[″ + Gr. plege, stroke]
Paralysis of all four extremities, usually caused by an injury to or disease of the cervical spinal cord. Quadriplegia most often results from trauma to the neck, although it may occasionally result from spinal stenosis, infections, aneurysms, vasculitis, autoimmune diseases, neurosurgery, or mass lesions. The higher the injury (the closer it is to the brainstem) the less function will be present in the arms. Injury above the third cervical vertebra paralyzes the diaphragm; in patients with high cervical lesions, life can be sustained only with mechanical ventilation.
SYN: SEE: tetraplegia
Patients with quadriplegia benefit from physical therapy, occupational therapy, and respiratory care to regain optimal functioning. Assistance is provided with self-care deficits, including bladder paralysis, skin and oral care, feeding and nutrition, elimination, respiratory toilet, positioning, and exercise. The patency of the urinary catheter is checked, and a bulk diet is provided to prevent impaction. Both patient and family are encouraged to verbalize their concerns, and support is offered to help them cope with their grief and loss. Assistance is provided to help the family set realistic plans for the future in view of the patient's functional abilities, body image, and self-concept. The patient is urged to participate in a rehabilitation program as soon as stabilized. Rehabilitative care may be provided in a skilled nursing care facility, rehabilitation center, or in the home with home health care providers and family participation.
SEE: spinal cord injury, acute.
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