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
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
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
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
Astrocyte - Star-shaped glial cells which provide the
necessary chemical and physical environment for nerve
Ataxia - Failure or irregularity of muscle
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
Augmentative and Alternative Communication (AAC) -
Forms of communication that supplement or enhance speech or
writing, including electronic devices, picture boards, and sign
Autoimmune Response - The body produces a response
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
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.
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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
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
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.
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Calculi - Stones that may form in either kidney or
Carpal Tunnel Syndrome - A painful disorder in the
hand caused by inflammation of the median nerve in the wrist
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
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 / Injury - 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
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
Cystometric Examination - An exam measuring the
pressure of forces to empty, or resisting to empty, the bladder.
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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
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
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
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
Dysphagia - Difficulty in swallowing.
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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
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.
Electro-ejaculation - A means of extracting sperm from
men with erectile dysfunction by using an electrical probe in
the rectum. The sperm can be used to fertilize eggs in the
uterus or in a test tube.
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)
Ė Male external urine
control device that attaches to tip of penis.
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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
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Gait Training - Instruction in walking, with or
Ganglioside - Complex, carbohydrate-rich lipids found
in cell membranes, most concentrated at the surface of brain
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
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."
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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
Handicap dimensions - Physical independence, mobility,
roles and activities, social integration, and economic
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.
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
Hypoxia - Lack of blood oxygen due to impaired lung
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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
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
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
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.
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KUB - An X-ray of the abdomen, showing the kidneys,
ureters, and bladder.
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Laminectomy - An operation used to relieve pressure on
the spinal cord, or used to examine the extent of damage to the
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
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.
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Malingering - Faking or conscious deception; voluntary
production of symptoms for a rationally considered goal, such as
financial recompense, avoidance of responsibility, etc.
Medicaid - An American 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
Medicare - An American 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
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
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).
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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
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
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
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
Nucleic acid - Complex organic acids found in the
nucleus of all living cells that contain the genetic code
essential to life.
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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 ADLís.
Oedema - Swelling; most commonly present in legs and
feet. Oedema occurs when the body tissues contain an excessive
amount of fluid (plasma), increasing skin sensitivity and risk
of pressure sores.
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
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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
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
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
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.
Physiotherapist / Physical Therapist (PT) - A key member of the
Physiotherapist / 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
Piloerection - "goose bumps"
Plasticity - Long-term adaptive mechanism by which the
nervous system restores or modifies itself toward normal levels
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).
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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
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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
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
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Sacral - The fused vertebrae and spinal cord below the
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
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
- 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
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
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.
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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
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
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~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
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.
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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.
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Weaning - Gradual removal of mechanical ventilation,
as patient's lung strength and vital capacity increases.
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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.