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M/S 3 > Exam 3 - SCI > Flashcards

Exam 3 - SCI Flashcards

1
Q

what are the 4 components to the spinal cord

A

cervical (C1-8)
thoracic (T1-12)
lumbar (L1-5)
sacral (S1-5)

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2
Q

SCI above __ causes paralysis of respiratory muscles AND all 4 extremities (quadriplegia)

A

C4

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3
Q

primary SCI is caused by cord compression d/t

A

bone displacement
interruption of blood supply
traction from pulling on cord

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4
Q

what is secondary SCI

A

ongoing, progressive damage that occurs after initial injury

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5
Q

secondary SCI: permanent damage may occur within __ hours d/t ___

A

24 hours; edema

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6
Q

extent of SCI damage and prognosis is not determined until __ hours or more after injury

A

72 hours

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7
Q

greatest improvement of SCI occurs in the first __ to __ months after injury

A

3-6 months

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8
Q

3 measures to classify SCI

A

mechanism of injury
level of injury
degree of injury

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9
Q

what are the 5 major mechanisms of SCI

A

flexion
hyperextension
flexion-rotation
extension-rotation
compression

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10
Q

tetraplegia is aka ___ and occurs d/t injury in which area

A

quadraplegia; cervical

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11
Q

paraplegia occurs d/t injury in which areas

A

thoracic
lumbar

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12
Q

complete vs. incomplete (partial) injuries

A

c: total loss of sensory and motor function below level of injury

i/p: mixed loss; some tracts intact

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13
Q

what is central cord syndrome

A

damage to central spinal cord, commonly cervical

older adults
motor weakness
sensory loss - low extremities not affected
dysesthetic

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14
Q

what is dysesthetic

A

burning pain in upper extremities

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15
Q

what is anterior cord syndrome

A

damage to anterior spinal artery (compromised blood flow)

resulted from flexion injury
motor paralysis, loss of pain + temp sensation below level of injury

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16
Q

what is brown-sequard syndrome

A

damage to 1/2 of cord
resulted from penetrating injury

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17
Q

what is conus medullaris syndrome

A

damage to conus medullaris (lowest portion of spinal cord)

leg: preserved, weak or flaccid
decrease, loss of sensation in perianal
areflexic (flaccid) bladder, bowel
impotence

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18
Q

what is cauda equina syndrome

A

damage to cauda equine (lumbar, sacral nerve roots)

flaccid paralysis of lower extremities
complete loss of sensation in saddle area
areflexic bladder, bowel
severe, radicular, asymmetric pain

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19
Q

injuries above __ lead to dysfunction of sympathetic nervous system

A

T6

20
Q

neurogenic shock

A

bradycardia
peripheral vasodilation
hypotension

21
Q

acute phase: urinary system function

A

retention
bladder atonic, over distended, fails to empty
indwelling catheter

22
Q

postacute phase: urinary system function

A

bladder can become hyperirritable
loss of inhibition from brain
reflex emptying, failure to store urine

23
Q

GI s/sx

A

gastric distention
paralytic ileus
delayed gastric emptying
stress ulcers
dysphagia

24
Q

integumentary s/sx

A

skin breakdown potential
piokilothermia

25
Q

NG suctioning puts the pt at risk for which acid-base imbalance

A

metabolic alkalosis

26
Q

what is of concern the first 3 months after a SCI

A

DVT, PE

27
Q

nociceptive pain

A

musculoskeletal: dull, ache; worse with movement
visceral: thorax, abdomen, pelvis

28
Q

neuropathic pain location

A

at or below level of injury

hot, burning, tingling, pins + needles, cold, shooting

29
Q

when is spinal immobilization not recommended

A

penetrating trauma

30
Q

you want to maintain SBP > __ mmHg

A

90

31
Q

surgery within __ hours is associated with improved neurological outcome

A

24 hours

32
Q

why are vasopressors given

A

maintain MAP > 85-90 mmHg

33
Q

S/E of vasopressor agents

A

tachycardia
VT, afib
elevated troponin
metabolic acidosis

34
Q

C1-3 will have ___ and inability to ___

A

apnea; inability to cough

35
Q

C4 will have a poor ___ and ___

A

poor cough; hypoventilation

36
Q

C5-6 will have a ___ ___ reserve

A

decrease respiratory

37
Q

what to auscultate with a T5 injury

A

bowel sounds

38
Q

overall goal of SCI

A

optimal level of neurologic functioning

39
Q

pin site care

A

cleanse with 1/2 strength peroxide and NS BID
apply abx ointment

40
Q

what is kinetic therapy

A

continual side-to-side rotation

prevent pulmonary complications
prevent pressure ulcers

41
Q

nutrition should be started within __ hours. it should be what

A

72 hours

high protein, high calorie

42
Q

what occurs during intermittent catheterization program

A

4-6 times daily
monitor for s/sx of UTI
increase fluid intake

43
Q

what is daily rectal stimulation

A

suppository or small-volume enema
dulcolax, colace

44
Q

when does stress ulcers commonly occur after injury

A

6-14 days

45
Q

what are some meds that can be given to help with neuropathic pain

A

gabapentin
lyrica
cymbalta
amitriptyline

46
Q

return of ___ may complicate rehab

A

reflexes

hyperactive
exaggerated responses
penile erection
spasms

47
Q

what are some antispasmodic meds that can be given

A

baclofen
dantrium
xeniflex
botox injections

M/S 3 (17 decks)

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