No numbers can be found on injuries from bungee jumping. Experts report that deaths is very minimal and the injuries suffered are usually just rope burn or a pinched finger. More serious injuries have seldom been reported though there are some.
In human anatomy, the wrist is variously defined as 1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus; and (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, the flexor retinaculum, and the extensor retinaculum.
As a consequence of these various definitions, fractures to the carpal bones are referred to as carpal fractures, while fractures such as distal radius fracture are considered fractures to the wrist.
The English word "wrist" is etymologically derived from the ancient German word wristiz from which are derived modern German rist ("instep", "wrist") and modern Swedish vrist ("instep", "ankle"). The base writh- and its variants are associated with Old English words "wreath", "wrest", and "writhe". The wr- sound of this base seems originally to have been symbolic of the action of twisting.
The radiocarpal, intercarpal, midcarpal, carpometacarpal, and intermetacarpal joints often intercommunicate through a common synovial cavity.
The distal radioulnar joint is a pivot joint located between the bones of the forearm, the radius and ulna. Formed by the head of ulna and the ulnar notch of radius, this joint is separated from the radiocarpal joint by an articular disk lying between the radius and the styloid process of ulna. The capsule of the joint is lax and extends from the inferior sacciform recess to the ulnar shaft. Together with the proximal radioulnar joint, the distal radioulnar joint permits pronation and supination.
The radiocarpal joint or wrist joint is an ellipsoid joint formed by the radius and the articular disc proximally and the proximal row of carpal bones distally. The carpal bones on the ulnar side only make intermittent contact with the proximal side — the triquetrum only makes contact during ulnar abduction. The capsule, lax and un-branched, is thin on the dorsal side and can contain synovial folds. The capsule is continuous with the midcarpal joint and strengthened by numerous ligaments, including the palmar and dorsal radiocarpal ligaments, and the ulnar and radial collateral ligaments.
The parts forming the radiocarpal joint are the lower end of the radius and under surface of the articular disk above; and the scaphoid, lunate, and triquetral bones below. The articular surface of the radius and the under surface of the articular disk form together a transversely elliptical concave surface, the receiving cavity. The superior articular surfaces of the scaphoid, lunate, and triquetrum form a smooth convex surface, the condyle, which is received into the concavity.
In the hand proper a total of 13 bones form part of the wrist: eight carpal bones—scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate, and hamate— and five metacarpal bones—the first, second, third, fourth, and fifth metacarpal bones.
The midcarpal joint is the S-shaped joint space separating the proximal and distal rows of carpal bones. The intercarpal joints, between the bones of each row, are strengthened by the radiate carpal and pisohamate ligaments and the palmar, interosseous, and dorsal intercarpal ligaments. Some degree of mobility is possible between the bones of the proximal row while the bones of the distal row are connected to each other and to the metacarpal bones —at the carpometacarpal joints— by strong ligaments —the pisometacarpal and palmar and dorsal carpometacarpal ligament— that makes a functional entity of these bones. Additionally, the joints between the bases of the metacarpal bones —the intermetacarpal articulations— are strengthened by dorsal, interosseous, and palmar intermetacarpal ligaments.
The extrinsic hand muscles are located in the forearm where their bellies form the proximal fleshy roundness. When contracted, most of the tendons of these muscles are prevented from standing up like taut bowstrings around the wrist by passing under the flexor retinaculum on the palmar side and the extensor retinaculum on the dorsal side. On the palmar side the carpal bones form the carpal tunnel through which some of the flexor tendons pass in tendon sheaths that enable them to slide back and forth through the narrow passageway (see carpal tunnel syndrome).
Starting from the mid-position of the hand, the movements permitted in the wrist proper are (muscles in order of importance):
However, movements at the wrist can not be properly described without including movements in the distal radioulnar joint in which the rotary actions of supination and pronation occur and this joint is therefore normally regarded as part of the wrist.
Wrist joint. Deep dissection. Posterior view.
Wrist joint. Deep dissection. Posterior view.
Wrist joint. Deep dissection.Anterior, palmar, view.
Wrist joint. Deep dissection.Anterior, palmar, view.
anat (h/c, u, t, l)/phys
noco (arth/defr/back/soft)/cong, sysi/epon, injr
proc, drug (M01C, M4)
Spinal cord injury
A bungee cord (sometimes spelled bungie), also known as a shock cord, (Occy strap / Octopus strap in Australian common usage) is an elastic cord composed of one or more elastic strands forming a core, usually covered in a woven cotton or polypropylene sheath. The sheath does not materially extend elastically, but it is braided with its strands spiraling around the core so that a longitudinal pull causes it to squeeze the core, transmitting the core's elastic compression to the longitudinal extension of the sheath and cord. Specialized bungees, such as some used in bungee jumping, may be made entirely of elastic strands.
Bungee cords have been used to provide a lightweight suspension for aircraft undercarriages from before World War I, and are still used on many small homebuilt aircraft where weight remains critical. Bungee cords were also used in parachuting to assist in opening the old-style parachute container after the ripcord was pulled.
Today, bungee cords are most often used to secure objects without tying knots and to absorb shock. Inexpensive bungee cords, with metal or plastic hooks on each end, are marketed as a general utility item. This form is also known as kangaroo, octopus, or "occy", straps in Australia, these can be an individually, or a set of four hooked straps held together by a metal ring allowing the occy strap to secure items around various tie points, for example a suitcase to a car roof rack. Extensions of the concept are available as a coarse net of bungee cords with metal or plastic hooks around the periphery, for securing irregularly shaped loads of luggage and cargo on the backs of pickup trucks, roofs of cars, and so on.
Bungee cords have also been used for other purposes, including office chairs.
The origin of the name "bungee", bungie" or "bungy" is uncertain. The Oxford English Dictionary records the use in 1938 of the phrase bungee-launching of gliders using an elasticized cord.
A spinal cord injury (SCI) refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence. Spinal cord injuries are described at various levels of "incomplete", which can vary from having no effect on the patient to a "complete" injury which means a total loss of function.
Treatment of spinal cord injuries starts with restraining the spine and controlling inflammation to prevent further damage. The actual treatment can vary widely depending on the location and extent of the injury. In many cases, spinal cord injuries require substantial physical therapy and rehabilitation, especially if the patient's injury interferes with activities of daily life.
Spinal cord injuries have many causes, but are typically associated with major trauma from motor vehicle accidents, falls, sports injuries, and violence. Research into treatments for spinal cord injuries includes controlled hypothermia and stem cells, though many treatments have not been studied thoroughly and very little new research has been implemented in standard care.
The American Spinal Injury Association (ASIA) first published an international classification of spinal cord injury in 1982, called the International Standards for Neurological and Functional Classification of Spinal Cord Injury. Now in its sixth edition, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is still widely used to document sensory and motor impairments following SCI. It is based on neurological responses, touch and pinprick sensations tested in each dermatome, and strength of the muscles that control ten key motions on both sides of the body, including hip flexion (L2), shoulder shrug (C4), elbow flexion (C5), wrist extension (C6), and elbow extension (C7). Traumatic spinal cord injury is classified into five categories on the ASIA Impairment Scale:
Dimitrijevic proposed a further class, the so-called discomplete lesion, which is clinically complete but is accompanied by neurophysiological evidence of residual brain influence on spinal cord function below the lesion.
Signs recorded by a physician and symptoms experienced by a patient will vary depending on where the spine is injured and the extent of the injury. These are all determined by the area of the body that the injured area of the spine innervates. A section of skin innervated through a specific part of the spine is called a dermatome, and spinal injury can cause pain, numbness, or a loss of sensation in the relevant areas. A group of muscles innervated through a specific part of the spine is called a myotome, and injury to the spine can cause problems with voluntary motor control. The muscles may contract uncontrollably, become weak, or be completely unresponsive. The loss of muscle function can have additional effects if the muscle is not used, including atrophy of the muscle and bone degeneration.
A severe injury may also cause problems in parts of the spine below the injured area. In a "complete" spinal injury, all function below the injured area are lost. In an "incomplete" injury, some or all of the functions below the injured area may be unaffected. If the patient has the ability to contract the anal sphincter voluntarily or to feel a pinprick or touch around the anus, the injury is considered to be incomplete. The nerves in this area are connected to the very lowest region of the spine, the sacral region, and retaining sensation and function in these parts of the body indicates that the spinal cord is only partially damaged. An incomplete spinal cord injury involves preservation of motor or sensory function below the level of injury in the spinal cord. This includes a phenomenon known as sacral sparing which involves the preservation of cutaneous sensation in the sacral dermatomes, even though sensation is impaired in the thoracic and lumbar dermatomes below the level of the lesion. Sacral sparing may also include the preservation of motor function (voluntary external anal sphincter contraction) in the lowest sacral segments. Sacral sparing has been attributed to the idea that the sacral spinal pathways are not as likely as the other spinal pathways to become compressed after injury. The sparing of the sacral spinal pathways can be attributed to the lamination of fibers within the spinal cord.
A complete injury frequently means that the patient has little hope of functional recovery.][ The relative incidence of incomplete injuries compared to complete spinal cord injury has improved over the past half century, due mainly to the emphasis on better initial care and stabilization of spinal cord injury patients. Most patients with incomplete injuries recover at least some function.][
In addition to sensation and muscle control, the loss of connection between the brain and the rest of the body can have specific effects depending on the location of the injury.
Determining the exact "level" of injury is critical in making accurate predictions about the specific parts of the body that may be affected by paralysis and loss of function. The level is assigned according to the location of the injury by the vertebra of the spinal column. While the prognosis of complete injuries are generally predictable since recovery is rare, the symptoms of incomplete injuries can vary and it is difficult to make an accurate prediction of the outcome.
Cervical (neck) injuries usually result in full or partial tetraplegia (Quadriplegia). However, depending on the specific location and severity of trauma, limited function may be retained.
Patients with complete injuries above C7 typically cannot handle activities of daily living making functioning independently difficult and not often possible.][
Additional signs and symptoms of cervical injuries include:
Complete injuries at or below the thoracic spinal levels result in paraplegia. Functions of the hands, arms, neck, and breathing are usually not affected.
Typically lesions above the T6 spinal cord level can result in Autonomic Dysreflexia.
The effects of injuries to the lumbar or sacral regions of the spinal cord are decreased control of the legs and hips, urinary system, and anus.
Central cord syndrome is a form of incomplete spinal cord injury characterized by impairment in the arms and hands and, to a lesser extent, in the legs. This is also referred to as inverse paraplegia, because the hands and arms are paralyzed while the legs and lower extremities work correctly.
Most often the damage is to the cervical or upper thoracic regions of the spinal cord, and characterized by weakness in the arms with relative sparing of the legs with variable sensory loss.
This condition is associated with ischemia, hemorrhage, or necrosis involving the central portions of the spinal cord (the large nerve fibers that carry information directly from the cerebral cortex). Corticospinal fibers destined for the legs are spared due to their more external location in the spinal cord.
Ischemia of the spinal cord is reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with arterioscleorosis, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to infarction of the spinal cord tissue. Ischemia of the spinal cord affects its function and can lead to muscle weakness and paralysis. The spinal cord may also suffer circulatory impairment if the segmental medullary arteries, particularly the great anterior segmental medullary artery are narrowed by obstructive arterial disease. When systemic blood pressure drops severely for 3-6 min, blood flow from the segmental medullary arteries to the anterior spinal artery supplying the midthoracic region of the spinal cord may be reduced or stopped. These people may also lose sensation and voluntary movement in the areas supplied by the affected level of the spinal cord.
This clinical pattern may emerge during recovery from spinal shock due to prolonged swelling around or near the vertebrae, causing pressures on the cord. The symptoms may be transient or permanent.
Anterior cord syndrome is often associated with flexion type injuries to the cervical spine, causing damage to the anterior portion of the spinal cord and/or the blood supply from the anterior spinal artery. Below the level of injury motor function, pain sensation, and temperature sensation are lost. While touch, proprioception (sense of position in space), and sense of vibration remain intact.
Posterior cord syndrome can also occur, but is very rare. Damage to the posterior portion of the spinal cord and/or interruption to the posterior spinal artery causes the loss of proprioception and epicritic sensation (e.g.: stereognosis, graphesthesia) below the level of injury. Motor function, sense of pain, and sensitivity to light touch remain intact.
Brown-Séquard syndrome usually occurs when the spinal cord is hemisectioned or injured on the lateral side. True hemisections of the spinal cord are rare, while partial lesions due to penetrating wounds (e.g.: gunshot wounds or knife penetrations) are more common. On the ipsilateral side of the injury (same side), there is a loss of motor function, proprioception, vibration, and light touch. Contralaterally (opposite side of injury), there is a loss of pain, temperature, and crude touch sensations.
Tabes Dorsalis results from injury to the posterior part of the spinal cord, usually from infection diseases such as syphilis, causing loss of touch and proprioceptive sensation.
Conus medullaris syndrome results from injury to the tip of the spinal cord, located at L1 vertebra.
Spinal cord injuries are most often traumatic, caused by lateral bending, dislocation, rotation, axial loading, and hyperflexion or hyperextension of the cord or cauda equina. Motor vehicle accidents are the most common cause of SCIs, while other causes include falls, work-related accidents, sports injuries, and penetrations such as stab or gunshot wounds. SCIs can also be of a non-traumatic origin, as in the case of cancer, infection, intervertebral disc disease, vertebral injury and spinal cord vascular disease.
Men are at more risk for spinal cord injury than women. More than 80% of the spinal cord injury patients are men.
A radiographic evaluation using a x-ray, MRI or CT scan can determine if there is any damage to the spinal cord and where it is located. A neurologic evaluation incorporating sensory testing and reflex testing can help determine the motor function of a person with a SCI.
Modern trauma care includes a step called clearing the cervical spine, where a person with a suspected injury is treated as if they have a spinal injury until that injury is ruled out. The objective is to prevent any further spinal cord damage. People are immobilized at the scene of the injury until it is clear that there is no damage to the highest portions of the spine. This is traditionally done using a device called a long spine board and hard collar.
Once at a hospital and immediate life-threatening injuries have been addressed, they are evaluated for spinal injury, typically by x-ray or CT scan. Complications of spinal cord injuries include neurogenic shock, respiratory failure, pulmonary edema, pneumonia, pulmonary emboli and deep venous thrombosis, many of which can be recognized early in treatment and avoided. SCI patients often require extended treatment in an intensive care unit.
Techniques of immobilizing the affected areas in the hospital include Gardner-Wells tongs, which can also exert spinal traction to reduce a fracture or dislocation.
One experimental treatment, therapeutic hypothermia, is used but there is no evidence that it improves outcomes. Maintaining mean arterial blood pressures of at least 85 to 90 mmHg using intravenous fluids, transfusion, and vasopressors to ensure adequate blood supply to nerves and prevent damage is another treatment with little evidence of effectiveness.
Surgery may also be necessary to remove any bone fragments from the spinal canal and to stabilize the spine.
Inflammation can cause further damage to the spinal cord, and patients are sometimes treated with drugs to reduce swelling.
Corticosteroid drugs are used within 8 hours of the injury. This practice is based on the National Acute Spinal Cord Injury Studies (NASCIS) I and II, though other studies have shown little benefit and concerns about side effects from the drug have changed this practice. High dose methylprednisolone may improve outcomes if given within 6 hours of injury. However, the improvement shown by large trials has been small, and comes at a cost of increased risk of serious infection or sepsis due to the immunosuppressive qualities of high-dose corticosteroids. Methylprednisolone is not longer recommended in the treatment of acute spinal cord injury.
A food dye, brilliant blue G, has also been shown to have some effect at reducing inflammation after spinal injury.
When treating a patient with a SCI, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.
The rehabilitation process following a spinal cord injury typically begins in the acute care setting. Physical therapists, occupational therapists, social workers, psychologists and other health care professionals typically work as a team under the coordination of a physiatrist to decide on goals with the patient and develop a plan of discharge that is appropriate for the patient’s condition.
In the acute phase physical therapists focus on the patient’s respiratory status, prevention of indirect complications (such as pressure sores), maintaining range of motion, and keeping available musculature active. Also, there is great emphasis on airway clearance during this stage of recovery. Following a spinal cord injury, the individual’s respiratory muscles become weak and, in turn, the patient is unable to cough. This results in an accumulation of secretions within the lungs. Physical therapy treatment for airway clearance may include manual percussions and vibrations, postural drainage, respiratory muscle training, and assisted cough techniques. With regards to cough techniques, patients are taught to increase their intra-abdominal pressure by leaning forward to induce cough and clear mild secretions. The quad cough technique is done with the patient lying on their back and the therapist applies pressure on their abdomen in the rhythm of the cough to maximize expiratory flow and mobilize secretions. Manual abdominal compression is another effective technique used to increase expiratory flow which later improves cough. Other techniques used to manage respiratory dysfunction following spinal cord injury include respiratory muscle pacing, abdominal binder, ventilator- assisted speech, and mechanical ventilation.
Depending on the Neurological Level of Impairment (NLI), the muscles responsible for expanding the thorax, which facilitate inhalation, may be affected. If the NLI is such that it affects some of the ventilatory muscles, more emphasis will then be placed on the muscles with intact function. For example, the intercostal muscles receive their innervation from T1 - T11, and if any are damaged, more emphasis will need to placed on the unaffected muscles which are innervated from higher levels of the CNS. As SCI patients suffer from reduced total lung capacity and tidal volume it is pertinent that physical therapists teach SCI patients accessory breathing techniques (e.g. apical breathing, glossopharyngeal breathing, etc.) that typically are not taught to healthy individuals.
The Functional Independence Measure (FIM) is an assessment tool that aims to evaluate the functional status of patients throughout the rehabilitation process following a stroke, traumatic brain injury, spinal cord injury or cancer. Its area of use can include skilled nursing facilities and hospitals aimed at acute, sub-acute and rehabilitation care. It serves as a consistent data collection tool for the comparison of rehabilitation outcomes across the health care continuum. Furthermore, it aims to allow clinicians to track changes in the functional status of patients from the onset of rehab care through discharge and follow-up. The FIM’s assessment of degree of disability depends on the patient’s score in 18 categories, focusing on motor and cognitive function. Each category or item is rated on a 7-point scale (1 = <25% independence; total assistance required, 7 = 100% independence). As such, FIM scores may be interpreted to indicate level of independence or level of burden of care.
Spinal cord injuries frequently result in at least some incurable impairment even with the best possible treatment. In general, patients with complete injuries recover very little lost function and patients with incomplete injuries have more hope of recovery. Some patients that are initially assessed as having complete injuries are later reclassified as having incomplete injuries.
The place of the injury determines which parts of the body are affected. The severity of the injury determines how much the body will be affected. Consequently, a person with a mild, incomplete injury at the T5 vertebrae will have a much better chance of using his or her legs than a person with a severe, complete injury at exactly the same place in the spine.
Recovery is typically quickest during the first six months, with very few patients experiencing any substantial recovery more than nine months after the injury.
The ASIA motor score (AMS) is a 100 point score based on ten pairs of muscles each given a five point rating. A person with no injury should score 100. In complete tetraplegia, a recovery of nine points on this scale is average regardless of where the patient starts. Patients with higher levels of injury will typically have lower starting scores.
In incomplete tetraplegia, 46 percent of patients were able to walk one year after injury, though they may require assistance such as crutches and braces. These patients had similar recovery in muscles of the upper and lower body. Patients who had pinprick sensation in the sacral dermatomes such as the anus recovered better than patients that could only sense a light touch.
In one study on 142 individuals after one year of complete paraplegia, none of the patients where the initial injury was above the ninth thoracic vertebra (T9) were able to recover completely. Less than half, 38 percent, of the studied subjects had any sort of recovery. Very few, five percent, recovered enough function to walk, and those required crutches and other assistive devices, and all of them had injuries below T11. A few of the patients, four percent, had what were originally classified as complete injuries and were reassessed as having incomplete injuries, but only half of that four percent regained bowel and bladder control.
Of the 54 patients in the same study with incomplete paraplegia 76 percent were able to walk with assistance after one year. On average, patients improved 12 points on the 50 point lower extremity motor score (LEMS) scale. The amount of improvement was not dependent on the location of the injury, but patients with higher injuries had lower initial motor scores and correspondingly lower final motor scores. A LEMS of 50 is normal, and scores of 30 or higher typically predict ability to walk.
Spinal injury can occur without trauma. Many people suffer transient loss of function ("stingers") in sports accidents or pain in "whiplash" of the neck without neurological loss and relatively few of these suffer spinal cord injury sufficient to warrant hospitalization. The prevalence of spinal cord injury is not well known in many large countries. In some countries, such as Sweden and Iceland, registries are available. In the United States, the incidence of spinal cord injury has been estimated to be about 40 cases (per 1 million people) per year or around 12,000 cases per year. The most common causes of spinal cord injury are motor vehicle accidents, falls, violence and sports injuries. The average age at the time of injury has slowly increased from a reported 29 years of age in the mid-1970s to a current average of around 40. Over 80% of the spinal injuries reported to a major national database occurred in males. In the United States there are around 250,000 individuals living with spinal cord injuries. In China, the incidence of spinal cord injury is approximately 60,000 per year.
Scientists are investigating many promising avenues for treatment of spinal cord injury. Numerous articles in the medical literature describe research, mostly in animal models, aimed at reducing the paralyzing effects of injury and promoting regrowth of functional nerve fibers. Despite the devastating effects of the condition, commercial funding for research investigating a cure after spinal cord injury is limited, partially due to the small size of the population of potential beneficiaries.][ Some experimental treatments, such as systemic hypothermia, have been performed in isolated cases in order draw attention to the need for further preclinical and clinical studies to help clarify the role of hypothermia in acute spinal cord injury. Despite the limitation on funding, a number of experimental treatments such as local spine cooling and oscillating field stimulation have reached controlled human trials,
Advances in identification of an effective therapeutic target after spinal cord injury have been newsworthy, and considerable media attention is often drawn towards new developments in this area. However, aside from methylprednisolone, none of these developments have reached even limited use in the clinical care of human spinal cord injury in the U.S.
Around the world, proprietary centers offering stem cell transplants and treatment with neuroregenerative substances are fueled by glowing testimonial reports of neurological improvement. It is also evident that when stem cells are injected in the area of damage in the spinal cord, they secrete neurotrophic factors, and these neurotrophic factors help neurons and vessels grow, thus helping repair the damage. Bone Marrow Stem cells especially the CD34+ cells have been found to be relatively more in men compared to women in the reproductive age group among spinal cord injury patients.
In 2009 the FDA approved the country's first human trial on embryonic stem cell transplantation into patients suffering from varying levels of traumatic spinal cord injury. The trial however came to a halt in November 2011 when the company, which was financing the trial, announced the discontinuation of the trial due to financial issues. It is important to note that only financial issues led to the trial being discontinued and not any scientific or ethical reasons.
Other than stem cells, transplantation of tissues such as olfactory ensheathing mucosa have been shown to produce beneficial effects in spinal cord injured rats.
Independent validation of the results of the various stem cell treatments is lacking. However, current approaches on cell and tissue based therapies for clinical application for spinal cord injury need to establish the underlying efficacy and mechanisms.
Recent approaches have used various engineering techniques to improve spinal cord injury repair. The general hypothesis of this is that bridging the lesion site using a growth permissive scaffold may promote axonal extension and in turn improve behavioral function. Engineered treatments are ideal for spinal cord injury repair because they do not induce an immune response like biological treatments, and they are easily tunable and reproducible. In-vivo administration of hydrogels or self-assembling nanofibers has been shown to promote axonal sprouting and partial functional recovery. In addition, administration of carbon nanotubes has shown to increase motor axon extension, decrease the lesion volume, and not induce neuropathic pain. In addition, administration of poly-lactic acid microfibers has shown that topographical guidance cues alone can promote axonal regeneration into the injury site. However, all of these approaches induced modest behavioral or functional recovery suggesting that further investigation is necessary.
Recent research shows that combining brain–computer interface and functional electrical stimulation can restore voluntary control of paralyzed muscles. A study with monkeys showed that it is possible to directly use commands from the brain, bypassing the spinal cord and enable limited hand control and function.
The technology for creating bionic suits, more commonly known as exo-skeletons, is currently making some significant advances. There are products available, such as the Ekso, which allows individuals with up to a C7 complete (or any level of incomplete) spinal injury to stand upright and make technologically assisted steps. The initial purpose for this technology is for functional based rehabilitation, but as the technology develops, so will its uses. A significant downside for the users of these systems is that they find themselves extremely tired after a very short period of time. This is because the muscles that they are using have atrophied over time, and have little stamina.
noco (m/d/e/h/v/s)/cong/tumr, sysi/epon, injr
proc, drug (N1A/2AB/C/3/4/7A/B/C/D)
anat (h/r/t/c/b/l/s/a)/phys (r)/devp/prot/nttr/nttm/ntrp
noco/auto/cong/tumr, sysi/epon, injr
proc, drug (N1B)
Bungee jumping (; also spelt "Bungy" jumping) is an activity that involves jumping from a tall structure while connected to a large elastic cord. The tall structure is usually a fixed object, such as a building, bridge or crane; but it is also possible to jump from a movable object, such as a hot-air-balloon or helicopter, that has the ability to hover above the ground. The thrill comes from the free-falling and the rebound. When the person jumps, the cord stretches and the jumper flies upwards again as the cord recoils, and continues to oscillate up and down until all the kinetic energy is dissipated.
The first modern bungee jumps were made on 1 April 1979 from the 250-foot (76 m) Clifton Suspension Bridge in Bristol, by members of the Oxford University Dangerous Sports Club. The jumpers were arrested shortly after, but continued with jumps in the US from the Golden Gate and Royal Gorge bridges, (this last jump sponsored by and televised on the American programme That's Incredible) spreading the concept worldwide. By 1982, they were jumping from mobile cranes and hot air balloons.
Organised commercial bungee jumping began with the New Zealander, A J Hackett, who made his first jump from Auckland's Greenhithe Bridge in 1986. During the following years, Hackett performed a number of jumps from bridges and other structures (including the Eiffel Tower), building public interest in the sport, and opening the world's first permanent commercial bungee site; the Kawarau Bridge Bungy at Queenstown in the South Island of New Zealand. Hackett remains one of the largest commercial operators, with concerns in several countries.
Several million successful jumps have taken place since 1980. This safety record is attributable to bungee operators rigorously conforming to standards and guidelines governing jumps, such as double checking calculations and fittings for every jump. As with any sport, injuries can still occur (see below), and there have been fatalities. A relatively common mistake in fatality cases is to use a cord that is too long. The cord should be substantially shorter than the height of the jumping platform to allow it room to stretch. When the cord becomes taut and then is stretched, the tension in the cord progressively increases. Initially the tension is less than the jumper's weight and the jumper continues to accelerate downwards. At some point, the tension equals the jumper's weight and the acceleration is temporarily zero. With further stretching, the jumper has an increasing upward acceleration and at some point has zero vertical velocity before recoiling upward. See also Potential energy for a discussion of the spring constant and the force required to distort bungee cords and other spring-like objects.
The Bloukrans River Bridge was the first bridge to be 'bungee jumped off' in Africa when Face Adrenalin introduced bungee jumping to the African continent in 1990. Bloukrans Bridge Bungy has been operated commercially by Face Adrenalin since 1997, and is the highest commercial bridge bungy in the world.
In April 2008 a 37-year-old Durban man, Carl Mosca Dionisio, made bungy jumping history when he jumped off a 30 m (100 ft) tower attached to a bungy cord made entirely of 18,500 condoms.
The word "bungee" originates from West Country dialect of English language, meaning "Anything thick and squat", as defined by James Jennings in his book "Observations of Some of the Dialects in The West of England" published 1825. Around 1930, the name became used for a rubber eraser. The word bungy, as used by A J Hackett, is "Kiwi slang for an Elastic Strap". Cloth-covered rubber cords with hooks on the ends have been available for decades under the generic name bungy cords.
In April 1960 BBC Television broadcast a documentary film The Land Divers of Pentecost, made by David Attenborough, which featured the "land divers" (Sa: ) of Pentecost Island in Vanuatu, young men who jumped from tall wooden platforms with vines tied to their ankles as a test of their courage and passage into manhood. A similar practice, only with a much slower pace for falling, has been practised as the Danza de los Voladores de Papantla or the 'Papantla flyers' of central Mexico, a tradition dating back to the days of the Aztecs.
A tower 4,000 feet (1,200 m) high with a system to drop a "car" suspended by a cable of "best rubber" was proposed for the Chicago World Fair, 1892-1893. The car, seating two hundred people, would be shoved from a platform on the tower and then bounce to a stop. The designer engineer suggested that for safety the ground below "be covered with eight feet of feather bedding". The proposal was declined by the Fair's organizers.
The elastic rope first used in bungee jumping, and still used by many commercial operators, is factory-produced braided shock cord. This consists of many latex strands enclosed in a tough outer cover. The outer cover may be applied when the latex is pre-stressed, so that the cord's resistance to extension is already significant at the cord's natural length. This gives a harder, sharper bounce. The braided cover also provides significant durability benefits. Other operators, including A. J. Hackett and most southern-hemisphere operators, use unbraided cords with exposed latex strands (pictured at right). These give a softer, longer bounce and can be home-produced.
There may be a certain elegance in using only a simple ankle attachment, but accidents where participants became detached led many commercial operators to use a body harness, if only as a backup for an ankle attachment. Body harnesses generally derive from climbing equipment rather than parachute equipment.
In August 2005, AJ Hackett added a SkyJump to the Macau Tower, making it the world's highest jump at 233 metres (764 ft). The SkyJump did not qualify as the world's highest bungee as it is not strictly speaking a bungee jump, but instead what is referred to as a 'Decelerator-Descent' jump, using a steel cable and decelerator system, rather than an elastic rope. On 17 December 2006, the Macau Tower started operating a proper bungee jump, which became the "Highest Commercial Bungee Jump In The World" according to the Guinness Book of Records. The Macau Tower Bungy has a "Guide cable" system that limits swing (the jump is very close to the structure of the tower itself) but does not have any effect on the speed of descent, so this still qualifies the jump for the World Record.
Another commercial bungee jump currently in operation is just 13m smaller, at 220 metres (720 ft). This jump, made without guide ropes, is from the top of the Verzasca Dam near Locarno, Switzerland. It appears in the opening scene of the James Bond film GoldenEye. The Bloukrans Bridge Bungy in South Africa and the Verzasca Dam jumps are pure freefall swinging bungee from a single cord.
Bloukrans Bridge Bungy has been operated by Face Adrenalin commercially since 1997 and uses a pendulum bungee system. It is 216m high, from the platform to the river below. It is the highest commercial bridge bungy in the world.
Guinness only records jumps from fixed objects to guarantee the accuracy of the measurement. John Kockleman however recorded a 2,200-foot (670 m) bungee jump from a hot air balloon in California in 1989. In 1991 Andrew Salisbury jumped from 9,000 feet (2,700 m) from a helicopter over Cancun for a television program and with Reebok sponsorship. The full stretch was recorded at 3,157 feet (962 m). He landed safely under parachute.
One commercial jump higher than all others is at the Royal Gorge Bridge in Colorado. The height of the platform is 321 metres (1,053 ft). However, this jump is rarely available, as part of the Royal Gorge Go Fast Games—first in 2005, then again in 2007. Previous to this the record was held in West Virginia, USA, by New Zealander Chris Allum, who bungee jumped 823 ft (251m) from the New River Gorge Bridge on "Bridge Day" 1992 to set a world's record for the longest bungee jump from a fixed structure.
Several major movies have featured bungee jumps, most famously the opening sequence of the 1995 James Bond film GoldenEye in which Bond makes a jump over the edge of a dam in Russia (in reality the dam is in Switzerland: Verzasca Dam, and the jump was genuine, not an animated special effect). The jump in the dam later makes an appearance as a Roadblock task in the 14th season of the reality competition series The Amazing Race.
It appears in the title of the South Korean film Bungee Jumping of Their Own (Beonjijeompeureul hada 번지점프를 하다; 2001), although it does not play a large part in the film.
A fictional proto-bungee jump is a plot point in the Michael Chabon novel The Amazing Adventures of Kavalier and Clay.
In the film Selena, in which Jennifer Lopez plays Selena Quintanilla-Perez, she is shown bungee jumping at a carnival. This actual event took place shortly before Selena's murder on March 31, 1995.
In "Catapult" (Reverse Bungee or Bungee Rocket) the 'jumper' starts on the ground. The jumper is secured and the cord stretched, then released and shooting the jumper up into the air. This is often achieved using either a crane or a hoist attached to a (semi-)perma structure. This simplifies the action of stretching the cord and later lowering the participant to the ground.
"Twin Tower" is similar with two oblique cords. There are two towers, each with a cord leading the jumper. When the cords are stretched the jumper is released and shoots straight up.
"Bungy Trampoline" uses, as its name suggests, elements from bungy and trampolining. The participant begins on a trampoline and is fitted into a body harness, which is attached via bungy cords to two high poles on either side of the trampoline. As they begin to jump, the bungy cords are tightened, allowing a higher jump than could normally be made from a trampoline alone.
"Bungee Running" involves no jumping as such. It merely consists of, as the name suggests, running along a track (often inflatable) with a bungee cord attached. One often has a velcro-backed marker that marks how far the runner got before the bungee cord pulled back. This activity can often be found at fairs and carnivals and is often most popular with children.
Bungee jumping off a ramp. Two rubber cords - the "bungees" - are tied around the participant's waist to a harness. Those bungee cords are linked to steel cables along which they can slide due to stainless pulleys. The participants bicycle, sled or ski before jumping.
SCAD diving is similar to bungee jumping in that participant is dropped from a height, but in this variation there is not a cord; instead the participant falls into a net.
Bungee jumping injuries may be divided into those that occur after jumping secondary to equipment mishap or tragic accident, and those that occur regardless of safety measures. In the first instance, injury can happen if the safety harness fails, the cord elasticity is miscalculated, or the cord is not properly connected to the jump platform. In 1986 Michael Lush died of multiple injuries after bungee jumping for a stunt on a BBC television programme and in 1997 Laura Patterson, one of a 16-member professional bungee jumping team, died of massive cranial trauma when she jumped from the top level of the Louisiana Superdome and collided head-first into the concrete-based playing field. She was practicing for an exhibition intended to be performed during the halftime show of Super Bowl XXXI. In 2002 Chris Thomas died after his harness tore off during a charity jump in Swansea, Wales: it was later claimed that the harness was not safe for his weight. On New Year's Eve 2011, Erin Langworthy, an Australian woman was plunged into the Zambezi River at Victoria Falls, where she nearly drowned with her feet still tied together after her bungee rope snapped during a jump.
Injuries that occur despite safety measures generally relate to the abrupt rise in upper body intravascular pressure during bungee cord recoil. Eyesight damage is the most frequently reported complication. Impaired eyesight secondary to retinal haemorrhage may be transient or take several weeks to resolve. In one case, a 26 year old woman's eyesight was still impaired after 7 months. Whiplash injuries may occur as the jumper is jolted on the bungee cord and in at least one case, this has led to quadriplegia secondary to a broken neck. Very serious injury can also occur if the jumper's neck or body gets entangled in the cord. More recently, carotid artery dissection leading to a type of stroke after bungee jumping has also been described. All of these injuries have occurred in fit and healthy people in their twenties and thirties. Bungee jumping has also been shown to increase stress and decrease immune function.
Bungee balls are toys that are produced as a means of enhancing a person's hand–eye coordination.
Traditionally, a bungee ball is made of plastic. At one end or an elastic cord a person slips his/her finger into a notch and at the other end is an elastic hollow ball containing synthetic liquid.
Bungee balls were a fad in February 1991 and most bungee balls were sold during this time period][. After March 2003, they started vanishing from stores partly due to controversy over what was contained inside them][. They were also discontinued in many stores because often after about 4–7 hours of use, the Bungee Ball's bungee cord would snap, and the ball itself would break, releasing synthetic liquid. They were recalled in October 2003. By then, nearly all Bungee Balls had vanished from retail stores. Bungee Balls are now most available by online shopping][.
Bloukrans Bridge Bungy
Injury is damage to a biological organism which can be classified on various bases.
Bloukrans Bridge Bungy is the world's highest commercial bridge bungy at 216 metres (709 ft) above the Bloukrans River. It is situated at Bloukrans Bridge on the N2 Highway at the border between the Eastern Cape and the Western Cape in the Tsitsikamma area of South Africa's Garden Route. It has been operated by Face Adrenalin commercially since 1997.
In 1990, the Bloukrans River Bridge became the first African bridge for bungee jumping. Face Adrenalin has been operating the Bloukrans Bridge Bungy accident free since 1997.
Mohr Keet set a Guinness World Record as the oldest person to bungy jump when he jumped from Bloukrans Bridge on 6 April 2010 at the age of 96.
Scott Huntly broke the world record for the Most bungee jumps in a day when he jumped from Bloukrans Bridge 107 times in nine hours on May 11, 2011. Scott completed the project to raise funds for local communities.
The world record for the most bungy jumps in 24 hours was held by South African Bill Boshoff who performed 101 bungy jumps in 14 hours and 23 minutes at Bloukrans on May 10, 2002.
The record stood until August 16, 2008 when Mike Heard broke the record with 103 bungy jumps within 24 hours from Auckland's Harbour Bridge.
The operators of Bloukrans Bridge Bungy, Face Adrenalin, employ 60 people from neighbouring communities – Coldstream, Thornham, Storms River, Covie, and The Crags - as part of the Bloukrans Bridge Bungy operation.
A significant percentage of turnover has been paid over to the local community trust since 1998.