Week 4 Notes – HSO205

Neurological Impairment

Anatomy and Physiology

CNS = central nervous system made up of brain and spinal cord

- Pathway for information to travel to and from the brain.
Spinal Cord = 31 pairs of nerves
- Enter and exit at different levels of the spinal cord, with each
level associated with varied bodily functions.
- Categorised into:
o Cervical (8)
o Thoracic (12)
o Lumbar (5)
o Sacral (5)
o Coccygeal (1)
Afferent = carry information from the body to the CNS
Efferent = send messages out to the body

Spinal cord =
Travels within the vertebral canal with nerve roots emerging between
the vertebrae. The actual spinal cord is described as the texture of a
“ripe banana” suggesting the high risk of injury, therefore essential to
have a solid skeletal structure surrounding to protect, that is still
flexible to allow movement and pathways for the nerves entering and
exiting the spinal cord.

White Matter: Myelinated nerve axons, vessels, and neuroglia that

travel up and down the spinal cord (ascending and descending
pathways)

Grey Matter: located in the centre of the spinal cord, butterfly

shape, comprised of the cell bodies and synapse between neurons.
Meninges: Covers the spinal cord and brain, to supply nutrition,
strength, and cerebrospinal fluid (CSF)

SCI =

What does the SCI innervate?

Health conditions

Predominant focus on spinal

cord injuries (SCI)

The nervous system can also be affected in the peripheral nervous

system (PNS). This will directly impact the functioning of the
structure that the nerve innervates or communicates with. E.g., the
radial nerve of the arm innervates the muscles that produce wrist
extension, if this nerve is injured, then those muscles may stop or be
limited functioning, unable to complete wrist extension.

Spinal Cord Injury (SCI)

 - Fragile structure
- Plays a significant importance in the communication of
information around the body.
- SCI is common
- This communication becomes disrupted
- Currently in Australia, between 9,000 and 12,000 people are
living with SCI.
- Accidents are most common prevalence; 4 out of 5.
- Traffic accidents account for 2 out of 5 accident-related
injuries.
- Falls are seconds most common cause, accounting for another
1 out of 5 accident-related injuries.

Complete vs Incomplete

- Complete will result in the loss of both motor and sensory

function below the lesion site, and any automatic function
e.g., bowel and bladder control.
- An incomplete SCI will result in common patterns of loss, be
it motor but not sensory, one side of the body but not the
other.

Common Incomplete SCI:

Anterior cord syndrome = anterior spinal cord tissue

- Los off motor
- Thermal control
- Pain and tactical touch
- Light touch and proprioception is not affected

Brown-Sequard’s Syndrome = one side of the spinal cord affected

- Loss of motor on the affected side
- Loss of sensation on the contralateral side

Central Cervical Cord Syndrome =

- Motor and sensory of lower limbs less often
- More often upper limb changes with change in motor and
sensory