Seminar 11 Flashcards
What are the 3 classifications of a spinal cord injury
-Mechanism of injury
-level of injury
-degree of injury
What are the different mechanisms of injury
Traumatic
non traumatic
what are the different degrees of injury
-Complete (spinal cord is completely severed)
-incomplete (Some movement of sensory below the level of injury)
what is the gold standard diagnostic test for imaging soft tissues
MRI
what level of injury results in a total loss of respiratory muscle function
Anything above C4
what level of injury results in neurogenic shock
Injury at T5 or higher
what are clinical manifestations of neurogenic shock
-Bradycardia
-Peripheral Vasodilation
what level of injury determines if a person will have a spastic or flaccid bladder
-Above T12 spastic bladder
-below T12 Flaccid
What are some common bladder complications after a SCI
-Urinary retention
-Bladder becomes atonic (unable to contract) and overdistended
What level of injury results in neurogenic bowel
injury at T5 or above
what is the main clinical manifestation of neurogenic bowel
mostly causes hypomotility which results in constipation paralytic ileus etc
what level of injury determines if someone will have a spastic bowel or flaccid bowel
-T12 or above will result in a spastic bladder
-T12 or below will result in a flaccid bladder
what is poikilothermia and why does it occur in people with SCI
Inability to maintain core temperature because the injury prevents temperature sensation from reaching the hypothalamus
When is a DVT most likely to occur in a SCI
most likely to occur within the first 3 months after injury
what level of injury can result in autonomic dysreflexia
T6 or higher
what is autonomic dysreflexia
when the sympathetic NS becomes hyperactive after an SCI because of sustained stimulus at or below level of injury which can lead to seizures, strokes and MI (from the increase in BP and increased work on the heart from the SNS activation)
what are clinical manifestations of autonomic dysreflexia
-bradycardia
-everything else is a symptom of SNS stimulation ie hypertension blurred vision diaphoresis flushing etc
what are examples of things that could cause autonomic dysreflexia
-restrictive clothing
-pressure areas
-full bladder or UTI
-fecal impaction
what are nursing interventions for autonomic dysreflexia
-elevate head of bed to 45 degrees
-remove stimulus that is causing the problem
what are the 3 things that make up ICP
Brain tissue
Blood
Cerebrospinal fluid
what is usually the earliest sign of increased ICP
Changes in LOC
what are late stage signs of increased ICP
-Cushing’s Triad
-Decrease in motor function
what is the normal range for ICP
5-15 mm Hg
what position is best for a client with increased ICP
positioned with the HOB elevated to 30 degrees
what would the GCS score be for a mild brain injury
GCS of 15-13
what would the GCS score be for a moderate brain injury
GCS of 12-9
what would the GCS score be for a severe brain injury
score of 8-3
what is diffuse axonal injury
when the axons in the brain shear from the brain shifting around inside the skull
how long does it take until a person starts to show symptoms of a DAI
12-24 hours
what are clinical manifestations of DAI
-decreased LOC
-Increased ICP
-Decerebrate (straight arms parallel to the body) or decorticate posturing (Arms are bent towards the center of the body)
-persistent vegetative stateif DAI is severe
what is a coup countercoup injury
when there is damage from the primary impact (coup) and damage from the secondary impact when the brain bounces back and hits the opposite side of the skull from where the force was applied (Countercoup)
what is a traumatic subarachnoid hemorrhage
hemorrhage that is a result of traumatic force that damages the vascular structures of the subarachnoid space
