Quadriplegia Tetraplegia Case Study

Quadriplegia, also known as tetraplegia, is defined as complete or partial paralysis with loss of motor and/or sensory function in both the upper and lower extremities as well as the trunk as a result of an injury to the spinal cord.1 The spinal cord is a component of the central nervous system (CNS) along with the brain and runs within a protective, bony-structured vertebral column from the foramen magnum to approximately the second lumbar vertebra of an adult where the it becomes the conus medullaris. The spinal cord is about 17 inches long and has three protective layers like the brain: the outer dura mater, the arachnoid membrane, and the inner pia mater; and like the brain, cerebrospinal fluid flows between the middle and inner layers of the spinal cord.2 Within the spinal cord are areas of white matter containing axons and neurons, and an H-shaped area of gray matter which contains neuronal cells. The white matter has ascending sensory tracts and descending motor tracts in which the ascending tracts send signals from receptors
In a complete injury, there is total loss of motor and sensory function below the level of injury, even in the lowest sacral segments (S4, S5). All signals from the brain have been cut off from the rest of the body below the level of injury.5 In an incomplete injury, partial motor and sensory function are present below the level of injury, including the sacral segments of S4 and S5, which can be termed sacral sparing.6 Motor and sensory functions of S4 and S5 are measured by anal/perianal sensation and voluntary external anal sphincter contraction.5,6 This is extremely important in determining a complete versus incomplete injury. If a person is able to feel or has some type of movement below the level of injury, but does not have any motor or sensory function at S4 and S5, the areas with sensation and/or movement below the level of injury are defined as zones of partial