The Respiratory System

Effects of a Spinal Cord Injury on The Respiratory System

The effects on the respiratory (breathing) system from a spinal cord injury will vary from person to person, however, several generalisations can be made with regards to the level of injury and how it affects the breathing process.

With a spinal cord injury of C4 and higher, all the muscles that control breathing will be paralysed; these are the intracostal muscles (muscles between the ribs that life them to enable breathing in), the diaphragm and the abdominal muscles. In order to breath, the person will need a machine called a ventilator to breath for them, this machine forces air in and out of the lungs to re-oxygenate the blood. In order to cough, the person will need help by way of a carer performing an assisted cough procedure. This was the problem for “Superman”……………

Injuries between C4 and T6 will enable the person able to breathe by themselves, however, because the intracostal muscles may be weakened or paralysed depending on the level of injury, breathing may be mainly enabled in patients with a cervical injury solely by the diaphragm. Thuscoughing may also be a problem, quadriplegics may need help in coughing, whilst paraplegics may have enough abdominal movement to allow sufficient pressure to clear their airways on their own.

Injuries occurring between T6 and T12 do not normally affect breathing; however the ability to cough will be impaired. It is only with injuries below T12 that normal breathing and cough reflexes are preserved.

Respiratory Infections

The inability to cough is of major importance to a person with a spinal cord injury, as failure to remove dust, mucus or saliva from the lungs can lead to infection. The most common infections are common colds, bronchitis, bronchiolitis and pneumonia. If an infection does occur in the lungs it may be necessary to take a course of antibiotics to help clear the chest.

With all infections of the chest, it may be necessary to clear the lungs with an assisted cough. This procedure is done by applying firm, even pressure just below the ribcage by a carer, while the person breathes out or tries to cough. Careful control of the pressure used by the carer is critical, to avoid causing injury and to help give the most effective ‘cough’.

A way to help keep the fine structures of the lungs clear is to do deep breathing exercises, and one of the best deep breathing exercises is to do physical exercise.

It goes without saying that those people who continue to smoke following a spinal cord injury, are at an even higher risk of developing a chest infection, and pneumonia, than a non smoker.