MedFriendly®
Quadriplegia
Quadriplegia is a loss of the ability to move and/or feel both arms, both
legs, and the parts of the body below the area of injury to the spinal cord,
which is what causes the condition to occur. Quadriplegia is typically
caused by an injury to the spinal cord (which sends messages to body
parts important for movement and sensation). In the picture to the right,
the blue area is the region of the body that the person cannot feel who is
quadriplegic. Quadriplegic means pertaining to quadriplegia.
UNDER WHAT CONDITIONS IS QUADRIPLEGIA MOST LIKELY TO
OCCUR?
Quadriplegia is most likely to occur when a spinal cord injury is in the
area of the 5th to 7th cervical vertebrae (bones in the neck that make up
part of the structure surrounding the spinal cord).
FEATURED BOOK: Spinal Cord Injury: Functional Rehabilitation
The 5th to 7th cervical vertebrae are located in the neck area. The reason why spinal
cord injuries in this area are likely to cause quadriplegia is because the spinal cord
cannot send messages below the area where it is seriously damaged.
Since the arms and legs are both below the neck area, serious injury to the spinal cord in
this area often leads to an inability to feel the arms, legs, and any other body parts below
the level of the injury.
"Where Medical Information is Easy to Understand"™
WHAT ARE COMMON CHARACTERISTICS ASSOCIATED WITH
QUADRIPLEGIA?
When quadriplegia occurs, it is characterized by a decrease in the
normal level of tension that exists in muscles of the arms and legs.
There is also a loss of power and sensation below the area of the
spinal cord injury. Many people with quadriplegia die of breathing
failure because voluntary control over the muscles and organs that
are necessary to breathe is dramatically impaired. Thus, it is crucial
for health care providers to make sure that someone with
quadriplegia can breathe properly.
To help people with quadriplegia breathe properly, they may need a machine known as a respirator that
artificially breathes for them.
Some people with quadriplegia develop heart complications when the spinal cord is injured above the level
of the 5th cervical vertebrae (located in the neck). The reason for this is because the spinal cord injury
causes connections to become interrupted between the spinal cord and the sympathetic nervous system
(a system that generally excites the body by doing things such as increasing both the heart rate and blood
pressure).
A life threatening condition known as autonomic dysreflexia can be caused by interruptions between the
connections of the spine to both the sympathetic and parasympathetic nervous system (a system that
generally calms the body down by doing things such as decreasing both the heart rate and blood
pressure). In autonomic dysreflexia, the sympathetic and parasympathetic nervous systems (which
generally work in opposition to each other) are activated at the same time, and this causes all sorts of
serious problems. The sympathetic and parasympathetic nervous systems make up the autonomic
nervous system. Interrupted connections between the spinal cord and the autonomic nervous system can
lead to other difficulties such as low body temperature and loss of bowel and bladder control.
HOW IS QUADRIPLEGIA DIAGNOSED?
Quadriplegia is diagnosed by interviewing the person with the suspected condition and conducting a
complete physical and neurological examination. To assess for other injuries, X-rays of the head, chest,
and the abdomen (belly) are taken. X-rays and myelography (a type of picture of the spinal cord and spinal
nerves, using radiation) of the spine are done to examine for any blockages in the spinal cord or fractures
in the bones that surround the spinal cord.
HOW IS QUADRIPLEGIA DIAGNOSED?
Quadriplegia is diagnosed by interviewing the person with the suspected condition and conducting a
complete physical and neurological examination. To assess for other injuries, X-rays of the head, chest,
and the abdomen (belly) are taken. X-rays and myelography (a type of picture of the spinal cord and spinal
nerves, using radiation) of the spine are done to examine for any blockages in the spinal cord or fractures
in the bones that surround the spinal cord.
HOW MANY PEOPLE HAVE QUADRIPLEGIA?
Approximately 150,000 people in America have quadriplegia, and most of them are between the ages of
20 and 40.
WHAT ARE SOME CAUSES OF SPINAL CORD INJURIES THAT LEAD TO QUADRIPLEGIA?
Causes of spinal cord injuries that result in quadriplegia include a motor vehicle or motorcycle accident,
gunshot wounds, and falls.
HOW IS QUADRIPLEGIA TREATED?
Treatment of quadriplegia begins at the scene of the accident. To prevent further damage from occurring
at the scene of the spinal cord injury, health care professionals strap the injured person to a special type
of board and place a brace around the person's neck to prevent the spine or neck from moving. Once a
person with a spinal cord injury comes to the hospital, the neck and head may be prevented from moving
by being placed in a special metal device known as a halo. This device is called a halo because it forms a
circle around the head, much like the halo of an angel.
Medications known as diuretics and steroids are administered to decrease any buildup of fluid in the spine
that is caused by leakage from dead cells. After additional therapy, surgery is often performed to remove
any pieces of bones and to fuse (combine) together any unstable sections of the bones that surround the
spine.
Health care providers also need to make sure that many types of complications are avoided or treated
quickly in patients with quadriplegia. For example, to treat hypothermia (abnormally decreased body
temperature), the person is placed in blankets. Hot water bottles or electric heating devices are not used
because the skin can get burned due to sensory loss. To provide support to the abdomen (belly) area due
to weak muscles, a bandage known as an abdomen binder is wrapped around it. To prevent blood clots,
the patient is given special stocking to wear on the legs. Pressure sores, which develop from staying in
the same position for an extended period of time, also need to be prevented.
The heart rate is monitored regularly and slow heart rate is treated with special medications known as
antimuscarinic drugs. Hardened feces (affectionally known to many as #2) are important to monitor
because it can cause high blood pressure. To understand how stimulation of the body by hardened feces
or other causes can lead to high blood pressure in people with quadriplegia, please see the entry for
autonomic dysreflexia. Blockage of tubes inserted into the body to drain or enter fluids also needs to be
monitored. The proper functioining of the digestive system needs to be monitored as well.
WHAT ELSE IS QUADRIPLEGIA KNOWN AS?
Quadriplegia is also known as tetraplegia.
WHAT IS THE ORIGIN OF THE WORD, "QUADRIPLEGIA"?
Quadriplegia comes from the Latin word "quattuor," meaning "four," and the word "plege," meaning
"stroke." Put the two words together and you have "four stroke," referring to the four limbs (arms and legs)
of the body. A stroke is a burst artery (a type of blood vessel that carries blood away from the heart) or a
blockage of an artery in the brain. Because strokes sometimes lead to loss of movement and/or sensation
in parts of the body, the word "plegia" is used to refer to such conditions. Other types of plegias include
paraplegia, hemiplegia, and diplegia.
