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1.2. Medical Terms and Definitions

The Spinal Cord Disabilities Lexicon is focused on medical words and terms related to Spinal Cord Injury and Disorders.
 
A

Abdominal Binder (Abdominal support, binder, corset)
Wide elastic (or other material) binders that are worn to help prevent a drop in blood pressure or to help empty the bladder in some patients. They can also be used to improve posture and balance while seated in a wheelchair.

Abductor muscle
A muscle used to pull a body part away from the midline of the body (e.g., the abductor leg muscles are used to spread the legs).

Acute
Having rapid onset, usually with recovery; not chronic or long-lasting.

Acute Stage
The early stage of an injury (as opposed to chronic, which is long term), in SCI, early management of acute trauma, including better roadside emergency care, has reduced the number of complete injuries.

Activities of Daily Living (ADLs)
ADL's include activities necessary for everyday living. These include such activities as eating, bathing, grooming, dressing, and using the toilet. Smaller parts of a larger activity can also be considered ADL's. Opening a can, writing, driving, and just the act of moving or having mobility can all be considered ADL's that contribute to a larger or an end activity. Activities of daily living need not be accomplished independently. Many people with disabilities require assistance with some or all ADL's. Whether accomplished independently or with help, it still constitutes performing an ADL. Healthcare professionals such as therapists and rehabilitation specialists train people how to best perform activities of daily living by maximizing the persons potential either through therapy programs or by using adaptive and assistive devices and technology.

Adductor muscle
A muscle that pulls inward toward the midline of the body (e.g., the adductor leg muscles are used to pull the legs together).

Advance (medical) directive
Advance directives preserve the person's right to accept or reject a course of medical treatment even after the person becomes mentally or physically incapacitated to the point of being unable to communicate those wishes. Advance directives come in two basic forms: (1) a living will, in which the person outlines specific treatment guidelines that are to be followed by health care providers; (2) a health care proxy (also called a power of attorney for health care decision-making), in which the person designates a trusted individual to make medical decisions in the event that he or she becomes too incapacitated to make such decisions. Advance directive requirements vary greatly from one state to another and should therefore be drawn up in consultation with an attorney who is familiar with the laws of the particular state.

Ambulation
Walking with or without aids, such as braces and crutches.

Americans With Disabilities Act (ADA)
The ADA is a federal civil rights law designed to prevent discrimination and enable individuals with disabilities to participate fully in all aspects of society.

Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease, ALS)
A rapidly progressive, invariably fatal neurological disease that attacks the nerve cells (neurons) responsible for controlling muscles.

Ankle-foot orthosis (AFO)
An ankle-foot orthosis is a brace, usually plastic, that is worn on the lower leg and foot to support the ankle and correct foot drop. By holding the foot and ankle in the correct position, the AFO promotes correct heel-toe walking.

Ankylosing Spondylitis
Arthritis of the spine which may progress to bony ankylosis (fusion) with ossification of the anterior and posterior longitudinal ligaments; the disease is more common in males.

Ankylosis
Fixation (fusion) of a joint leading to immobility, due to ossification or bony deposits of calcium at joints.

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 (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).

Anticholinergic
The action of certain medications commonly used in the management of neurogenic bladder dysfunction. These medications inhibit the transmission of parasympathetic nerve impulses and thereby reduce spasms of smooth muscle in the bladder.

Arachnoid Membrane
The middle of three membranes protecting the brain and spinal cord.

Arachnoiditis
Inflammation and scarring of the arachnoid membrane covering the spinal cord.

ASIA Impairment Scale
A measure of function after spinal cord injury, used by physicians, physical therapists and occupational therapists.

Assisted Cough
A technique in which the patient is assisted by another individual to produce a more forceful and productive cough.

Assistive Technology (AT)
Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. Individuals with disabilities use AT to accommodate limitations due to their disabilities.

Astrocyte
Star-shaped glial cells which provide the necessary chemical and physical environment for nerve regeneration.

Ataxia
The lack of coordination and unsteadiness that result from the brain's failure to regulate the body's posture and the strength and direction of limb movements.

Atrophy
A wasting away or decrease in size of a cell, tissue, organ, or part of the body due to lack of nourishment, or use.

Autonomic Dysreflexia (Hyperreflexia or Crisis)
A potentially dangerous complication which occurs in people with spinal cord injuries at the level of T6 and above causing high blood pressure, sweating, chills and headaches. Typical causes include an overfull bladder, impacted bowel or ingrown toenail. It is treated by removing the offending stimulus and giving the patient medication.

Autonomic Nervous System (ANS)
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 systems.

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.

B

Bed Sore – See Decubitus Ulcer

Bell's palsy
A paralysis of the facial nerve (usually on one side of the face), which can occur as a consequence of MS, viral infection, or other infections. It has acute onset and can be transient or permanent.

Biofeedback
A process that provides sight or sound information about body functions, such as blood pressure and muscle tension, and enables patients to control these functions.

Bladder Training Program
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 intermittent catheterization.

Bowel Training 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. Stool softeners might be recommended, as might common laxatives. The main side effect of both softeners and laxative is diarrhea. Suppositories useful to initiate elimination however; an ideal management program does not rely on suppositories. Enemas relieve fecal impaction but should not be used as a routine method.

Breakdown - See Decubitus Ulcer

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.

C

Calculi
Stones that may form in either kidney or bladder.

Catheter (includes Urinary catheter, intermittent catheter, Foley catheter, external catheter, Texas catheter, condom catheter, suprapubic catheter)
Internal catheters are a hollow, flexible tube, most often made of plastic or rubber, that is inserted through the urinary opening into the bladder to drain urine. These tubes are connected to an external bag that collects the urine. Intermittent catheters are used periodically throughout the day. They are inserted routinely for purposes of emptying the bladder and are removed once the process is finished. External catheters can be used by men. They resemble a condom that is placed over the penis. The external catheter is connected to a collection bag (customarily strapped to the users leg) by way of tubing.

Cauda Equina
The collection of spinal roots descending from the lower part of the spinal cord at the L1 level.

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 (tetraplegia).

Cervical Spine
The seven bones or vertebrae of the spine in the region of the neck.

Chronic
Of long duration, not acute; a term often used to describe a disease or injury that shows gradual worsening.

Clinical Trial
Rigorously controlled studies designed to provide extensive data that will allow for statistically valid evaluation of the safety and efficacy of a particular treatment.

Clonus
A sign of spasticity in which involuntary shaking or jerking of the leg occurs when the toe is placed on the floor with the knee slightly bent. The shaking is caused by repeated, rhythmic, reflex muscle contractions.

Cognition
High level functions carried out by the human brain, including comprehension and use of speech, visual perception and construction, calculation ability, attention (information processing), memory, and executive functions such as planning, problem-solving, and self-monitoring.

Cognitive impairment
Changes in cognitive function caused by trauma or disease process. Some degree of cognitive impairment occurs in approximately 50-60 percent of people with MS, with memory, information processing, and executive functions being the most commonly affected functions.

Complete Spinal Cord Injury or Lesion
Severing of the spinal cord that causes total paralysis (loss of movement) and loss of sensation (feeling) below the level of injury. Below the level of injury the spinal cord is no longer able to send sensory and motor nerve impulses resulting in permanent loss of function. This results in complete paraplegia or tetraplegia.  How complete an injury is may not be known for several months after injury. 

Condom Catheter
External urine collecting device used by males. A condom catheter is an external incontinence device consisting of a flexible sheath that fits over the penis similar to a condom. The condom part is attached to a tube that drains the urine into a urinary storage bag.

Contracture
Contracture is a pathologic, involuntary, irreversible shortening of a muscle. The affected joint can no longer be moved through its normal range. A muscle contracture is a permanent shortening of a muscle or joint. It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy and spinal cord injury. Contractures are essentially muscles or tendons that have gotten too tight for too long, thus becoming shorter. Once they occur they cannot be stretched or exercised away; they must be released by surgical or other methods. Physical therapy, occupational therapy, and other exercise regimens targeted towards people with spasticity focuses on trying to prevent contractures from happening in the first place.

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 higher lesions.

Crede
A technique of pressing down and inward over the bladder to facilitate voiding.

Crisis – See Autonomic Dysreflexia

Cystoscopy
A diagnostic procedure in which a special viewing device called a cystoscope is inserted into the urethra (a tubular structure that drains urine from the bladder) to examine the inside of the urinary bladder.

Cystostomy
A surgically created opening through the lower abdomen into the urinary bladder. A plastic tube inserted into the opening drains urine from the bladder into a plastic collection bag. This relatively simple procedure is done when a person requires an indwelling catheter to drain excess urine from the bladder but cannot, for some reason, have it pass through the urethral opening.

D

Decubitus Ulcer (Pressure Sores, Bed Sores, Breakdown)
Decubitus ulcers are ulcerated areas of skin over bony areas. When parts of the body are under continuous pressure, blood supply to that area is hindered and a decubitus ulcer may develop. Decubitii (multiple deculitus ulcers) occur whenever and wherever there is too much pressure on soft tissue. They can develop where there is a small amount of pressure applied for a long time, or a great deal of pressure for a short period of time. Other factors such as poor diet, poor personal hygiene, and incontinence can increase the risk for developing pressure sores.

Demyelination
The loss of nerve fiber "insulation" due to trauma or disease, which reduces the ability of nerves to conduct impulses.

Diplopia
Double vision, or the simultaneous awareness of two images of the same object that results from a failure of the two eyes to work in a coordinated fashion. Covering one eye will erase one of the images.

Dysphagia
Difficulty in swallowing.

E

Edema
Swelling; most commonly present in legs and feet. Edema occurs when the body tissues contain an excessive amount of watery fluids, increasing skin sensitivity and risk of pressure sores.

Electro-ejaculation
A means of extracting sperm from men with erectile dysfunction by electrical stimulation.

Endotreacheal Tube
A tube inserted into the mouth or nose that serves as an artificial airway. It passes through the vocal cords, and therefore speech is not possible with this tube in place. It is the tube that connects a respirator to the patient.

External Continence Device (ECD)
Male external urine control device that attaches to tip of penis.

F

Flaccidity
A form of paralysis in which muscles are soft and limp. Sometimes considered to be the opposite of spasticity.

Foley Catheter
A Foley catheter is a flexible tube that is passed through the urethra and into the bladder. The tube has two separated channels, or lumens, running down its length. One lumen is open at both ends, and allows urine to drain out into a collection bag. The other lumen has a valve on the outside end and connects to a balloon at the tip; the balloon is inflated with sterile water when it lies inside the bladder, in order to stop it from slipping out.

Functional Ability
How well an individual can perform activities of daily living without assistance from another person. Functional ability can be improved through therapy or training in techniques specific to the acitivity as in performing transfers. Assistive technology devices such as wheelchairs, walking aids and other devices help to improve function and can be an important component of the activity.

Functional Electric Stimulation (FES)
The application of low-level, computer-controlled electric current to the neuromuscular system, including paralyzed muscle. FES is a method of producing contractions in muscles, paralysed due to central nervous system lesions, by means of electrical stimulation. The electrical stimulation is applied either by skin surface electrodes or by implanted electrodes for purposes of restoring movement for functional use of the extremeties.

G

Glial Cells
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 Schwann cells.

H

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 immobilization.

Health care proxy – See Advance (medical) directive.

Hemiparesis
Weakness on one side of one's body, including one arm and one leg.

Hemiplegia
Paralysis on one side of one's body, including one arm and one leg.

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. [heterotopic bone].

Hyperreflexia – See Autonomic Dysreflexia

Hypothermia
An extreme lowering of the body temperature. A technique used to cool the spinal cord after injury.

I

Impaction
A blockage of the bowel with stool that results in severe constipation. Persons at risk for chronic constipation and fecal impaction include those who do not move around much and spend most of their time in a chair or bed and those that have diseases of the brain or nervous system that damage the nerves that go to the muscles of the intestines. Fecal impaction can cause pain and vomiting, and a person with fecal impaction may require emergency treatment or hospitalization.

Incomplete Injury or Lesion
Some movement and/or feeling remains below the level of injury, movement and feeling may improve over time. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. Spinal cord injuries that are described as "incomplete", can vary from having no effect on the patient to a "complete" injury which means a total loss of function.

Incontinence (Bladder incontinence, bowel incontinence)
Incontinence can relate to the bladder or the bowels. It means that there is no control over the process of emptying the bladder or having a bowel movement. For many people with spinal cord involvement this means using a catheter to help with urinating and using a planned program of bowel training and care to help with bowel movements.

Indwelling Catheter
A flexible tube, retained in the bladder, and used for continuous urinary drainage to a leg bag/urinary drainage bag or other device.

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 self-catheterization. The process is performed on a regular timed basis. Procedure intervals are closer together at first, often 4 to 6 times daily. As the person improves and the bladder voids more efficiently, the procedure interval time is extended and may result in 10 and 12 hour intervals between procedures.

Intrathecal Baclofen
Administration of the anti-spasm drug Baclofen directly to the spinal cord by way of a surgically implanted pump. Baclofen (brand names Kemstro, Lioresal, and Gablofen) is a derivative of gamma-aminobutyric acid (GABA). It is primarily used to treat spasticity

Intubation
Insertion of a tube through the nose or mouth into the windpipe to keep the airways open, prevent fluids from entering the lungs, and remove fluids from the lung.

J

Joint Extension
A movement of a joint that results in increased angle between two bones. Extension usually results in straightening of the bones or body surfaces involved. For example, extension is produced by extending the flexed (bent) elbow. Straightening of the arm would require extension at the elbow joint. Tilting the head all the way back places the neck in extension. Standing up requires extending both the knee and hip joints. Fingers point out straight when the joints of the fingers are all extended. Depending on the level and completeness of spinal cord injury, muscle function may be insufficient for extending joints (paralysis). This makes performing even small tasks and activities difficult or even impossible independently.

Joint Flexion
Bending of a joint that results in a decreased angle between two bones. It is the opposite of extension. It occurs at the knee when bending down or sitting. Bending down or leaning forward when picking something up requires flexion of the hips and knees. Making a fist or grasping requires joints of the fingers to flex inward. Depending on the level and completeness of spinal cord injury, muscle function may be insufficient for flexing joints (paralysis). This makes performing even small tasks and activities difficult or even impossible independently.

L

Laminectomy
The complete or partial surgical removal of the arch of bony sections of the spinal vertebra.

Leg Bag
External bag which is strapped to the leg for collection of urine.

Lesion
An injury or wound.

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.

Lumbar
Pertaining to that area immediately below the thoracic spine; the lumbar spine is the strongest part of the spine, the lower back.

M

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. Motoneurons supply information to muscle. A motor unit is the combination of the motoneuron and the set of muscle fibers it innervates.

Multiple Sclerosis (MS)
An autoimmune disease, or disease that affects the system of the body that fights illness and disease, affects twice as many women as men. In Multiple Sclerosis, the body's immune system attacks the central nervous system, destroying myelin (the fatty sheath which surrounds and insulates the nerve fibers). As a result, nerve impulses that send signals to and from the brain are slowed or halted.

Myelin
A white, fatty insulating material for axons which is 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 color.

N

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".

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 dendrites.

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 dysfunction at the nerve root or spinal cord.

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 transmissions.

O

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).

Osteoporosis
Loss of bone density or atrophy of skeletal tissue, common in immobile bones after spinal cord injury. This loss of bone density increases the potential for fractures and breaks. Persons with spinal cord injury or disease need to be cautious. Depending on the degree of osteoporosis, it need not take a fall or hard impact to fracture a bone. Fractures can occur after mild impacts or even by twisting an extremity while performing any number of activities of daily living.

Ostomy
An opening in the skin to allow for a suprapubic catheter (for elimination of intestinal contents) or for the passage of air (a tracheostomy).

P

Paraplegia, Paraplegic, Para
Loss of use of the lower half of the body (paralysis) including both legs, certain bodily functions, and loss of sensation to the involved area. Usually caused by spinal cord damage, disease, or congenital malformation (as in Spina Bifida). A paraplegic or para is a person who experiences paraplegia.

Paresis
Weakness in muscle; partial or incomplete paralysis.

Peripheral Nervous System (PNS)
Nerves outside the spinal cord and brain (not part of the central nervous system). Peripheral nerves have the ability to regenerate.

Plasticity
Long-term adaptive mechanism by which the nervous system restores or modifies itself toward normal levels of function.

Poliomyelitis (Polio)
Polio is an acute infectious disease affecting the motor nerves (lower motor neurones) in the central nervous system responsible for muscle contraction. If nerve cells are damaged the corresponding muscles are affected, resulting in muscular weakness or paralysis with varying degrees of severity and distribution. Polio can cause death by paralyzing the muscles that help in breathing.

Pressure Release (Pressure Relief, Weight Shift)
Relieving pressure from the ischial turberosities (bones on which we sit) every 15 min. in order to prevent pressure sores when in a wheelchair or a seated position. This can be accomplished in a number of ways depending upon the upper extremity strength of the individual. If able, a person can lift himself up off of the wheelchair seat for 15-30 seconds. If unable to lift up, pressure relief can be accomplished by cautious leaning to one side for 15-30 seconds, then to the other side for a similar period of time. For those indiviudals who are unable to lean to one side or the other, a wheelchair with a tilting or reclining seat may be necessary. Tilting the seating system back will lower pressure to some extent as will laying back. When in bed, pressure is greatly reduced when the hips are kept at no more than 30 degrees of flexion (bending forward at the hip).

Pressure Sore - See Decubitus Ulcer

Proprioception
The internal sense that allows a person to know the position of parts of the body, relative to other parts of the body.

Prosthesis (Prosthetic, Prosthetics)
Replacement device for a body part, for example an artificial limb.

Psychosocial
Pertaining to the psychological, social and environmental aspects of human functioning.

Post Void Residual (PVR)
The volume of urine left in bladder after the patient voids (urinates).

Q

Quad Cough
A method of helping a patient with tetraplegia (quadriplegia) cough by applying external pressure to the diaphragm, thus increasing the force and clearing the respiratory tract. This is very often necessary for those with new spinal cord injuries to prevent pneumonia. In some cases a lightweight elastic binder that exerts some inward pressure can be worn to assist in coughing and exhaling.

Quadriparesis
Partial loss of function in all four (4) extremities of the body.

Quadriplegia Quadirplegic, Quad
Loss of function affecting all four limbs caused by an injury to or disease affecting the cervical spinal cord. A high quad is usually defined as someone with an injury at the C1, C2, C3 or even C4 level. Mid-level quads are those persons injured at C5. Low level quads those persons injured at C6 and C7. Outside of the U.S., the term tetraplegia is used (which is etymologically more accurate, combining tetra-plegia, both from the Greek, rather than quardri-plegia, a Latin/Greek amalgam). A quadriplegic or quad is person who has quadriplegia.

R

Range of Motion (ROM)
The range of movement of a joint. Joint excursion or how far in degrees a joint can move in any given direction. Range of Motion also refers to exercises designed to maintain a normal joint range and prevent contractures.

Reflex
An involuntary response to a stimulus involving nerves not under the control of the brain. In some types of paralysis, reflexes become exaggerated and may cause spasms.

Reflux
The backflow of urine from the bladder into the ureters and kidney.

Regeneration
The re-growth or repair of nerve fiber tissue, which can permit the return of function.

Residual Urine
Urine that remains in the bladder after voiding. Too much left can lead to a bladder infection.

Rhizotomy
The cutting, or interruption, of spinal nerve roots.

S

Sacral
Refers to the fused segments of the lower vertebrae or lowest spinal cord segments below the lumbar level.

Sacrum
The lowest part of the spine. The bones or vertebrae in this section of the spine end with the "tailbone" and join the pelvis (hip).

Schwann Cells
Responsible in the peripheral nervous system for myelinating axons they also provide trophic (nutrition) 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.

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 (section of skin innervated by a single sensory axon) on the right and 28 dermatomes on the left side of the body, and (2) a key muscle within each of 10 myotomes (section of muscle innervated by a single motor axon) on the right and 10 myotomes on the left side of the body.

Spasm, Spasticity
Hyperactive muscles that move or jerk involuntarily. Spasms may be caused by bladder infections, skin ulcers, and any other sensory stimulus. Such uncontrolled muscle activity is caused by excessive reflex activity below the level of lesion. Some spasticity can be beneficial in that they serve as a warning mechanism to identify pain or problems, they improve circulation and maintain muscle tone. If severe, through, spasms can interfere with normal activities, and can hasten contractions as muscles shorten. Spasticity is typically treated with the following medications: baclofen, clonidine, dantrium, tizanidine or valium.

Sphincterotomy
The cutting of the bladder sphincter muscle to eliminate spasticity and related voiding problems.

Spina Bifida
Spina Bifida occurs when the spine of an infant does not form properly. An opening in the spine causes damage to the lining of the spinal column, the spinal nerves, and frequently to the spinal cord itself. The damage that occurs may lead to muscle weakness, paralysis, and loss of bowel and bladder control. Most of these infants grow into adulthood with different degrees of disabilities.

Spinal Cord
The spinal cord is a bundle of nerves and fibers, about the thickness of a little finger, that transmits messages to and from the brain. It extends from the brain to the lower back and is protected by the 33 vertebrae. These nerves can be either motor, sensory, or autonomic nerves.

The spinal cord transmits messages between the peripheral nerves and the brain. For example if a person puts his hand near a flame, a sensory nerve, which is part of the peripheral system, transmits the "message" that the hand is very hot to the spinal cord. The spinal cord then transmits the message to the brain, where it is interpreted. The brain then sends a message down the spinal cord to the motor nerves at the place of the sensation so that the motor nerves can instruct the muscles to pull the hand away from the flame.

Spinal Cord Injury (SCI)
Spinal cord injury occurs when there is damage to the spinal cord, the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. It can also be associated with congenital or degenerative disease. SCI results in a loss of mobility, feeling, or other bodily function. Frequent causes of SCI are trauma (such as a car accident, an act of violence, or falls), disease (such as polio or multiple sclerosis) or congenital defects (such as spina bifida).

A complete injury results in no function below the injury, no sensation, and no voluntary movement. An incomplete injury allows some function, sensation, and movement below the primary site of the injury. People with SCI may also have many other problems including bowel and bladder that do not function right, pressure sores, kidney involvement, respiratory problems, severe and chronic pain, osteoporosis (brittle bones), sexual dysfunction, involuntary spasms, impaired vision, inability to chew or swallow, and joint contractures (fixed joint deformities).

Sphincter
A muscle that encircles a duct, tube, or orifice.

Spinal Shock
The body's initial response to SCI, which lasts 3-4 weeks and causes immediate flaccid paralysis, in which the muscles are soft or weak. Similar to a concussion in the brain, spinal shock causes the system to shut down.

Spinal Stenosis
Spinal stenosis is an abnormal narrowing (stenosis) of the spinal column that may occur in any of the regions of the spine. The most common forms are cervical spinal stenosis, at the level of the neck, and lumbar spinal stenosis, at the level of the lower back. Thoracic spinal stenosis, at the level of the mid-back, is much less common. Spinal cord stenosis can lead to compression of the spinal cord that can result in serious symptoms, including major body weakness or even paralysis.

Stenosis
A narrowing of a canal.

Suctioning
The upper airway warms, cleans and moistens the air we breathe. The trach tube bypasses these mechanisms, so that the air moving through the tube is cooler, dryer and not as clean.  In response to these changes, the body produces more mucus.  Suctioning clears mucus from the tracheostomy tube and is essential for proper breathing. Also, secretions left in the tube could become contaminated and a chest infection could develop.  Avoid suctioning too frequently as this could lead to more secretion buildup.
Johns Hopkins Medicine

Suprapubic Catheter
This is a small surgical incision that is made just above the pubic bone and into the bladder. A catheter (SP-tube) is inserted for purposes of draining urine. This is sometimes a temporary procedure after surgery or while treating a medical problem that does not allow for the persons regular method of urine drainage. People who have had problems with other methods or can not manage other types of catheters are often advised to have a suprapubic procedure done. The catheter that is inserted must be changed on a regular basis. Patients with suprapubic catheters and other inswelling catheters should be mindful that there is an increased risk of bladder tumors associated with these devices.

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 possible.

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. As a syrinx gets larger with in the spinal cord, the surrounding nerve fibers are compressed and blood flow is restricted. The fluid buildup seen in syringomyelia may be a result of spinal cord trauma, tumors of the spinal cord, or birth defects (specifically, "chiari malformation," in which part of the brain pushes down onto the spinal cord at the base of the skull). The fluid-filled cavity usually begins in the neck area. It expands slowly, putting pressure on the spinal cord and slowly causing damage.

T

Tetraplegia – See Quadriplegia

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.

Tracheostomy or Tracheotomy
Opening in the trachea, or windpipe, to insert a tube that protects the airway and allows secretions to be removed from the lungs.

Transverse Myelitis
ransverse myelitis is a neurological disorder caused by inflammation across both sides of one level, or segment, of the spinal cord. The term myelitis refers to inflammation of the spinal cord; transverse simply describes the position of the inflammation, that is, across the width of the spinal cord. Attacks of inflammation can damage or destroy myelin, the fatty insulating substance that covers nerve cell fibers. This damage causes nervous system scars that interrupt communications between the nerves in the spinal cord and the rest of the body.

U

Urinary Tract Infection (UTI)
Bacterial invasion of the urinary tract, which includes the bladder, bladder neck, and urethra. Symptoms of UTI may include urine that is cloudy, contains sediment, and has a foul smell. A fever may also be present.

V

Ventilator
Mechanical device to facilitate breathing in persons with impaired diaphragm function.

Vertebrae
The bones that form the spinal column. In humans there are 33 vertebrae: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (fused into one), 4 cocygeal (fused into one). Vertebra (singular). Vertebrae (plural).

Vital Signs
Include blood pressure, pulse, respiration, and temperature.

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