Tetraplegia, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Tetraplegia, Diagnosis and Treatment and Related Diseases

The most well known example of a tetraplegic patient was Christopher Reeves who was well known for his Superman movies.

He fell from his horse in 1995 and broke his first and second vertebrae injuring his spinal cord.

He became a tetraplegic, paralyzed from the neck downwards due to a spinal cord injury in the neck and had difficulty in breathing.

He started the Christopher and Dana Reeves Foundation to support the work on spinal paralysis and its treatment and was a great supporter of stem cell research for treatment of spinal injuries.

Tetraplegia (previously known as quadriplegia) is a medical disorder in which the lower extremities, upper extremities, and almost the complete trunk/body become paralyzed.

Tetraplegia is a form of paralysis that is produced by some injury or illness and causes partial or complete loss of usage of body and 4 limbs.

Generally both the sensory and motor nerves are involved, which indicates that one loses both sensation and motor control of that body part.

Most people with tetraplegia have significant paralysis below the neck, and many are totally unable to move.

This form of paralysis is inevitably the product of damage high in the spinal cord, normally in the cervical spine between C1-C7.

The higher the injury is, the more extensive the injury to the spine will be, and very high spinal cord injuries are often instantly fatal.

The injury to spinal cord is normally due to an injury suffered by the spinal vertebrae present in cervical section of spinal column.

The spinal cord injury may cause the loss of total or partial functioning of all the four limbs, i.e. the arms and legs.

If the vertebrae are dislocated or fractured without the spinal cord being injured, it is quite possible to have a broken neck even without becoming tetraplegic.

A person can also injure his or her spinal cord without actually fracturing the spine, like when a bony spur or a ruptured disc on the vertebra protrudes itself into spinal column.

All tetraplegics have finger dysfunction in some form or another.

It is not really infrequent to find a tetraplegic person having fully functional arms but having difficulty in moving fingers.

Tetraplegia Classification

Based on the American Spinal Injury Association (ASIA), spinal cord injuries can be classified into 2 types:

A. Complete tetraplegia

The spinal cord of a tetraplegic individual can be classified into 3 segments that can be utilized to classify the injury:

1. The injured functional medullary segment has un-paralyzed, functional muscles whose motions are voluntary and not permanent.

Assessment of their strength can be done by the BMRC (British Medical Research Council) scale.

2. An injured metamere or a lesional segment is made up of many denervated corresponding muscles that have an injured LMN (lower motor neuron).
These muscles are atrophic, hypotonic and reveal no spontaneous contractions.

3. The injured sub-lesional segment sited below metamere segment has an uninjured lower motor neuron that reveals intact medullary reflexes but has no upper cortical control.
These muscles show some increase in tone when elongated and the trophicity is good

B. Incomplete spinal cord lesions

Incomplete spinal cord wounds may cause different post injury manifestations

1. Central cord syndrome:

The main part of cord lesion remains in gray matter of spinal cord; the lesion might occasionally persist in white matter.

2. Anterior cord syndrome:

This is a lesion happening in the anterior horns as well as in the anterolateral tracts.

3. Brown-Sequard syndrome

TABLE OF CONTENT
Introduction
Chapter 1 Tetraplegia
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Cha

• Language: English
• Publisher: Kenneth Kee
• Release date: Feb 18, 2020
• ISBN: 9780463246917

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Tetraplegia,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2020 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Tetraplegia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Tetraplegia)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Tetraplegia

The most well known example of a tetraplegic patient was Christopher Reeves who was well known for his Superman movies.

He fell from his horse in 1995 and broke his first and second vertebrae injuring his spinal cord.

He became a tetraplegic, paralyzed from the neck downwards due to a spinal cord injury in the neck and had difficulty in breathing.

He started the Christopher and Dana Reeves Foundation to support the work on spinal paralysis and its treatment and was a great supporter of stem cell research for treatment of spinal injuries.

What is Tetraplegia?

Tetraplegia (previously known as quadriplegia) is a medical disorder in which the lower extremities, upper extremities, and almost the complete trunk/body become paralyzed.

Tetraplegia is a form of paralysis that is produced by some injury or illness and causes partial or complete loss of usage of body and 4 limbs.

Generally both the sensory and motor nerves are involved, which indicates that one loses both sensation and motor control of that body part.

Most people with tetraplegia have significant paralysis below the neck, and many are totally unable to move.

This form of paralysis is inevitably the product of damage high in the spinal cord, normally in the cervical spine between C1-C7.

The higher the injury is, the more extensive the injury to the spine will be, and very high spinal cord injuries are often instantly fatal.

The injury to spinal cord is normally due to an injury suffered by the spinal vertebrae present in cervical section of spinal column.

The spinal cord injury may cause the loss of total or partial functioning of all the four limbs, i.e. the arms and legs.

If the vertebrae are dislocated or fractured without the spinal cord being injured, it is quite possible to have a broken neck even without becoming tetraplegic.

A person can also injure his or her spinal cord without actually fracturing the spine, like when a bony spur or a ruptured disc on the vertebra protrudes itself into spinal column.

All tetraplegics have finger dysfunction in some form or another.

It is not really infrequent to find a tetraplegic person having fully functional arms but having difficulty in moving fingers.

Tetraplegia Classification

Based on the American Spinal Injury Association (ASIA), spinal cord injuries can be classified into two types:

1. Complete tetraplegia

2. Partial or incomplete tetraplegia

The ASIA scale permits grading of the patients based on functional impairments produced by the injury, and grading patients from class A to class D.

This has significantly influenced therapy and surgical planning.

The ASIA scale is represented in this manner:

Grade A: Complete: No sensory or motor functioning is maintained in sacral segments of S4-S5.

Grade B: Incomplete: Sensory functioning is maintained without motor functioning below neurological level; composes of the sacral segments of S4-S5.

Grade C: Incomplete: Motor functioning is maintained below neurological level; more than 50% of the main muscles below neurological level have muscle grade lower than 3.

Grade D: incomplete: Motor functioning is maintained below neurological level; at least 50% of the main muscles below neurological level have muscle grade of 3 or more.

Grade E: Normal.

Complete spinal cord lesions

The spinal cord of a tetraplegic individual can be classified into 3 segments that can be utilized to classify the injury:

1. The injured functional medullary segment has un-paralyzed, functional muscles whose motions are voluntary and not permanent.

Assessment of their strength can be done by the BMRC (British Medical Research Council) scale.

2. An injured metamere or a lesional segment is made up of many denervated corresponding muscles that have an injured LMN (lower motor neuron).

These muscles are atrophic, hypotonic and reveal no spontaneous contractions.

3. The injured sub-lesional segment sited below metamere segment has an uninjured lower motor neuron that reveals intact medullary reflexes but has no upper cortical control.

These muscles show some increase in