Spinal Shock vs Neurogenic Shock Flashcards
Manifests with: 1.decreased oxygen saturation, 2.symptomatic bradycardia, 3.decreased level of consciousness, 4. decreased urine output, and 5.hypotension.
Neurogenic Shock
Neurogenic shock is:
_________ failure
caused by paralysis of the nerves
that control the _____ of the blood vessels, leading to widespread ________; seen in patients with spinal cord injuries.
circulatory
size
vasodilation
This is a Medical emergency;
It is a complete loss of all reflex, motor, sensory and autonomic activity below the lesion;
Spinal Shock
temporary concussion like insult to the spinal cord that causes effect below the level of the injury
Spinal Shock
Maldistribution of blood = ________ shock
neurogenic
Low cardiac output + hypotension would be found in what type of shock? (inappropriate bradycardia, should be tachy in setting of hypotension)
neurogenic
Located in the ventral (anterior) horn of the spinal cord or brain stem = ________ motor neuron
lower
Hyporeflexia, decreased muscle tone, and muscle atrophy = _______ motor neuron
lower motor neuron
Where is hyperflexion usually seen in the vertebrae
c5 and c 6
What kind of collision would cause hyperflexion
head on collision
What kind of collision would cause hyperextension
getting rear-ended
Paraplegia: 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.
Paraplegia
Cord injury which results in lower motor neuron deficit and loss of pain and temperature, with sparing of posterior column functions (proprioception, vibration)
Central cord syndrome
Common cause of central cord syndrome
hyperextension
Most common form of cervical spinal cord injury. It is characterized by loss of motion and sensation in arms and hands.
central cord syndrome
Loss of motor function, proprioception, and vibration sense on the side of injury. Loss of pain and temperature on the opposite side of injury.
brown sequard syndrome
Awareness of one’s body position
proprioreception
Mixed loss of voluntary motor activity and sensation below level of injury
incomplete injury
characterized by loss of motor function below the level of injury, loss of sensations carried by the anterior columns of the spinal cord (pain and temperature), and preservation of sensations carried by the posterior columns (fine touch, vibration and proprioception).
Anterior Cord Syndrome
caused by compression of posterior spinal after and is characterized by loss of proprioception, 2point discrimination, and stereognosis. motor function is preserved
Posterior Cord Syndrome
Ability to determine meaning or identity of an object by touch
stereogenesis
What can cause brown sequard
stabbing with ice pick of course
Loss of position sense, vibration, and pressure (May not have ability to walk) -
Motor function, pain and temperature sensation intact –KNOW
Posterior cord syndrome
Loss motor function below site of injury
Loss pain, temperature,& crude sensation
Anterior Cord Syndrome
Motor weakness
Upper extremities weaker than lower
Sensory function varies
Varying degrees bowel and bladder dysfunction
Central Cord Syndrome
-Transection/Damage of one side of spinal cord
Brown Sequard
-Transection/Damage of one side of spinal cord
Brown Sequard
IF injury above ___ need mechanical ventilation
C3
Initial period of flaccid paralysis and loss of sensation and reflexes
spinal shock
Traction:
Inspect skin under jacket for ______
Keep ______ _____ taped to jacket
breakdown
allen wrench
Loss of vasomotor tone & sympathetic innervation of heart
neurogenic shock
In neurogenic shock what is the skin like?
Warm and Dry
In neurogenic shock what is the heart rate like?
Brady
When a patient has neurogenic shock what is going on with their fluid volume?
Hypovolemia
What is done to manage hypovolemia in neurogenic shock?
Slowly and carefully replace fluids
In neurogenic shock what is going on with the patients vessels?
They are vasoconstricted
What kind of drug to a neurogenic shock patient to correct the blood vessels?
Vassopressor
What is a temperature goal for a neurogenic shock patient?
Maintain normothermia
Why is head of bed position in neurogenic shock?
To avoid orthostasis (keep HOB 10 degrees)
What is going on with a neurogenic shock patients bladder?
Urinary Retention
