Neurologic Trauma

Question 1

Common causes of SCI

Answer 1

MVA, violence (GSW), sports related

Question 2

risk factors SCI

Answer 2

younger age, male gender, alcohol and drug use

Question 3

if survive SCI major causes of death

Answer 3

pneumonia, PE, sepsis

Question 4

complete spinal cord lesion

Answer 4

loss of both sensory and voluntary motor communication b/w brain and periphery– paraplegia or tetraplegia (aka quadriplegia)

Question 5

incomplete spinal cord lesion

Answer 5

the ability of spinal cord to relay messages from brain to periphery is NOT completely absent

Question 6

motor

Answer 6

same side

Question 7

sensation

Answer 7

opposite side

Question 8

Goal of care for SCI

Answer 8

prevent secondary injury

Question 9

CPR for SCI

Answer 9

jaw thrust

Question 10

when would paralytic ileus happen if patient is in spinal/ neurogenic shock

Answer 10

first 2-3 days

Question 11

spinal shock

Answer 11

associated with sudden depression of reflex activity below the level of injury –> BP drops, HR drops –> bladder distention & paralytic ileus

Question 12

neurogenic shock

Answer 12

occurs due to loss fo autonomic NS function below level of lesion–> decreased BP, HR, and CO ; absence of perspiration on paralyze portion

Question 13

therapy for neurogenic shock

Answer 13

massive amount of IVF (NS), epi/norepi/dopamine

Question 14

injury of cervical and upper thoracic spinal cord leads to

Answer 14

lost of innervation of the accessory muscles of respiration –> decreased vital capacity, retention of secretions, CO2 retention, respiratory failure

Question 15

complications of SCI

Answer 15

spinal and neurogenic shock, venous thromboembolism secondary to immobility, adequate breathing and airwary clearance, urinary elimination, bowel function, autonomic dysreflexia

Question 16

what can stimulate autonomic dysreflexia

Answer 16

Example of stimuli: distended bladder (most common!), distention/contraction of bowel (constipation, impaction), stimulation of the skin -> remove the triggering stimulus ASAP (or prevent/avoid these stimuli)

Question 17

intervention for autonomic dysreflexia

Answer 17

Sitting position- to lower the BP (BE!); Bladder is emptied; Rectum is examined for fecal mass- > {topical anesthetic agent should be used}; Skin is assessed for irritation or area of pressure {even draft of cold air}; Antihypertensive meds given IV