Exam 2 Spinal Cord Injury

Question 1

define: spinal cord injury

Answer 1

spinal cord axon damage

Question 2

define: tetraplegia

Answer 2

T1 and above

Question 3

define: paraplegia

Answer 3

T2 and below

Question 4

SCI incidence, prognosis

Answer 4

Males, 16-30 yo

highest mortality within 1st year

Question 5

complications –> death

Answer 5

1) pneumonia
2) pulmonary edema
3) septicemia

Question 6

causes

Answer 6

1) vehicular
2) falls
3) violence
4) sports

Question 7

pathophysiology
primary
secondary

spiral shock
neurogenic shock

Answer 7

primary = 1st impact

secondary = 2nd effect

spiral shock = “concussion” of spinal cord, flaccid below level of injury

neurogenic shock = loss of sympathetic vascular tone, spastic, at T6 and above
characterized by hypotension, bradycardia, peripheral dilation

Question 8

classification

Answer 8

mechanism: hyperextension, flexion, compression
level: UMN, LMN
degree: complete vs. incomplete

Question 9

clinical manifestation

Answer 9

respiratory (apnea, insuf.)
cardiovascular (ortho/hypoTN, bradycardia)
urinary (areflexive/spastic bladder)
GI
skin (pressure ulcer)
neck/spine stability (leg roll, halo pin care)
thermoregulation (cold blooded)
peripheral vascular (DVT, PE)
pain
psychosocial (grief, depression, knowledge deficit)

Question 10

autonomic dysreflexia

Answer 10

“hyperreflexia”
T6 and above

elevate HOB, find and remove irritant, alpha blocker/nitro

Question 11

care

Answer 11

high steroids

nonoperative stabilizers
(skeletal traction, realignment)

surgical therapy (decompress the spinal cord, realign the vertebrae)

Question 12

nursing management

Answer 12

diagnosis (impaired physical mobility, ineffective breathing, self-care deficit)

planning (1) maintain optimal level of neurologic functioning (2) have no or minimal complications (3) learn new skills, gain new knowledge and acquire new behaviors to be able to care for self and successfully direct others to do so (4) return home and to community at optimal level of functioning

implementation (health promotion, acute care, rehab and home care)

evaluation

Question 13

C1-C3
C4
C5
C6
C7-8

Answer 13

entire head - mid. up neck
mid. low neck - above clavicle
clavicle, shoulder, middle of arm
outer arm - thumb
back of arms, elbows, 4 fingers

Question 14

T1-T9
T10-L1
L2-S5

Answer 14

under clavicle - above belly button
belly button - pubis area
inner thigh, reproductive, rectal