NCM 102 A

MEDICAL-SURGICAL NURSING

1.MANAGEMENT OF CLIENTS WITH

DISTURBANCES IN SPINAL CORD FUNCTION
2.ANATOMY AND PHYSIOLOGY OF THE EYES
3. ASSESSMENT OF THE VISUAL SYSTEM

Prepared by:
Lilian G. Tumapang, RMT,RN
 MANAGEMENT OF CLIENTS WITH
DISTURBANCES IN SPINAL CORD FUNCTION
• Cross section of a spinal cord
Picture of the human spinal cord showing C1 to S5 vertebra and which
vertebra effect what part of body functions
 SPINAL CORD INJURY

• result of damage to cells in the spinal cord

and causes a loss of communication between
the brain and the parts of the body below
the injury.
1.Central cord syndrome

2.Posterior cord Injury

3. Brown-Sequard’s
syndrome
• Research on images of conus medullaris
syndrome and conus equine syndrome
 MRI of an SCI

• The white arrow points

to an a the area in which the spinal cord
is being
compressed by
a fractured vertebra
PATHOPHYSIOLOGY OF SCI
NURSING DIAGNOSES
NURSING INTERVENTIONS
6. Encourage DBE and the use of an incentive
spirometer.
7. Administer medications as prescribed.
8. Use a specialty bed or a turning schedule of
at least every 2 hours.
9. Provide passive ROM exercises.
10. Insert an indwelling catheter to
decompress the bladder
11. Maintain optimal nutrition.
12. Support the psychological/emotional needs
of the client and the significant others.
Neck or cervical collars
 LAMINECTOMY
• This is a surgical procedure to remove a
portion of a vertebra, called the lamina. The
lamina is removed to get to a ruptured disc
that is pushing on nerves. The ruptured disc
is then removed. In other cases, the lamina is
removed because of pressure caused by bony
spurs or other problems
• Laminectomy (Lamina Removal; Removal of
the Lamina)
 DISCECTOMY
-surgical removal of herniated disc material
that presses on a nerve root or the spinal
cord. The procedure involves removing the
central portion of an intervertebral disc, the
nucleus pulposus, which causes pain by
stressing the spinal cord or radiating nerves.
 FORAMINOTOMY
medical operation used to relieve pressure on
nerves that are being compressed by the
intervertebral foramina, the passages through
the bones of the vertebrae of the spine that
pass nerve bundles to the body from the
spinal cord
A foraminotomy is
performed to relieve the
symptoms of nerve root
compression in cases
where the foramen is
being compressed by
bone, disc, scar tissue,
or excessive ligament
development and results
in a pinched nerve.
 Foraminotomy procedure
1. 2.

Indication: compression of Client tilted and in face

the nerve root by a disc down position
herniation
 » 5

» 5. The nerve
» course

3. Posterior cervical
approach

» 6. Drilling
4. The initial
entrance
7. Venous cuff

8. Nerve 9. Free Fragment

Root
Freedom
 Spinal fusion
• An anterior-posterior X-ray of a case of
adolescent idiopathic scoliosis post-fusion
Spinal fusion indication
 Spinal fusion series
1. incision 2. Procedure: Posterolateral gutter fusion
3.Interbody cage fusion 4. Pedicle screw
 HERNIATED INTERVERTEBRAL
DISC
* AKA
– Herniated nucleus pulposus (HNP)
– Ruptured disc
• Results from sudden or long-term
compression loads on the spine
• Ruptured Disc in Neck Pushing on Nerves
( Cervical disc herniationP
SPINAL TUMORS
 UNIT 2: ALTERED COGNITIVE-
PERCEPTUAL PATTERNS: CLIENT
WITH VISUAL DISORDERS
1. Concept Review Anatomy and
Physiology of the Visual System
2. Assessment of the visual system
VISUAL PATHWAY
ASSESSMENT OF THE EYE
(Subjective Data)
NORMAL VISION ON BOTH FIELDS

bitemporal hemianopsia