Concepts Exam #2 Ch 43

Question 1

Factors Contributing to Low Back Pain

Answer 1

Spinal stenosis
Osteoarthritis/Osteoporosis
Scoliosis/Lordosis
Diminished blood supply
Disk degeneration

Question 2

Paresthesia

Answer 2

tingling sensation or numbness

Question 3

Radiculopathies

Answer 3

Involvement of spinal nerve root. Distinguishes motor neuron diseases from peripheral neuropathies

Question 4

Williams position

Answer 4

Patient is in the semi-Fowlers position with a pillow under the knees to keep them flexed. Or sits in a recliner chair. This position relaxes the muscles to relieve pressure/pain from the lower back.

Question 5

What is phonophoresis?

Answer 5

Application of a topical drug like Xylocaine or hydrocortisonse followed by continuous ultrasound for 10 minutes. For chronic back pain.

Question 6

What is iontophoresis?

Answer 6

Procedure where a small electrical current and dexamethasone are typically used. For chronic back pain.

Question 7

Phonophoresis and Iontophoresis work by….

Answer 7

Pushing the medication into the subcutaneous tissue and provide longer-lasting pain relief.

Question 8

Safety Priority for Patient after back surgery

Answer 8

Inspect for blood or other drainage. The loss of large amount of CSF– patient will report sudden headache- nurse should report to provider immediately.

Question 9

Complications of Lumbar Spinal Surgery

Answer 9

CSF Leakage
Fluid Volume Deficit
Acute Urinary Retention
Paralytic ileus
Fat embolism
Persistent nerve root pain
Infection

Question 10

Best practice to avoid VTE postoperatively?

Answer 10

Early ambulation/mobility!

Question 11

Complete Spinal Cord Injury

Answer 11

Spinal cord has been damaged in a way that eliminates all innervation below the level of injury.

Question 12

Incomplete Spinal Cord Injury

Answer 12

Injuries that allow SOME movement or function below the level of injury. More common than complete SCI.

Question 13

Hyper-flexion injury

Answer 13

Occurs when head is suddenly and forcefully moved forward. Head on collision/diving accidents.

Question 14

Hyper-extension injury

Answer 14

Occurs when head is moved forward and then backward. Most often in vehicle collisions where vehicle is struck from behind or during falls when chin is struck.

Question 15

Axial loading (vertical compression) injury

Answer 15

Diving accidents, falls on buttocks, or a jump in which person lands on feet. Pieces of bone shatter and enter
spinal canal and damage the cord.

Question 16

Rotation injury

Answer 16

Caused by turning the head beyond the normal range

Question 17

Penetrating trauma

Answer 17

Low impact (knife wound)
High impact (gun shot wound)

Question 18

What does a positive halo sign indicate?

Answer 18

CSF Leak

Question 19

Dermatome and myotomes

Answer 19

Zones of sensory and motor function, helps determine neurological level.

Question 20

Patients with Spinal cord injury

Answer 20

Cardiovascular and Respiratory dysfunction

Question 21

Quadraplegia

Answer 21

Paralysis in all four extremities. Seen in Cervical Cord and Upper thoracic injury

Question 22

Paraplegia

Answer 22

Paralysis in lower extremities only. Seen in thoracic and lumbosacral injuries or lesions

Question 23

Spinal Cord Shock

Answer 23

The patient has complete but temporary loss of motor, sensory, reflex and autonomic function lasting less than 48 hours. NOT the same as neurogenic shock

Question 24

Euvolemia

Answer 24

Normal volume of intravascular fluid

Question 25

Heterotopic Ossification (HO)

Answer 25

Overgrowth of bone into tissue

Question 26

Priorities for patient iwth spinal cord injury?

Answer 26

AIRWAY. Assess breath sounds q 2-4 hours during first few days of injury. Watch for changes in respiratory pattern or airway obstruction. Report to physician if SBP is

Question 27

Neurogenic Shock

Answer 27

Occurs within 24 hours of injury above T6. Bradycardia, hypotension, pulse ox

Question 28

Autonomic Dysreflexia

Answer 28

Life threatening. Visceral or cutaneous stimuli causes sudden, massive, uninhibited reflex sympathetic discharge in people with high SCI. Significant rise in BP with bradycardia. Profuse sweating. Skin flushing, blurred vision, nasal congestion, onset of headache.

Question 29

Intramedullary tumors

Answer 29

Are within the cord in central gray matter or glial cells of spinal cord. Cancerous and grow rapidly and invasively

Question 30

Extramedullary tumors

Answer 30

Are within spinal dura but outside the spinal cord. 90% of spinal cord tumors.

Question 31

Radicular pain

Answer 31

Nerve root pain. Stabbing or dull with intermittent episodes of sharp, piercing pain. Increased pain with coughing or straining or lying flat.

Question 32

Multiple Sclerosis

Answer 32

life long inflammatory disease of unknown etiology that affects brain and spinal cord especially in young adults

Question 33

Amyotrophic lateral sclerosis (ALS)

Answer 33

Lou Gehrigs disease. Upper and lower motor neuron disease of adult onset. Weakness, muscle wasting, and spasticity that lead to paralysis.