skin Breakdown – Skin breakdowns (also termed “decubitus ulcers”) occurs as a result of excessive pressure, primarily over the bones of the buttock.

Social Work (SW) – Supportive service for psychosocial adjustment and intervention, financial resources, and discharge planning.

Space Boots – Plastic boots with foam linens worn on the feet when lying on your side.

Spasticity – Hyperactive muscles that move or jerk involuntarily. There are some benefits to spasticity:

Warning mechanism to identify pain or problems in areas of no sensation.

Helps in spotting an oncoming urinary tract infection.

Helps to maintain muscle size and bone strength.

Helps to maintain circulation.

Helps to prevent osteoporosis.

Speech and Language Pathology (SLP) – Structured activity focused on communication skills, perceptual and cognitive skills, and swallowing.

Sphincterotomy – The cutting of the bladder sphincter muscle to eliminate spasticity and related voiding problems.

Spinal accessory nerve – Cranial Nerve XI. Largely motor, this nerve supplies sternomastoid and trapezius muscles.

Spinal nerves – Sensory and motor nerves which connect the spinal cord to the periphery of the body.

Spinal Shock – Similar to a concussion in the brain, spinal shock causes the system shuts down.

Subluxation – Complete or partial dislocation (as in shoulder).

Suctioning – Removal of mucus and secretions from lungs. It is important for people with high-level tetraplegia who lack ability to cough.

Suprapubic Catheter – A catheter surgically inserted into the bladder by incision above the pubis.

Suprapubic Cystostomy – A small opening made in the bladder and through the abdomen, sometimes to remove large stones, more commonly to establish a catheter urinary drain.

Synapse – The specialized junction between a neuron and another neuron or muscle cell for transfer of information such as brain signals, sensory inputs, etc., along the nervous system. These are the junctions between the “sending” fibers of one nerve cell, to the “receiving” fibers of other nerve cells. The axon (sending fiber) ends in multiple branches, each of which has a button-like enlargement that nearly touches the “receiving” fibers of the other nerve cell bodies. Nerve cells “talk” to each other via synapses. Basically the connection between the end of a nerve and the adjacent structure, such as a muscle cell or another nerve ending. Various transmitter chemicals liberated into the synapse make nerve transmissions possible.

Syringomyelia – The formation of a fluid-filled cavity (a syrinx) in an injured area of the spinal cord, which is a result of nerve fiber degradation and necrosis. It sometimes extends upward, extending also the neurological deficit. Treatment often includes surgery to insert a shunt for drainage of the cavity.

Syringomyelocele – A congenital neural tube defect which can cause spinal bifida in which spinal fluid fills a sac of spinal membrane.

Syrinx – A cyst; a cavity.

Tendon Lengthening – A procedure, usually involving the Achilles tendon, to treat contractures caused by spasms.

Tenodesis (Hand Splint) – Metal or plastic support for hand, wrist and/or fingers. Used to facilitate grater function to a disabled hand by transferring wrist extension into grip and finger control.

Tetraplegia – (Quadriplegia) Refers to impairment or loss of motor and/or sensory function in the cervical segments of the spinal cord due to damage of neural elements within the spinal canal. Tetraplegia results in impairment of function in the arms as well as in the trunk, legs, and pelvic organs. It does not include brachial plexus lesions or injury to peripheral nerves outside the neural canal.

Thoracic – Pertaining to the chest, vertebrae or spinal cord segments between the cervical and lumbar areas.

Thrombophlebitis – A clot in a vein due to diminished blood flow which can occur in a paralyzed leg. Symptoms include swelling and redness.

Tilt Table – A table which is used to gradually increase patients tolerance to being in a standing position. Also used to teach partial weight bearing and to give prolonged stretch in each position.

Tracheostomy – Opening in windpipe to facilitate breathing.

Upper Motor Neurons – Long nerve cells that originate in the brain and travel in tracts through the spinal cord. Any injury to these nerves cuts off contact with brain control. Reflex activity is still intact, however resulting in spasticity. For men with upper motor neuron injuries, reflex erections are possible.

Urinary Tract Infection (UTI) – Bacterial invasion of the urinary tract, which includes bladder, bladder neck and urethra. Symptoms of UTI include urine that is cloudy, contains sediment and smells foul, and fever. UTI involving the kidneys is preventable but dangerous. Medications often prescribed for UTI include Keflex, Macrodantin, Furadantin, Septra, Bactim, Mandelamine, penicillin, and amoxicillin. Side effects vary, and may include nausea and vomiting, skin rash or hives.

Ventilator – Mechanical device to facilitate breathing in persons with impaired diaphragm function.

Vertebrae – The bones that make up the spinal column.

Vital Capacity – The measure of air in a full breath. It is an important consideration for people with high-level tetraplegia who also have impaired pulmonary function.

Vital Signs – Consist of taking blood pressure, pulse, respiration and temperature.

Weaning – Gradual removal of mechanical ventilation, as patient’s lung strength and vital capacity increases.

Zone of Partial Preservation – Refers to those dermatomes and myotomes below the neurological level that remain partially innervated. When some impaired sensory and/or motor function is found below the lowest normal segment, the exact number of segments so affected make up the ZPP. The term is used only with incomplete injuries.