Glossary on SCI and Rehabilitation
Terminology
(NOTE: Those words with * indicate use within the text of the manual.)
Introduction
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Manual - Resources
Acute: The early stages of an injury. In SCI, for example, early management of acute trauma and acute medical and surgical care. Also may refer to level of rehabilitation care. The opposite of acute is chronic or long-term.
ADL: Activities of daily living, such as eating, dressing, grooming, or shaving. Nurses, occupational and physical therapists are the main coaches for ADL, which is sometimes called DLS or daily living skills.
Advocate: Someone who represents your best interest; works on your behalf. Often, people with disabilities become their own advocates.
*Anesthesia: Medication that blocks pain sensations. Some anesthesia causes a person to also fall asleep, while others may simply numb an area while the injured person is conscious.
*Angiogram: A diagnostic procedure done in the X-ray department to visualize blood vessels following introduction of a high-contrast dye injected into an artery.
Assistive Technology: The utilization of technology, strategies, and methods in enabling individuals to master tasks at home, school, work, increase independence, and quality of life—use of computers, toys, controls, equipment, communications, modifications, etc. Usually done by OT or PT. Some centers for independent living provide assistance on assistive techologies.
*Associated Injury: An injury that occurs at the same time as the spinal cord injury. Injuries such as broken limbs or ribs or internal bleeding are not directly related to the spinal cord injury, but add to the medical problems of the person with a new SCI.
Attendant Care (Personal Assistance): Assistance given for personal care by a hired, trained assistant or personal care attendant hired by the person with SCI as part of his or her self-directed care.
*Attending Physician: The medical doctor who oversees all of a patient's hospital care, no matter how many specialists or therapists are involved in the person's care.
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 systems. Sympathetic activities are marked by the flight or fight emergency response, initiated by way to the transmitter norepinephrine (adrenaline). Parasympathetic activities are known by lowered blood pressure, pupil contradiction, and slowing of the heart.
*Bedsore: See Pressure Sore
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 intermittent catheterization.
Bowel Program: The establishment of a “habit program” or a specific time to empty the bowel so that regularity can be achieved. Stool softeners might be recommended as well as laxatives. The main side effect of both softeners and laxative is diarrhea. Suppositories are useful to start elimination; however, an ideal management program doesn't rely on suppositories. Enemas relieve fecal impaction, but should not be used routinely.
Catheter: A flexible rubber or plastic tube for withdrawing or introducing fluids into a cavity of the body, usually the bladder.
Cauda Equina: The collection of spinal roots descending from the lower part of the spinal cord (the conus medullaris—T11 to L2), occupying the vertebral canal below the spinal cord. These roots have some recovery potential.
*Center for Independent Living (CIL): Not-for-profit, charitable, organizations that advocate for the civil rights and service needs of people with disabilities so that they can live independently in the community.
Central Nervous System (CNS): The CNS includes the brain and spinal cord. The prevailing theory is that CNS cells won't repair themselves. Experiments show, however, that CNS nerves can re-grow and reconnect to appropriate targets. A clinical “cure” for spinal cord injury has not yet been found.
Central Cord Syndrome: A lesion occurring almost exclusively in the cervical region that produces sacral scaring and greater weakness in the upper limb then the lower limbs. It indicates injury to the central structures of the spinal cord.
Cervical: The upper spine or neck area of the vertebral column. Cervical injuries often result in quadriplegia, also known as tetraplegia.
Complete Lesion: An injury with no motor or sensory function below the zone of cord destruction at the site of primary trauma.
*Co-Payment: A fee set by an insurance company that a person pays each time she or he receives service for health care.
*CT Scan: A special radiographic technique that uses a computer to assimilate multiple X-ray images into a 2-dimensional cross-sectional image.
*Decubitus Ulcer: See Pressure Sore
*Deductible: An amount up to a certain limit that is set by an insurance company and that shows how much a client must pay toward his or her health-care costs. Under most insurance policies, the insurance company will pay the full cost of care once the client has met his or her deductible.
Discharge Planning: Preparation for life after rehab, including insurance and legal issues, home adaptation, and community support issues.
*Elective Surgery: Surgery that does not involve a medical emergency and that can be done at the convenience of the patient or medical staff.
*Endotracheal Tube: A tube that runs from the mouth into the windpipe and that allows air into the lungs.
Extension: Movement that brings the body or limbs into straight position.
Fecal Impaction: Blockage of bowels resulting in severe constipation.
Flexion: Movement that brings body or limbs into a bent position.
Foley Catheter: A rubber tube placed in the urethra that extends into the bladder and empties it. It is held in place with a small fluid-filled balloon.
Functional: The ability to carry out a purposeful activity.
Functional Level: Motor level in patients with spinal disease or injury indicative of activity performance capability.
Gait Training: Instruction in walking, with or without equipment.
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.
Heterotopic Ossification: Extra bone growth, typically located in the hip area.
Incomplete Lesion or Injury: A spinal cord lesion in which some sensation or muscle function below the level of injury is preserved.
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 other device. The catheter can enter the bladder via the urethra or through an opening in the lower abdomen (suprapubic ostomy). It is important for those using this method of bladder management to drink lots of water, up to six quarts a day. A sterile procedure should be used when changing an indwelling catheter.
Intermittent Catheterization (ICP): Use of a catheter for emptying the bladder on a regular schedule. See self-catheterization.
*Interventions: In layman’s terms, this means using some type of treatment or variable to see if it has any positive or negative effect upon a specifically identified condition. For example, one could do a comparison test to see if one type of wheelchair cushion is more helpful in preventing pressure sores from developing than another type of wheelchair cushion.
*Intravenous: Within a vein. For example, intravenous medications are put directly into the vein.
Lesion: An injury or wound, any pathologic or traumatic injury to the spinal cord.
*Lower Motor Neurons: Nerve cells that are located in the spinal cord and that provide the connection from the brain's upper motor neurons to the skeletal muscles which move joints and limbs.
Lumbar: Pertaining to that area immediately below the thoracic spine; the strongest part of the spine, the lower back.
*Medicaid: State health care programs that cover the health care costs of those with low incomes. The level of one's income, not age or amount paid in to Social Security, is the qualifying factor. Although partially funded federally, each state's Medicaid program is different.
*Medicare: The federal health care program that goes along with Social Security for those over 65 and for those receiving Social Security Disability after two years.
Motor: Referring to motion/movement
Magnetic Resonance Imaging (MRI): A high-tech diagnostic tool to display tissues unseen in X-rays or by other techniques.
Myelin: A white, fatty insulating material produced in the peripheral nervous system necessary for rapid signal transmission along nerve fibers. Loss of myelin accompanies many central nervous system injuries. The process of remyelination is very important in spinal cord injury research.
*Neuropsychologist: A specialist who tests for brain damage and helps people find ways to adjust and compensate for thinking and memory problems.
*Neurosurgeon: A medical doctor who specializes in operating on any part of the nervous system, including the spinal cord.
*Non-penetrating Injury: An injury to the spinal cord that comes when bones to the spine or vertebrae are damaged. This injury also is known as a closed injury, because the injuries are internal and not visible.
*Nutritionist: A person who helps others nourish their bodies with foods that promote health and healing.
Occupational Therapist (OT): The member of the rehabilitation team who helps maximize a person's independence. OTs teach daily living activities, health maintenance and self care, and consult on equipment choices.
*Occupational Therapy: Treatment approach, which can include exercises, self-help skills, and adaptive equipment, designed to help people care for themselves.
*Orthopedic Surgeon: A medical doctor who specializes in operating on or manipulating the skeletal system or on the muscles that enable movement.
Orthotic: A device applied to the exterior of the body to support and align the body and limbs; or to influence motion by assisting, resisting, blocking, or unloading part of the body weight.
Ostomy: An opening in the skin to allow for catheter drainage for urine, for elimination of intestinal contents, or for passage of air.
*Paramedic: Medical emergency person who is often the first medical person called to assist someone at the accident site.
Paraplegia: Loss of function below the cervical spinal cord segments, wherein the upper body retains most function and sensation. Paraplegia results in paralysis of the lower limbs; however, the degree of loss depends on the level of spinal cord lesion.
Paresis: Weakness.
*Penetrating Injury: An injury to the spinal cord that results from something such as a knife or bullet entering the body and damaging the spinal cord.
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.
Physiatrist: A doctor whose specialty is physical medicine and rehabilitation.
Physical Therapist (PT): A key member of the rehabilitation team. The PT examines, tests, and treats persons to enhance their maximum physical activity.
*Physical Therapy: Movements and exercises designed to improve mobility.
Plegia: Paralysis.
Pressure Sore: Also known as decubitus ulcer. A potentially dangerous skin breakdown due to pressure on skin resulting in infection and tissue death. Pressure sores usually occur over bony area and are subject to infection, which may move to the bone. Skin sores are preventable with twice daily checks for redness, weight shifts, and an appropriate seating system and cushion.
*Primary Care Physician (PCP): The medical doctor who is a patient's first contact for medical help. Generally, the PCP manages the patient's care after he or she has left the hospital and has returned home or has gone to a rehabilitation setting.
Prosthetic: Replacement device for a body part, for example an artificial limb.
*Psychologist: A mental health professional—not a medical doctor—who helps others deal with, manage and understand their emotions and behaviors.
*Pulmonary: Pertaining to the lungs.
Quadriplegia: Loss of function of any injured or damaged cervical spinal cord segment, affecting all four body limbs.
*Recreational Therapy: Exercises and activity usually guided by a medical professional towards promoting a patient's physical recovery or rehabilitation.
*Rehabilitation Psychologist: Someone who has training and experience to work with the mental health needs of someone who has a physical disability caused by injury or illness.
Reflex: An involuntary response to a stimulus involving nerves not under control of the brain. In some types of paralysis, reflexes cannot be inhibited by the brain and they become exaggerated, thereby causing spasms.
Regeneration: In brain or spinal cord injury, regeneration is the regrowth of nerve fiber tissue by way of some as-yet-unknown biologic process. In the peripheral system, nerves do regenerate after damage, and reform functional connections. Regeneration researchers are confident central nerves can be induced to grow, with the proper environment. The challenge remains to restore functional connections to effectively restore function.
Rehabilitation: A sequence of services built around the problems of a disabled individual and designed to restore optimum physical, psychological, social, and vocational levels of function.
*Respiratory Treatment: Treatments, most often given in a medical facility, that help to keep the lungs breathing more freely.
Sacral: Refers to the fused segments of the lower vertebrae or lowest spinal cord segments below the lumbar level.
SCI Care System: An organized multi-disciplinary system of care including acute treatment, rehabilitation and lifetime follow-up services for spinal cord injured individuals.
Self-Catheterization: The process of emptying the bladder as needed, on one's own. This procedure minimizes the risk of infection, and is typically easier for men. Women need to use a mirror. People with tetraplegia may need help if hand function is impaired. Can be done “sterile,” with no touching of special cath equipment, or “clean,” which doesn't require time-consuming and more expensive sterile conditions.
Sensory Level: Feelings from the body: hot, cold, pain, touch.
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 for circulation and muscle tone. If severe, though, spasms can interfere with normal activities, and can hasten contractions as muscles shorten.
*Speech Therapist: Someone trained to help others improve their ability to communicate.
*Speech Therapy: Field that works to improve people's communication skills, including their speech, listening and writing skills, and their ability to think, swallow, and problem solve.
Spinal Cord Injury: Impairment or loss of motor and sensory function in the cervical, thoracic, lumbar, or sacral neurologic segments secondary to damage of neural elements within the spinal canal.
Spinal Shock: Similar to concussion in the brain, spinal shock causes the system to shut down. In spinal cord injury, shock causes immediate flaccid (lack of muscle tone) paralysis, which lasts about three or four weeks.
Suprapubic Catheter: A catheter surgically inserted into the bladder by incision above the pubis, or the hipline.
*Tetraplegia: Another word for quadriplegia, which is a
spinal cord injury that affects all four limbs. The term is most often used
outside the
Thoracic: Pertaining to the chest, vertebrae, or spinal cord segments between the cervical and lumbar areas.
Tone: Refers to normal state of balance and tension in the tissues and muscles of the body.
Tracheostomy: Opening in windpipe to promote breathing.
*Transected: Divided by cutting across.
*
*Traumatic Injury: An extreme or acute injury that results from a major accident, such as a fall or car crash.
*Upper Motor Neurons: Brain nerve cells that initiate voluntary movements by sending an electrical impulse down their axons lying in the spinal cord to stimulate lower motor neurons.
*Urethra: The canal, extending from the bladder, through which urine leaves the body.
Urinary Tract Infection (UTI): Bacterial invasion of the urinary tract, which includes bladder, bladder neck and urethra.
Ventilator: Mechanical device to help facilitate a person with impaired diaphragm function to breathe.
Vertebrae: The bones that make up the spinal column.
Vocational Therapy: A special program designed to help those with a physical or mental impairment to obtain, prepare for, engage in, or retain a job. Services are provided through the division of vocational rehabilitation. This program is supported by federal and state funds.
*Vocational Rehabilitation: Services that guide those with a physical or mental impairment with vocational therapy (see above definition) for the purpose of integration or reintegration into the workforce consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, and informed choice.
Weaning: Gradual removal of mechanical ventilation as patient's lung strength and vital capacity increases.
OTHER
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