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Exam 2 - AH > SCI > Flashcards

SCI Flashcards

1
Q

What are the two things that determine spinal cord injury?

A

Mechanism of injury and location of trauma

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2
Q

What is primary injury vs secondary injury?

A

Primary = result of initial trauma
Secondary = result of ischemic/hypoxia/hemorrhage that destroys nerve tissues

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3
Q

For how long is secondary injury preventable for SCI?

A

first 4-6 hours after injury

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4
Q

What are the 6 types of injury that can cause SCI?

A
  • fractures
  • dislocations/subluxations
  • flexion injuries
  • extension injuries
  • compression injuries
  • axial rotational injuries
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5
Q

What type of injury is highly unstable and often occurs when patient falls on their head?

A

Axial rotational injuries

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6
Q

What injury causes vertebral bones to shatter or burst, and often occurs with blow to top of head or landing forcefully on feet?

A

Compression injuries

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7
Q

What injury is caused by backward bending of spinal column, e.g. fall when chin is point of impact?

A

Extension injuries

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8
Q

What SCI injury is most common and is caused by forward bending of spinal column e.g. head struck from behind?

A

Flexion injuries

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9
Q

What is quadriplegia defined by?

A

Patient with cervical level injury (C1-C7)

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10
Q

What is paraplegia defined by?

A

patient with injury from thoracic level (T1-T12) through to sacral level (S1-S5)

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11
Q

SCI Function varies depending on what?

A

vertebrae involved, e.g. injury to C1 vs injury to S5

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12
Q

Intermediate interventions for SCI?

A
  • ABC’s
  • immobilise spine
  • intubate/vent if needed
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13
Q

ED interventions for SCI?

A
  • give steroids
  • monitor for neurogenic and spinal shock
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14
Q

Example of an IV Corticosteroid used to treat SCI in ED?

A

Methylprednisolone

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15
Q

Neuro interventions for stabilised SCI?

A
  • halo traction
  • spine fusion
  • neck brace/collar
  • assess q4h
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16
Q

Respiratory interventions for stabilised SCI?

A
  • trach care as needed
  • lung sounds
  • suctioning
  • quad coughing
17
Q

Mobility interventions for stabilised SCI?

A
  • active/passive ROM
  • maintain body alignment
  • increase HOB
18
Q

bowel/bladder function interventions for stabilised SCI?

A
  • pt may initially have paralytic ileus, may use NG tube to decompress
  • high fiber diet
  • stool softeners
  • bladder program
  • intermittent cath q6h
19
Q

Describe the SCI complication spinal shock?

A

absence of voluntary and reflexive activity below level of injury, lasts days-months

20
Q

Describe the SCI complication neurogenic shock?

A

-hemodynamic phenomenon including loss of vasomotor tone
- occurs within 30 min of injury T5 or above
- lasts up to 6 weeks

21
Q

Symptoms of spinal shock?

A
  • decreased reflexes
  • loss of sensation
  • flaccid paralysis below injury
22
Q

Symptoms of neurogenic shock?

A
  • hypotension
  • bradycardia
  • poikilothermia
23
Q

Intervention for neurogenic shock?

A
  • airway support
  • fluids PRN
  • atropine for bradycardia
  • vasopressors for BP
24
Q

Describe the SCI complication autonomic dysreflexia?

A

excessive uncontrolled sympathetic response, usually from noxious stimuli, occurs with SCI above T6

25
Q

Symptoms of autonomic dysreflexia?

A
  • severe HA
  • increase in BP
  • sweating
  • blurry vision
  • nausea
  • nasal congestion
26
Q

Interventions for autonomic dysreflexia?

A
  • sit pt up
  • call MD
  • antihypertensives
27
Q

Describe the SCI complication spasticity?

A

Increase in reflex activity and spasms, triggered by movement, pain, bladder etc.

28
Q

Symptoms of spasticity?

A

muscle spasms, increased reflex activity

29
Q

Interventions for spasticity?

A

medication, rehab program e.g. exercise, stretching

30
Q

What antihypertensive medications could be used to treat autonomic dysreflexia?

A

NTG, Apresoline, Prazosin

31
Q

What medication could be used to treat spasticity?

A

Baclofen

Exam 2 - AH (17 decks)

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