AG2-Spinal fractures Flashcards
Manifestations associated with above C4 SCI?
- Total loss of respiratory muscle function.
- Mechanical ventilation is required to keep the patient alive.
What is spinal shock?
Temporary neurological syndrome characterized by decreased reflexes, loss of sensation, absent termorregulation, and flaccid paralysis below the level of the injury. May last days to weeks.
Manifestations associated with a below C4 SCI?
Diaphragmatic breathing if the phrenic nerve is functioning.
Manifestations associated with above T5 SCI?
Primary GI problems are related to hypomotility.
Manifestations associated with above T6 SCI?
Decreases the effect of the SNS.
Bradycardia occurs.
Peripheral vasodilation results in hypotension.
What is neurogenic shock?
Results from the loss of vasomotor tone caused by the injury and is characterized by hypotension and bradycardia. Loss of SNS inner action causes peripheral vasodilation, venous pooling, and decreased cardiac output. Effects are generally associated with a cervical or high thoracic spinal cord injury.
What is autonomic dysreflexia?
Life threatening emergency characterized by HTN and bradycardia that occurs caused by an overreaction of the ANS. Usually occurs with spinal injuries above the level of T6.
What are the 5 syndromes associated with an incomplete spinal cord injury?
Central cord syndrome, anterior cord syndrome, Brown-Sequard syndrome, cauda equina syndrome, and conus medullaris syndrome.
What are the classifications of spinal cord tumors?
Extradural (outside of the spinal cord) and intradural (within the dura mater but outside the cord).
What is posterior cord syndrome?
Presents with loss of proprioception but pain, temp, and sensation remain intact below level of the injury.
Indications for early spinal cord surgery?
- Evidence of cord compression
- Progressive neurological deficit.
- Compound fix of the vertebrae
- Bony fragments (may dislodge and penetrate the cord).
- Penetrating wounds of the spinal cord or surrounding structures.
When mobilizing the patient how should the patient move?
Log rolling, no twisting of the back
What medications may be used in the acute phase to control BP?
Vasopressors like dopamine ; maintain mean arterial pressure at a level > 90mmHg so that perfusion to the spinal cord is improved.
Why are drug interactions especially important with spinal cord injuries?
Drug metabolism may be altered
Nursing interventions for patients in autonomic hyperreflexia?
Elevating the HOB 45 degrees or sitting the patient upright, determining the cause, and notifying the health care provider.
