Spinal Cord Injury Flashcards
What is damage to the spinal cord that disrupts the transmission of nerve signals called?
Pathological damage to the spinal cord
This can cause ischemia and inflammation of the spinal cord, resulting in permanent functional impairments.
What are some traumatic injuries that can cause damage to the spinal cord?
Hyperflexion, hyperextension, compression, rotation, penetration
Examples include falls, motor vehicle accidents, medical conditions (cancer, arthritis, osteoporosis, inflammation), and infections.
Which age-related factors can contribute to spinal cord damage?
Age, alcohol, tumors on the spine, ischemia
These factors can exacerbate the risk of spinal cord injuries.
Where in the body can spinal cord damage occur?
Cervical, thoracic, lumbar, sacral spine
Patients are initially in the NTICU but can be found anywhere in the hospital.
What is Anterior Cord Syndrome?
Damage to gray and white matter of anterior portion of spinal cord
This syndrome affects motor function and pain perception.
What characterizes Posterior Cord Syndrome?
Damage in the gray and white matter of posterior spinal cord
This condition is rare and affects proprioception.
What is Central Cord Syndrome?
Lesions on the central spinal cord
It typically affects the upper limbs more than the lower limbs.
What results from Brown-Sequard Syndrome?
Hemisection injury affecting one half of the spinal cord
This syndrome leads to motor loss on one side and sensory loss on the other.
What is Cauda Equina?
Damage to the lumbar and sacral nerve roots
This condition can lead to significant lower body dysfunction.
What is Conus Medullaris?
Damage to the very lowest portion of the spinal cord
It can result in bowel and bladder dysfunction.
What are some signs and symptoms of spinal cord damage?
Cardiac dysrhythmias, hypotension, hypothermia, neurogenic bladder, pulmonary edema, ineffective breathing, decreased sensation, decreased mobility, flaccidness, paralysis, loss of pain perception
These symptoms can vary based on the level and severity of the injury.
What diagnostic tests can be used to identify spinal cord damage?
Physical examination, CT, MRI, nerve conduction tests, neurological exams
These tests help assess the extent of injury and plan treatment.
What complications can arise from spinal cord damage?
Progressive damage, paraplegia, quadriplegia, spinal shock, neurogenic shock, autonomic dysreflexia, sensory and motor deficits
Complications can affect all body systems: respiratory, cardiovascular, sensory and motor, urinary, gastrointestinal, integumentary, and psychological.
What treatment options are available for spinal cord damage?
No definitive treatment; therapies and rehabilitation to maximize quality of life
Medications can help manage some symptoms.
Fill in the blank: Damage to the spinal cord can cause _______ and inflammation.
Ischemia
Ischemia refers to reduced blood flow to the spinal cord.
What is spinal shock?
A temporary condition following spinal cord injury characterized by loss of reflexes and flaccid paralysis.
True or False: Spinal shock is a permanent condition.
False
Fill in the blank: Spinal shock typically occurs within ______ hours after a spinal cord injury.
24
What are the initial symptoms of spinal shock?
Loss of reflexes, flaccid paralysis, and hypotension.
What is neurogenic shock?
A type of shock resulting from the loss of sympathetic tone due to spinal cord injury, leading to vasodilation and hypotension.
Which type of spinal cord injury is most commonly associated with neurogenic shock?
Injuries above the T6 vertebra.
True or False: Neurogenic shock can lead to bradycardia.
True
What is autonomic dysreflexia?
A condition characterized by sudden high blood pressure and other symptoms due to overactivity of the autonomic nervous system, often triggered by a noxious stimulus below the level of injury.
Fill in the blank: Autonomic dysreflexia is most commonly seen in patients with spinal cord injuries at or above ______.
T6
What triggers autonomic dysreflexia?
Noxious stimuli such as bladder distension, bowel impaction, or skin irritation.
What are common symptoms of autonomic dysreflexia?
Severe headache, hypertension, sweating, and flushing above the level of injury.
True or False: Autonomic dysreflexia can be life-threatening.
True
What is the first-line treatment for autonomic dysreflexia?
Identify and remove the triggering stimulus.
What role does the sympathetic nervous system play in neurogenic shock?
Loss of sympathetic nervous system activity leads to vasodilation and reduced blood pressure.
Fill in the blank: Spinal shock can last from ______ to several weeks.
days
What is the physiological response during spinal shock?
Areflexia and loss of voluntary motor control.
True or False: Patients in spinal shock will exhibit normal reflexes.
False
What vital sign changes are associated with neurogenic shock?
Hypotension and bradycardia.
What is the potential consequence of untreated autonomic dysreflexia?
Severe hypertension can lead to stroke or seizure.
Fill in the blank: Neurogenic shock often requires ______ management.
fluid
What is the primary concern in managing spinal shock?
Monitoring and supporting respiratory function and hemodynamics.
True or False: Autonomic dysreflexia occurs only in paraplegic patients.
False
What is a common method to prevent autonomic dysreflexia?
Regularly emptying the bladder and managing bowel care.
What distinguishes spinal shock from neurogenic shock?
Spinal shock is a temporary loss of reflexes, while neurogenic shock is a state of cardiovascular instability.
Fill in the blank: The onset of autonomic dysreflexia is ______ and can occur suddenly.
rapid
What is the importance of recognizing autonomic dysreflexia early?
Early recognition can prevent serious complications such as hypertensive crisis.
What is spinal shock?
Spinal shock is a temporary loss of all neurological activity below the level of injury following a spinal cord injury.
True or False: Spinal shock is a permanent condition.
False
What are the primary nursing interventions for spinal shock?
Monitor vital signs, maintain airway, assess neurological status, and provide supportive care.
Fill in the blank: Neurogenic shock is characterized by ________ and ________.
hypotension; bradycardia
What is the main cause of neurogenic shock?
Loss of sympathetic tone due to spinal cord injury.
Which position should a patient in neurogenic shock be placed in?
Supine or flat position to promote venous return.
True or False: Autonomic dysreflexia can occur in patients with spinal cord injuries above T6.
True
What is a key nursing intervention for managing autonomic dysreflexia?
Identify and remove the triggering stimulus.
Multiple Choice: Which of the following is a common trigger for autonomic dysreflexia? A) Full bladder B) Low blood pressure C) Fever D) Infection
A) Full bladder
What vital sign changes are associated with neurogenic shock?
Hypotension and bradycardia.
Short Answer: Describe the role of intravenous fluids in managing spinal shock.
IV fluids are used to maintain blood pressure and hydration.
True or False: Patients with spinal shock may experience flaccid paralysis.
True
What medication may be used to manage bradycardia in neurogenic shock?
Atropine.
Fill in the blank: In autonomic dysreflexia, blood pressure can rise significantly, sometimes exceeding ________ mmHg.
300
What is the first step in responding to a patient exhibiting signs of autonomic dysreflexia?
Sit the patient upright to help lower blood pressure.
Multiple Choice: Which of the following is NOT a sign of autonomic dysreflexia? A) Severe headache B) Blurred vision C) Bradycardia D) Sweating
C) Bradycardia
What should be monitored closely in patients experiencing spinal shock?
Neurological status and vital signs.
True or False: Autonomic dysreflexia can lead to life-threatening complications if not treated promptly.
True
What is the typical duration of spinal shock?
It can last from days to weeks but is usually temporary.
Fill in the blank: Neurogenic shock can lead to ________ due to decreased vascular resistance.
hypotension
What is the primary goal in managing spinal shock?
Stabilizing the patient’s condition and preventing complications.
Short Answer: Describe the importance of patient education in autonomic dysreflexia.
Patients must recognize symptoms and triggers to seek timely intervention.
What type of monitoring is critical for patients with neurogenic shock?
Continuous cardiac monitoring.
True or False: Spinal shock can cause loss of reflexes below the level of injury.
True
What is a common complication of untreated neurogenic shock?
Organ dysfunction or failure.
What is spinal shock also known as?
Spinal shock syndrome
Spinal shock is a temporary neurologic syndrome following spinal cord injury.
What is spinal shock characterized by?
- Areflexes
- Loss of sensation
- Flaccid paralysis below the level of injury
These symptoms occur immediately after a spinal cord injury.
How long does spinal shock typically last?
Days to months, often less than 48 hours
The duration may vary but is usually brief.
What percentage of people with acute spinal cord injury experience spinal shock?
About 50%
Spinal shock affects a significant portion of individuals with acute spinal cord injuries.
What happens to muscle spasticity after spinal shock resolves?
Muscle spasticity begins
Spasticity is a common outcome following the resolution of spinal shock.
What causes neurogenic shock?
Loss of vasomotor tone caused by the injury
Neurogenic shock is a result of changes in the autonomic nervous system due to injury.
What are the key characteristics of neurogenic shock?
- Hypotension
- Bradycardia
These symptoms result from loss of sympathetic nervous system innervation.
What causes peripheral vasodilation and venous pooling in neurogenic shock?
Loss of SNS innervation
The sympathetic nervous system normally maintains vascular tone.
How soon may neurogenic shock occur after an injury?
Within 24 hours
This rapid onset is critical for monitoring and treatment.
Why is neurogenic shock considered potentially life-threatening?
Due to hypotension and bradycardia
These cardiovascular changes can lead to serious complications.
What types of injuries are generally associated with neurogenic shock?
Cervical or high thoracic injury
These locations on the spinal cord are critical for sympathetic nervous system control.
What is a recommended action during spinal shock?
Active rehabilitation should go ahead and start
Early rehabilitation is important for recovery and function.
What are immediate post-injury problems in spinal cord injury?
• Maintaining a patent airway
• Adequate ventilation
• Adequate circulating blood volume
• Preventing extension of cord damage (secondary damage)
These problems are critical to address right after a spinal cord injury.
What is the first priority in the assessment of a patient with spinal cord injury?
Assessment of the patient’s airway, breathing pattern, and circulation status
This ensures that the most vital functions are stabilized.
What should be assessed for indications of hemorrhage in spinal cord injury?
• Intra-abdominal hemorrhage
• Bleeding around fracture sites
Identifying hemorrhage is crucial to prevent further complications.
What scale is used to assess the level of consciousness in spinal cord injury patients?
Glasgow Coma Scale
This scale helps determine the patient’s responsiveness and neurological status.
What are the classifications of spinal cord injury based on the level of injury?
• Tetraplegia (quadriplegia)
• Quadriparesis
• Paraplegia
• Paraparesis
These classifications help in understanding the extent of motor and sensory loss.
