Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health l > Problems of the CNS: The Spinal Cord > Flashcards

Problems of the CNS: The Spinal Cord Flashcards

1
Q

What is lumbosacral back pain (Low Back Pain)

A

Herniated nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are preventative measures

A 
Good posture
Proper lifting
Exercise
Ergonomics 
Equipment that can be used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are nonsurgical management

A 
Positioning
Drug therapy
Heat therapy
Physical therapy
Weight control
Complementary and alternative therapies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Minimally invasive surgery

A

Percutaneous lumbar diskectomy
Thermodiskectomy
Laser-assisted laparoscopic lumbar diskectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Conventional open surgical procedures

A

Diskectomy
Laminectomy
Spinal fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Postoperative care

A 
Prevention/assessment of complications
Neurologic assessment; vital signs
Patient’s ability to void
Pain control
Wound care
CSF check
Patient positioning/mobility
Discharge teaching
(Home care management
Community resources)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cervical neck surgical management

A

Anterior cervical diskectomy

Fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Spinal cord secondary injuries

A 
Hemorrhage
Metabolic (Inflammatory Processes)
Cellular changes
Vasoconstriction/Thrombosis
Vasospasms/Edema
Decreased spinal cord blood flow
Spinal cord ischemia and hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Spinal cord injuries

A

Hyperflexion
Hyperextension
Axial loading or vertical compression (e.g., caused by jumping)
Excessive head rotation beyond its range
Penetration (e.g., caused by bullet or knife)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Frequently seen at C5 & C6
Deceleration motion
Head-on collisions

A

HYPERFLEXION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperflexion results in

A

Compression of cord from fractures

Rupture or tearing of muscles or ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Back and downward motion of the head
Rear-end collisions (Whiplash)
Diving accidents

A

HYPEREXTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperextension results in

A

Spinal cord is stretched and distorted resulting in contusion or ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Displacement of spinal column
Tearing of the posterior ligaments & displacement of the spinal column
Occurs along with extension flexion injuries

A

ROTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rotation results in

A

May disrupt ligaments, vessels, tissue, bone, and related organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vertical force on cord
Long fall landing on feet or buttocks
Burst fractures (Bony fragments into spinal canal)

A

Axial Loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Axial loading results in

A

vertical compression that may result in such force on the vertebral body to cause a “burst” fracture with fragments that impinge upon the cord.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Knife or Gun shot wounds

Cut cord

A

PENETRATING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Penetrating results in

A

May partially or completely severe the vertebra, cord, ligaments, and blood supply or indirectly cause injury by heat or shock wave.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Total loss of sensory and motor function below level of injury

A

Complete injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of complete injury

A

Tetraplegia (Quadriplegia)

Paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Paralysis of both arms and legs
Injury to cervical region C1-C8
Airway management
Paralysis of diaphragm if injury above C3
Requires wheelchair with breath, head or shoulder control

A

Tetraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Paralysis of both legs
Injury to thoracolumbar region T2-L1
May have full use of arms
May require wheelchair or have some limited use lower extremities
May have some respiratory compromise (varying degrees of intercostals and abdominal muscle paralysis

A

Paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mixed loss of voluntary motor activity and sensation below level of injury

A

Incomplete Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Types of incomplete injuries

A

Brown-Sequard Syndrome
Central Cord Syndrome
Anterior Cord Syndrome
Posterior Cord Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Transection/Damage of one side of spinal cord

A

Brown-Sequard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Below injured site cord
Loss voluntary motor function (same side as Injury)
Loss of pain, temperature, & sensation (opposite side of injury)

A

Brown-Sequard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Associated with cervical flexion/extension injury

Hematoma formation in center of cervical cord

A

Central Cord Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q 
Motor weakness (upper extremities weaker than lower)  
Sensory function varies
Varying degrees bowel and bladder dysfunction
A

Central Cord Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Acute compression of anterior portion of spinal cord

Associated with flexion injuries or acute herniation of an intervertebral disc

A

Anterior Cord Syndrome

31
Q

Loss motor function below site of injury

Loss pain, temperature,& crude sensation

A

Anterior Cord Syndrome

32
Q

Associated with cervical hyperextension injury

Damage to the posterior column

A

Posterior Cord Syndrome

33
Q

Loss position sense, vibration, and pressure (May not have ability to walk)
Motor function, pain and temperature sensation intact

A

Posterior Cord Syndrome

34
Q

Assessment findings of injures

A

Pain at level of injury
Numbness/weakness, loss of sensation below level of injury
Complete/incomplete
Respiratory distress
Alterations in bowel and bladder function
Alterations in temperature control

35
Q

Initial period of flaccid paralysis and loss of sensation and reflexes
Lasts between 48 hrs to several weeks

A

Spinal shock

36
Q

Occurs within days to weeks

Hyperreflexic and spastic

A

Muscle spasms

37
Q

Nursing Diagnosis for spinal cord injuries

A

Respiratory
Circulation (CO, Tissue Perfusion, Dysrhythmias, Emboli)
Skin Integrity

38
Q

Airway management of spinal cord injuries

A

Goal: Maintain patent airway
If unresponsive insert oral airway, keeping neck in neutral position
Jaw thrust method to open airway
Provide oxygen/ventilator
IF injury above C3 need mechanical ventilation
Monitor ABG’s, suction prn

39
Q

Circulation management of spinal cord injuries

A

Cardiac output: Sympathetic nervous system interrupted
Loss of vasomotor response
Blood vessels cannot constrict
(Hypotension, venous pooling, decreased CO)
Tissue perfusion: Orthostatic hypotension, DVT prophylaxis Loss of thermoregulation

40
Q

Cervical immobilization of spinal cord injuries

A

Immobilize and stabilize in neutral position
Sandbags, cervical collars, and backboards
Body should be correctly aligned, log roll

41
Q

Surgical stabilization of cervical immobilization

A

Laminectomy, Spinal fusion, Rods

42
Q

Spinal cord injury management

A

Cervical traction using skull tongs
Traction provided by pulley system and weights
Cleanse pin sites twice a day
Halo traction

43
Q

Halo vest management

A

Cervical traction using specially designed jacket
Allows greater mobility
Inspect skin under jacket for breakdown
Keep Allen wrench taped to jacket
Body shells for stable thoracolumbar injuries

44
Q

Management of cord edema

A 
Corticosteroids
High dose Methylprednisolone IV  
Administer within 8 hours of injury
Start bolus, then, continuous drip for 24-48 hours 
Complications from this therapy?
45
Q

What is neurogenic shock

A

Loss of vasomotor tone & sympathetic innervation of heart
Hypovolemia, vasodilitation, ↓SVR, ↓Venous Return, ↓Stroke Volume, ↓CO, ↓Preload, Inhibited Baroreceptor response
Blood vessels unable to constrict
Low HR
Poikilothermic
Skin warm & dry

46
Q

Neurogenic shock management

A

Careful fluid resuscitation
Vasopressors
Maintain normothermia
Position to avoid orthostasis

47
Q

Spinal cord injury nursing goals

A

Altered elimination pattern
Bladder
Retention urine due to loss of autonomic and reflex control of bladder and sphincter.
Results in over-distention and may reflux into kidney
Bowel
Prevent spasms

48
Q

Management of altered elimination pattern (initial)

A

indwelling catheter

49
Q

Management of altered elimination pattern (long term)

A

intermittent catheterization

50
Q

How to prevent UTI’s

A

cranberry, apple, and grape juice

51
Q

Management of bowel

A

Constipation due to loss of voluntary and involuntary evacuation.

52
Q

How to prevent bowel problems

A 
Scheduled bowel program
Encouraging food high in fiber
Increase fluid intake
Suppository and stool softeners
Digital stimulation for UMN injuries
Enemas
53
Q

How to relieve spasms

A

warm baths, muscle relaxants, antispasmodics

54
Q

How to prevent contractures and decubiti

A

Turn Q2h
OOB to Chair ASAP
Specialty beds that provide side-to-side lateral rotation

55
Q

How to prevent DVTs

A

anitcoagulants

56
Q

Complications

A

Autonomic Dysreflexia/Hyperflexia

57
Q

Exaggerated autonomic response to stimuli resulting in profound hypertension
Occurs mostly in tetraplegics

A

Autonomic Dysreflexia/Hyperflexia

58
Q

Autonomic Dysreflexia/Hyperflexia is caused by

A

Distended bladder or rectum

Stimulation of skin, pain

59
Q

A condition where the blood pressure in a person with a spinal cord injury (SCI) above T5-6 becomes excessively high due to the over activity of the Autonomic Nervous System.

A

Autonomic Dysreflexia, also known as Hyperreflexia

60
Q

Autonomic Dysreflexia is usually caused when

A

a painful stimulus occurs below the level of spinal cord injury. The stimulus is then mediated through the Central Nervous System (CNS) and the Peripheral Nervous System (PNS).

61
Q

Autonomic Dysreflexia/Hyperreflexia findings

A 
Severe HTN (SBP may be 300)
Bradycardia
Severe HABlurred vision
Nausea, Restlessness
Skin Flushed above injury, Pale below
Distended bladder, bowel
62
Q

Priority Problems for Long-Term Management

A

Difficulty breathing
Impaired physical mobility (safety)
Spastic or flaccid bladder and bowel
Impaired adjustment

63
Q

Types of spinal cord tumors

A

Primary
Intramedullary
Extramedullary

64
Q

Surgical management

A

emergency surgery

65
Q

Nonsurgical management

A

radiation, chemotherapy

66
Q

Autoimmune disorder characterized by plaque in the white matter of the CNS

A

Multiple Sclerosis

67
Q

Types of Multiple Sclerosis

A

Relapsing-remitting
Primary progressive
Secondary progressive
Progressive-relapsing

68
Q

MS risk factors & triggers

A 
Viruses or infectious agents
Cold climate
Physical injury
Emotional stress
Pregnancy
Overexertion
Temperature extremes
Hot shower/bath
69
Q

MS symptoms

A 
Fatigue
Pain or paresthesia
Diplopia
Tinnitus
Dysphagia
Muscle spasticity
Ataxia
Bladder dysfunction
70
Q

Medications to treat medications

A 
Immunosuppressive agents (Azathioprine & cyclosporine)
Corticosteroids (Prednisone)
Immunomodullators (Interferon beta)
Anticonvulsants (Carbamazepine)
Antispasmodics (Dantrolene, baclofen)
71
Q 
Lou Gehring’s disease
Progressive motor neuron disease
Upper & lower motor neurons
Destruction of motor neurons
Brain
Anterior gray horns of the spinal cord
Sensory pathways not effected
Etiology unknown
A

Amytrophic Lateral Sclerosis (ALS)

72
Q

ALS findings

A 
Muscle weakness, wasting, atrophy
Muscle spasticity & hyperreflexia
Fasciculations
Brain stem signs (Dysarthria, dysphagia)
Dyspnea, respiratory paralysis
Fatigue
73
Q

How to diagnosis ALS

A 
History
Neuro exam
Electromyogram (EMG)
CPK elevated
Muscle biopsy
74
Q

Management of ALS

A

No known cure
Riluzole (slows the progression, hepatotoxic risk)
Anti-spasmodics
Physical therapy, Speech therapy, Occupational therapy
Nutrition
Enteral feedings
Monitor for progression (Airway, trach, home vents)
Counseling, support groups
End of life discussions

Adult Health l (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions