Chapter 61 Nursing Management: Peripheral Nerve and Spinal Cord

Question 1

anterior cord syndrome, Table 61-3, p. 1472

Answer 1

Caused by damage to the anterior spinal artery.

• Results in compromised blood flow to the anterior spinal cord.
• Typically results from injury causing acute compression of anterior portion of the spinal cord, often a flexion injury.
• Motor paralysis and loss of pain and temperature sensation below the level of injury.
• Because posterior cord tracts are not injured, sensations of touch, position, vibration, and motion remain intact.

Question 2

autonomic dysreflexia, p. 1479

also known as autonomic hyperreflexia

Answer 2

is a massive uncompensated cardiovascular reaction mediated by the sympathetic nervous system.

Question 3

Bell’s palsy, p. 1466

Answer 3

a disorder characterized by a disruption of the motor branches of the facial nerve (cranial nerve [CN] VII) on one side of the face in the absence of any other disease such as a stroke.

Question 4

botulism, p. 1468

Answer 4

a serious food poisoning caused by GI absorption of the neurotoxin produced by Clostridium botulinum that results in disturbed muscle innervation.

Question 5

Brown-Séquard syndrome, Table 61-3, p. 1472

Answer 5

Results from damage to one half of the spinal cord.

Typically results from penetrating injury to spinal cord.

Ipsilateral (same side as injury): Loss of motor function and position and vibratory sense, vasomotor paralysis.

Contralateral (opposite side of injury): Loss of pain and temperature sensation below the level of injury.

Question 6

central cord syndrome, Table 61-3, p. 1472

Answer 6

damage to the central spinal cord characterized by microscopic hemorrhage, edema of the central spinal cord, and compression on anterior horn cells.

Caused by damage to the central spinal cord

Occurs most commonly in the cervical cord region.

More common in older adults.

Motor weakness and sensory loss are present in both upper and lower extremities.

Upper extremities are affected more than the lower ones.

Question 7

Guillain-Barré syndrome, p. 1467

Answer 7

an acute, rapidly progressing, and potentially fatal form of polyneuritis possibly caused by a cell-mediated immunologic reaction directed at the peripheral nerves.

Question 8

neurogenic bladder, p. 1480

Answer 8

any type of bladder dysfunction related to abnormal or absent bladder innervation caused by a lesion of the nervous system.

Question 9

neurogenic bowel, p. 1481

Answer 9

loss of voluntary neurologic control over the bowel.

Question 10

neurogenic shock, p. 1470

Answer 10

neurologic syndrome caused by the loss of vasomotor tone caused by spinal cord injury at the fifth thoracic (T5) vertebra or above and characterized by hypotension, bradycardia, and warm, dry extremities.

Question 11

neurosyphilis, p. 1468

Answer 11

an infection of any part of the nervous system by the organism Treponema pallidum.

Question 12

paraplegia, p. 1470

Answer 12

paralysis characterized by motor and/or sensory loss in the lower limbs and trunk.

Question 13

posterior cord syndrome, Table 61-3, p. 1472

Answer 13

Results from compression or damage to the posterior spinal artery.

Very rare condition.

Generally the dorsal columns are damaged, resulting in loss of proprioception.

Pain, temperature sensation, and motor function below the level of injury remain intact.

Question 14

spinal shock, p. 1470

Answer 14

the immediate failure of all spinal cord function at the time of injury below the level of cord damage resulting in flaccid paralysis, loss of reflexes, and loss of sympathetic innervation.

Question 15

tetanus, p. 1468

Answer 15

lockjaw; an extremely severe polyradiculitis and polyneuritis affecting spinal and cranial nerves that results from the effects of a potent neurotoxin released by the anaerobic bacillus Clostridium tetani.

Question 16

tetraplegia, p. 1470

Answer 16

the paralysis of the arms, legs, and trunk occurring with spinal cord damage at C8 or above.

Question 17

trigeminal neuralgia, p. 1464

Answer 17

a neurologic condition of the trigeminal facial nerve characterized by paroxysms of flashing, stablike pain radiating along the course of a branch of the nerve from the angle of the jaw.