Spinal Shock vs Neurogenic Shock

Question 1

Manifests with:
1.decreased oxygen saturation, 
2.symptomatic bradycardia, 
3.decreased level of consciousness, 
4. decreased urine output,
and 
5.hypotension.

Answer 1

Neurogenic Shock

Question 2

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.

Answer 2

circulatory

size

vasodilation

Question 3

This is a Medical emergency;

It is a complete loss of all reflex, motor, sensory and autonomic activity below the lesion;

Answer 3

Spinal Shock

Question 4

temporary concussion like insult to the spinal cord that causes effect below the level of the injury

Answer 4

Spinal Shock

Question 5

Maldistribution of blood = ________ shock

Answer 5

neurogenic

Question 6

Low cardiac output + hypotension would be found in what type of shock? (inappropriate bradycardia, should be tachy in setting of hypotension)

Answer 6

neurogenic

Question 7

Located in the ventral (anterior) horn of the spinal cord or brain stem = ________ motor neuron

Answer 7

lower

Question 8

Hyporeflexia, decreased muscle tone, and muscle atrophy = _______ motor neuron

Answer 8

lower motor neuron

Question 9

Where is hyperflexion usually seen in the vertebrae

Answer 9

c5 and c 6

Question 10

What kind of collision would cause hyperflexion

Answer 10

head on collision

Question 11

What kind of collision would cause hyperextension

Answer 11

getting rear-ended

Question 12

Paraplegia: Paralysis of both legs

Injury to thoracolumbar region ___-___

Answer 12

T2 - L1

Question 13

• 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.

Answer 13

Paraplegia

Question 14

Cord injury which results in lower motor neuron deficit and loss of pain and temperature, with sparing of posterior column functions (proprioception, vibration)

Answer 14

Central cord syndrome

Question 15

Common cause of central cord syndrome

Answer 15

hyperextension

Question 16

Most common form of cervical spinal cord injury. It is characterized by loss of motion and sensation in arms and hands.

Answer 16

central cord syndrome

Question 17

Loss of motor function, proprioception, and vibration sense on the side of injury. Loss of pain and temperature on the opposite side of injury.

Answer 17

brown sequard syndrome

Question 18

Awareness of one’s body position

Answer 18

proprioreception

Question 19

Mixed loss of voluntary motor activity and sensation below level of injury

Answer 19

incomplete injury

Question 20

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).

Answer 20

Anterior Cord Syndrome

Question 21

caused by compression of posterior spinal after and is characterized by loss of proprioception, 2point discrimination, and stereognosis. motor function is preserved

Answer 21

Posterior Cord Syndrome

Question 22

Ability to determine meaning or identity of an object by touch

Answer 22

stereogenesis

Question 23

What can cause brown sequard

Answer 23

stabbing with ice pick of course

Question 24

Loss of position sense, vibration, and pressure (May not have ability to walk) -

Motor function, pain and temperature sensation intact –KNOW

Answer 24

Posterior cord syndrome

Question 25

Loss motor function below site of injury

Loss pain, temperature,& crude sensation

Answer 25

Anterior Cord Syndrome

Question 26

Motor weakness
Upper extremities weaker than lower
Sensory function varies
Varying degrees bowel and bladder dysfunction

Answer 26

Central Cord Syndrome

Question 27

-Transection/Damage of one side of spinal cord

Answer 27

Brown Sequard

Question 28

-Transection/Damage of one side of spinal cord

Answer 28

Brown Sequard

Question 29

IF injury above ___ need mechanical ventilation

Answer 29

C3

Question 30

Initial period of flaccid paralysis and loss of sensation and reflexes

Answer 30

spinal shock

Question 31

Traction:
Inspect skin under jacket for ______
Keep ______ _____ taped to jacket

Answer 31

breakdown

allen wrench

Question 32

Loss of vasomotor tone & sympathetic innervation of heart

Answer 32

neurogenic shock

Question 33

In neurogenic shock what is the skin like?

Answer 33

Warm and Dry

Question 34

In neurogenic shock what is the heart rate like?

Answer 34

Brady

Question 35

When a patient has neurogenic shock what is going on with their fluid volume?

Answer 35

Hypovolemia

Question 36

What is done to manage hypovolemia in neurogenic shock?

Answer 36

Slowly and carefully replace fluids

Question 37

In neurogenic shock what is going on with the patients vessels?

Answer 37

They are vasoconstricted

Question 38

What kind of drug to a neurogenic shock patient to correct the blood vessels?

Answer 38

Vassopressor

Question 39

What is a temperature goal for a neurogenic shock patient?

Answer 39

Maintain normothermia

Question 40

Why is head of bed position in neurogenic shock?

Answer 40

To avoid orthostasis (keep HOB 10 degrees)

Question 41

What is going on with a neurogenic shock patients bladder?

Answer 41

Urinary Retention