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IntroductionWhat is protected by the vertebrae which

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IntroductionWhat is the Medical Definition of a Spinal Cord?The spinal cord is a major column of nerve tissue that is connected to the brain  and travels through the vertebrae from which the spinal nerves spread out to the rest of the body.  It is protected by the vertebrae which is split into 5 sections: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. It is also protected by three connective tissue envelopes called meninges and cerebrospinal fluid (CSF), a clear fluid that cushions the spinal cord from jarring shock.The spinal cord is composed of nerve fibres that transmit electrical impulses to the rest of the body from the brain to perform different commands such as walking and running. (MedicineNet, n.d)Functions of the Spinal CordSpinal column acts as the main support for our body as it allows us to stand upright, bend, and twist all while protecting the spinal cord from potential injuries. The spinal cord which runs through the vertebral canal has major roles in the functioning of the body such as :Electrical Communication: Impulses travel through the spinal cord sending messages to different parts of the body which allows communication with the brainWalking: During a simple activity such as walking, various muscle groups in our legs go through contraction. A lot of factors go into taking a simple step, in order for it to be coordinated properly to allow this motion to occur. Central pattern generators on the S.C are composed of neurons which send signals to the muscle groups, which initiates extension or contraction, and produce the alternating movements that occurs during walkingReflexes: Involuntary responses to stimuli, which involves the brain, S.C, and the nerves of the peripheral nervous system. (Team S.C, 2017)What is a Spinal Cord Injury (SCI)?Spinal Cord Injury (SCI) is an accident that causes your vertebrae to break that allows a risk for damaging the spinal cord. When spinal cord is damaged, nerve impulses can’t go through resulting in paralysis – immobility an a lack of sensation- below the injury. The level of injury determines what parts of your body are paralysed which means the higher your injury, the more body parts that are paralysed or affected. Some SCI may not cause complete paralysis. In some cases incomplete SCI, allows certain signals to get through which gives the person a certain low level of mobility and sensation. Often times in this case, one side of the body has better functioning than the other side. Injuries in the cervical region of the spine will affect the arms, trunk, legs and pelvic area. This level of injury is considered to be quadriplegic. Injuries in the lumbar or thoracic region is considered to be paraplegic. It is recorded that 50% of all people with SCI are quadriplegic and the other half are paraplegic. (SCI Ontario, n.d)Fig 1: Infographic representing the different types of paralysisSymptoms of SCIThere are 2 factors that decide how you control your limbs: the location of the injury along your spinal cord and the severity of the injury. Severity of injury is called “completeness” and can be either complete or incomplete. When there is no sensory feedback and you lose the ability to move your limbs below the injury, your injury is complete whereas if you have some sensory and motor feedback, your injury is incomplete. (MayoClinic, 2017)Causes of SCISCI can be sustained from damages to the vertebrae, the intervertebral discs of the spinal column or the spinal cord itself. Injuries to the spinal cord can be caused in either a traumatic or non-traumatic way. Traumatic SCI can be result of a blow to the the spine that can fracture, dislocate, crush/compress one or more of of the vertebrae. This type of impact can only be emulated through motor vehicle accidents, falls, acts of violence, sports injuries and alcohol. Non-traumatic SCI can be result of arthritis, cancer, inflammation, infections or disc degeneration of the spine. (MayoClinic, 2017)Complications of SCICoping with the changes that occured to your body can be  frightening. However with the help of a medical and rehabilitation team as well as determination from the person that sustained the injury, adjustments can be made to the lifestyle in order to control the complications listed below:Bladder Control: Bladder continues to store urine from kidneys, however your brain can’t control your bladder as it cannot send messages through a damaged spinal cordBowel Control:  Internal organs continue to function just the same, however bowel movements are alteredCirculatory Control: An SCI can trigger many circulatory problems such as low BP when you rise (orthostatic hypotension) and rise in BP(autonomic hyperreflexia) to swelling in the extremities. There is an increased chance in developing blood clots, such as deep vein thrombosis or pulmonary embolus.Respiratory System: Breathing becomes increasingly difficult and coughing can seem like a difficult task as your abdominal and chest muscles can be affected if you are quadriplegic. Muscle Tone: People with SCI experience 2 kinds of muscle tone problems: uncontrolled tightening/motion in the muscles or soft, limp muscles lacking muscle tone Fitness and Wellness: SCI patients tend to go through weight loss and muscle atrophy after their injury. Limited movement can lead to a sedentary lifestyle which puts the patient at  risk of obesity, diabetes, and heart disease. (MayoClinic, 2017)Treatments of SCIUnfortunately there is no way to reverse damage to the spinal cord. However technology is advancing in the field of medicine, so there may be hope for the future.Making ConnectionsThe Cost of Living for an SCI patient in CanadaAn estimated 86,000 Canadians have an SCI, with more than 4,300 new cases reported each year. Around $3 Billion is spent for treatment and other facilities for SCI in Canada. Money is spent on anything from wheelchairs to renovating homes to make it wheelchair-friendly. THis is why SCI are considered to be one of the most expensive in the global healthcare system (Rick Hansen Institute, 2012)Opportunities offered to SCI patientsMedical devices can help those affected by a SCI become more independent and mobile. Some devices could even lead to the restoration of muscle function. These include:Modern Wheelchairs: Improved performance, lightweight wheelchairs allow SCI patients to forget that they are immobileComputer Adaptations: Those who are quadriplegic have limited hand function may find computers as difficult to operate. Voice recognition and key guards allow them to still use technologyElectronic life assistance tools: Voice controlled or remote controlled devices that can be used to aid with daily livingElectronic Stimulation Devices: Allows patients to stand, walk, reach and grip with the help of electrical stimulators that control muscle groups in the arms and legsRobotic Gait Training: Used to retrain those with SCI to learn how to walk again (MayoClinic, 2017)Taking Control of Emotional HealthThose who initially experience an SCI may go through a range of emotions, after their life being flipped upside down. Anger, self-destructive behaviour, grief, denial, shame, helplessness and depression are a few of the things they go through. (SCI Ontario, n.d) One huge factor that SCI patients have to go through is the acceptance of their recent disability: Their emotional cycle may include:Coping : Paralysis is life-changing and suddenly having a disability can lead to emotional distress. It can affect everyday activities, job, relationships and more. Recovery can be a long journey, but people who get through it all can still lead productive and fulfilling livesGrieving: The grieving process is quite common with those who have SCI right after their injury. It is okay to grieve the life you once had, but you need to take a step forward to set new goals and find a way to move forward with your lifeAcceptance: The best way to get back on track is to be educated about your injury and about options and opportunities around you that could help you lead a normal life. This could mean renovating your house to make it wheelchair accessible or taking financial support or support services that the government provides youBeing open: Friends and family around you could respond to your sudden disabilities in different ways. Being educated about SCI can help you look past their comments and responses. Educating those around you and responding back in an informative way can be beneficial. (MayoClinic, 2017)A Step Into The FutureScientists in Geneva, Switzerland have found a way to reverse the effects of paralysis, giving hope to paralytics around the world. It was first tested on a macaque monkey that had it’s spinal cord sliced in half, paralysing it’s right foot. The scientists installed a recording device beneath its skull, touching its motor cortex, and sutured a pad of flexible electrodes around the animal’s spinal cord, below the injury. A wireless connection joined the two electronic devices.The end result was a system that read the monkey’s intention to move and then transmitted it immediately in the form of bursts of electrical stimulation to its spine. This whole procedure is known as a ” neural bypass”. The implant is made of silicon, and smaller than a postage stamp, they bristle with a hundred hair-size metal probes that can “listen” as neurons fire off commands. (Regalado, 2017)Thousands of people suffer paralyzing injuries every year. A solution to such a debilitating condition would result in a sigh of relief to paralytics and their family members. People with this condition will definitely appreciate being able to return back to their previous quality of life.Fig 2: A close-up of a brain-reading chip, bristling with electrodesConclusionBeing paralysed inhibits you from living an ordinary life in today’s world. It doesn’t allow you to do even the mundane tasks in a day such as eating while sitting upright or walk to a certain destination. It can even cause adverse health effects to the rest of the body as well as psychological effects such as depression due to the sudden change in their quality of life. However through the power of determination SCI patients can make it back on track and lead their regular lives just like they did before the injury.Appendix ASpinal Cord Injuries Research NotesMedical Definition of Spinal cord. (n.d.). Retrieved from https://www.medicinenet.com/script/main/art.asp?articlekey=17889Notes:A major column of nerve tissue that is connected to the brain  and travels through the vertebrae from which the spinal nerves spread out to the rest of the bodyParts of the vertebrae : 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygealConsists of nerve fibres that transmit electrical impulses to the rest of the body from the brain to perform different commands such as walkingProtected by three connective tissue envelopes called meningesCerebrospinal Fluid (CSF), is a clear fluid that cushions the spinal cord from jarring shock. Team, S. C. (2017, February 1). Functions of the Spinal Cord: What You Need to Know. Retrieved from https://www.spinalcord.com/blog/functions-of-the-spinal-cord-what-you-need-to-knowNotes:Spinal cord segments contains a pair of roots  that are referred to as the dorsal(back) and ventral(front) rootsSpinal column acts as the main support for our body as it allows us to stand upright, bend, and twist all while protecting the spinal cord from potential injuriesMajor Functions of S.C:Electrical Communication: Impulses travel through the spinal cord sending messages to different parts of the body which allows communication with the brainWalking: During a simple activity such as walking, various muscle groups in our legs go through contraction. A lot of factors go into taking a simple step, in order for it to be coordinated properly to allow this motion to occur. Central pattern generators on the S.C are composed of neurons which send signals to the muscle groups, which initiates extension or contraction, and produce the alternating movements that occurs during walkingReflexes: Involuntary responses to stimuli, which involves the brain, S.C, and the nerves of the peripheral nervous system.What is an SCI? (n.d.). Retrieved from http://www.sciontario.org/what-is-an-sciNotes:Spinal Cord Injury (SCI) is an accident that causes your vertebrae to break that risks a chance for damaging the spinal cordWhen spinal cord is damaged, nerve impulses can’t go through resulting in paralysis – immobility an a lack of sensation- below the injurySome SCI may not cause complete paralysis. In some cases incomplete SCI, allows certain signals to get through which gives the person a certain low level of mobility and sensation. Often times in this case, one side of the body has better functioning than the other side.The level of injury determines what parts of your body are paralysed . The higher the injury, the more body parts that are paralysed or affected Injuries in the cervical region of the spine will affect the arms, trunk, legs and pelvic area. This level of injury is considered to be quadriplegicInjuries in the lumbar or thoracic region is considered to be paraplegic50% of all people with SCI are quadriplegic and the other half are paraplegicAbout living with an SCI. (n.d.). Retrieved from http://www.sciontario.org/page/about-living-sciNotes:Those who initially experience an SCI may go through a range of emotions, after their life being flipped upside downAnger, self-destructive behaviour, grief, denial, shame, helplessness and depression are a few of the things they go throughSpinal cord injury. (2017, December 19). Retrieved from https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/symptoms-causes/syc-20377890Notes:Symptoms:2 factors decide how you control your limbs: the location of the injury along your spinal cord and the severity of the injurySeverity of injury is called “completeness” and can be either complete or incompleteWhen there is no sensory feedback and you lose the ability to move your limbs below the injury, your injury is completeWhen you have some sensory and motor feedback, your injury is incompleteCauses of SCITraumatic SCI can be result of a blow to the the spine that can fracture, dislocate, crush/compress one or more of of the vertebraeNon-traumatic SCI can be result of arthritis, cancer, inflammation, infections or disc degeneration of the spineCommon causes of SCI are motor vehicle accidents, falls, acts of violence, sports injuries, alcohol and diseasesComplicationsBladder Control: Bladder continues to store urine from kidneys, however your brain can’t control your bladder as it cannot send messages through a damaged spinal cordBowel Control:  Internal organs continue to function just the same, however bowel movements are alteredCirculatory Control: An SCI can trigger many circulatory problems such as low BP when you rise (orthostatic hypotension) and rise in BP(autonomic hyperreflexia) to swelling in the extremities. There is an increased chance in developing blood clots, such as deep vein thrombosis or pulmonary embolus.Respiratory System: Breathing becomes increasingly difficult and coughing can seem like a difficult task as your abdominal and chest muscles can be affected if you are quadriplegic. Muscle Tone: People with SCI experience 2 kinds of muscle tone problems: uncontrolled tightening/motion in the muscles (spasticity) or soft, limp muscles lacking muscle tone (flaccidity)Fitness and Wellness: SCI patients tend to go through weight loss and muscle atrophy after their injury. Limited movement can lead to a sedentary lifestyle which puts the patient at  risk of obesity, diabetes, and heart diseaseSpinal cord injury. (2017, December 19). Retrieved from https://www.mayoclinic.org/diseases-conditions/spinal-cord-injury/diagnosis-treatment/drc-20377895Notes:Treatment: Unfortunately there is no way to reverse damage to the spinal cord. However technology is advancing in the field of medicine, so there may be hope for the future.Opportunities provided to people with SCI:Modern Wheelchairs: Improved performance, lightweight wheelchairs allow SCI patients to forget that they are immobileComputer Adaptations: Those who are quadriplegic have limited hand function may find computers as difficult to operate. Voice recognition and key guards allow them to still use technologyElectronic life assistance tools: Voice controlled or remote controlled devices that can be used to aid with daily livingE-Stim Devices: Allows patients to stand, walk, reach and grip with the help of electrical stimulators that control muscle groups in the arms and legsRobotic Gait Training: Used to retrain those with SCI to learn how to walk againTaking control  of your emotional healthCoping : Paralysis is life-changing and suddenly having a disability can lead to emotional distress. It can affect everyday activities, job, relationships and more. Recovery can be a long journey, but people who get through it all can still lead productive and fulfilling livesGrieving: The grieving process is quite common with those who have SCI right after their injury. It is okay to grieve the life you once had, but you need to take a step forward to set new goals and find a way to move forward with your lifeAcceptance: The best way to get back on track is to be educated about your injury and about options and opportunities around you that could help you lead a normal life. This could mean renovating your house to make it wheelchair accessible or taking financial support or support services that the government provides youBeing open: Friends and family around you could respond to your sudden disabilities in different ways. Being educated about SCI can help you look past their comments and responses. Educating those around you and responding back in an informative way can be beneficial.Canadians Unaware of Staggering Costs of Spinal Cord Injury and Paralysis. (2012, January 19). Retrieved from http://www.rickhanseninstitute.org/resource/publications-media/news/313-canadians-unaware-of-staggering-costs-of-spinal-cord-injury-and-paralysisNotes:An estimated 86,000 Canadians have an SCI, with more than 4,300 new cases reported each yearSCI are considered to be one of the most expensive in the global healthcare systemAround $3 Billion is spent for treatment and other facilities for SCI in CanadaMoney is spent on anything from wheelchairs to renovating homes to make it wheelchair-friendly

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