Question

You are conducting the secondary assessment on a trauma patient who has fallen off a ladder onto a concrete floor. When assessing the pelvis of this patient, you should determine the presence or absence of wounds, deformities, and?

1) paralysis
2) distal circulation
3) pain
4) motor function

Answer 1

In a spinal cord hemisection, a patient will experience paralysis on the side of the injury, while pain is perceived but not fine touch. Conversely, the opposite side will retain fine touch sensation but lose pain perception. This differential sensory loss helps localize the level of spinal damage.

Step-by-step explanation:

When assessing a trauma patient who has experienced a fall, you should look for the presence or absence of wounds, deformities, pain, distal circulation, paralysis, and motor function. In the case of a spinal cord hemisection, resulting from an injury like a motorcycle accident, the patient may experience hemi paralysis, specifically the paralysis of limbs on one side of the body. The affected individual is likely to have intact motor function and normal sensation of fine touch on the side opposite of the injury due to the preserved dorsal column but will experience a loss of pain stimuli perception on that same side. Conversely, on the side with paralysis, pain stimuli may be perceived, but not fine touch.

Therefore, in a case where a victim loses the ability to move the right leg but maintains normal control over the left one, indicating hemisection in the thoracic region of the spinal cord, one would expect to find a loss of touch on the right side and a loss of pain sensation on the left side. This is due to the fact that the pain fibers crossing the midline in the spinal cord ascend in the contralateral lateral column, only reaching as far as the hemisection, whereas the dorsal column remains intact ipsilaterally on the intact side reaching the brain and allowing for the perception of fine touch.