Spinal Cord Injury

Question 1

CN I

Answer 1

olfactory – smell

Question 2

CN II

Answer 2

optic – central, peripheral vision

Question 3

CN III

Answer 3

ocularmotor – eye movement, pupil constriction

Question 4

CN IV

Answer 4

trochlear – eye movement oblique

Question 5

CN V

Answer 5

trigeminal – sensory perception everything on head, face, chewing

Question 6

CN VI

Answer 6

abducens – eye movement rectus

Question 7

CN VII

Answer 7

facial – pain and temp in ear area, face deep sensation, tongue taste, face and scalp muscles, face glands

Question 8

CN VIII

Answer 8

vestibulocochlear – hearing, equilibrium

Question 9

CN IX

Answer 9

glossopharyngeal – throat muscles, taste tongue and pharynx feels

Question 10

CN X

Answer 10

vagus – muscles soft palate, larynx, pharynx, thoracic abdominal viscera, cardiac smooth muscle at splenic flexure

Question 11

CN XI

Answer 11

accessory – skeletal muscles pharynx larynx, sternocleidomastoid, trapezius muscles

Question 12

CN XII

Answer 12

hypoglossal – tongue muscles

Question 13

ANS includes…

Answer 13

SNS and PNS – no conscious control

Question 14

What CN are important to assess after stroke or traumatic brain injury?

Answer 14

CN II, III, IV, VI

Question 15

What damage done after SCI?

Answer 15

lose motor function, sensory perception, reflex activity, bowel and bladder control

Question 16

2 SCI classifications

Answer 16

complete and incomplete

Question 17

complete SCI

Answer 17

spinal cord injury involving damage to functions below level of injury

Question 18

incomplete SCI

Answer 18

more common than complete, injury that allow some function movement below site of injury

Question 19

mechanisms of SCI injury

Answer 19

direct, subluxation, penetrating

Question 20

contusion, compression, laceration, transaction (severing)

Answer 20

destructive ways of SCI

Question 21

hyperflexion, hyperextension, axial loading, vertical compression, excessive rotation, penetrating trauma

Answer 21

primary causes of SCI

Question 22

head suddenly and forcefully accelerated forward, an extreme flexion of head

Answer 22

hyperflexion injury

Question 23

head suddenly accelerated then decelerated – stretches or tears anterior longitudinal ligament, fx or subluxates vertebrae, rupture intervertebral disk

Answer 23

hyperextension injury

Question 24

vertical compression – pieces enter spinal canal and damage cord

Answer 24

axial loading

Question 25

turning head beyond normal range

Answer 25

rotation injury

Question 26

classified by speed of object causing injury (knife, bullet)

Answer 26

penetrating trauma

Question 27

worsens primary SCI

Answer 27

secondary injury

Question 28

hemorrhage, ischemia, hypovolemia, impaired tissue perfusion neurogenic shock related, local edema

Answer 28

secondary injury examples

Question 29

contusion, petechial leaking into central gray matter then to white matter

Answer 29

hemorrhage of spinal cord

Question 30

results in shock and decreased perfusion to spinal cord

Answer 30

systemic hemorrhage

Question 31

occurs from primary and secondary injuries worsening capillary compression and cord ischemia

Answer 31

edema

Question 32

hypotension and bradycardia associated with cervical SCI injuries from autonomic function loss -- greatest risk first 24 hrs -- T6 and above injuries

Answer 32

neurogenic shock

Question 33

vehicle crashes, falls, violence (gunshot), sports, tumors

Answer 33

etiology of SCI

Question 34

80% of all in young males, cervical cord more prevalent than thoracic or lumbar injuries, C5 most common

Answer 34

incidence and prevalence of SCI

Question 35

loss of motor, sensory and reflex activity below SCI lesion -- immediate after injury lasts 48 hours, but temporary

Answer 35

spinal shock

Question 36

paralysis of lower extremities

Answer 36

paraplegia

Question 37

weakness of lower extremities

Answer 37

paraparesis

Question 38

weakness of all 4 extremities

Answer 38

quadriparesis

Question 39

paralysis of all 4 extremities

Answer 39

quadriplegia

Question 40

decreased sensation

Answer 40

hypoesthesia

Question 41

increased sensation

Answer 41

hyperesthesia

Question 42

what to do when pt has decreased sensation from baseline in proximal (upward) dermatome

Answer 42

notify neurosurgeon

Question 43

scale that refers to dermatomes and myotomes for indication of neurological level

Answer 43

ASIA scale (American Spinal Injury Association)

Question 44

complication of prolonged immobility, bony overgrowth often into muscle

Answer 44

heterotopic ossification

Question 45

when pt takes breath and coughs during exhalation, use hands to push on diaphragm below ribcage

Answer 45

cough assist

Question 46

pulse ox <90 (aspiration, stridor, garbled speech, can't clear airway), bradycardia with symptoms (reduced LOC and urine output), hypotension systolic <90 or MAP <65

Answer 46

emergency sx to notify physician