Podcast
Questions and Answers
What type of injury is classified as a primary neurologic injury?
What type of injury is classified as a primary neurologic injury?
What is spinal shock characterized by?
What is spinal shock characterized by?
Which demographic is most affected by spinal cord injuries?
Which demographic is most affected by spinal cord injuries?
Which of the following is a potential consequence of secondary injury following a spinal cord injury?
Which of the following is a potential consequence of secondary injury following a spinal cord injury?
Signup and view all the answers
What type of injury is characterized by direct trauma, such as from a penetrating object?
What type of injury is characterized by direct trauma, such as from a penetrating object?
Signup and view all the answers
What occurs during a secondary injury in spinal cord injury (SCI)?
What occurs during a secondary injury in spinal cord injury (SCI)?
Signup and view all the answers
Which of the following statements accurately describes complete spinal cord injury?
Which of the following statements accurately describes complete spinal cord injury?
Signup and view all the answers
What phenomenon can contribute to further damage during spinal cord injury?
What phenomenon can contribute to further damage during spinal cord injury?
Signup and view all the answers
Which condition results from damage to the anterior section of the spinal cord?
Which condition results from damage to the anterior section of the spinal cord?
Signup and view all the answers
What can occur as a vascular response to spinal cord injury that may worsen damage?
What can occur as a vascular response to spinal cord injury that may worsen damage?
Signup and view all the answers
What is a likely consequence of an injury located between C4 and C6?
What is a likely consequence of an injury located between C4 and C6?
Signup and view all the answers
Which spinal cord injury classification suggests temporary total loss of function below the injury?
Which spinal cord injury classification suggests temporary total loss of function below the injury?
Signup and view all the answers
Which nerve is primarily responsible for innervating the diaphragm?
Which nerve is primarily responsible for innervating the diaphragm?
Signup and view all the answers
What is a symptom associated with a spinal cord injury at the C7/T1 level?
What is a symptom associated with a spinal cord injury at the C7/T1 level?
Signup and view all the answers
Neurogenic shock occurs primarily due to the loss of which system's function?
Neurogenic shock occurs primarily due to the loss of which system's function?
Signup and view all the answers
What type of paralysis results from injuries below C5?
What type of paralysis results from injuries below C5?
Signup and view all the answers
Which injury results in complete irreversibility at the time of occurrence?
Which injury results in complete irreversibility at the time of occurrence?
Signup and view all the answers
What is a common characteristic of flaccid paralysis?
What is a common characteristic of flaccid paralysis?
Signup and view all the answers
What is the primary motor function lost with Central Cord Syndrome?
What is the primary motor function lost with Central Cord Syndrome?
Signup and view all the answers
In Brown-Sequard Syndrome, what type of sensory function is lost on the same side as the damage?
In Brown-Sequard Syndrome, what type of sensory function is lost on the same side as the damage?
Signup and view all the answers
Which of the following is NOT a diagnostic test for spinal cord injuries?
Which of the following is NOT a diagnostic test for spinal cord injuries?
Signup and view all the answers
What triggers Autonomic Dysreflexia in individuals with spinal cord injury above T6?
What triggers Autonomic Dysreflexia in individuals with spinal cord injury above T6?
Signup and view all the answers
What happens to pain and temperature sensations in Brown-Sequard Syndrome?
What happens to pain and temperature sensations in Brown-Sequard Syndrome?
Signup and view all the answers
Which area of the body is more affected in Central Cord Syndrome?
Which area of the body is more affected in Central Cord Syndrome?
Signup and view all the answers
What is a common cause of Autonomic Dysreflexia?
What is a common cause of Autonomic Dysreflexia?
Signup and view all the answers
What does Central Cord Syndrome primarily damage?
What does Central Cord Syndrome primarily damage?
Signup and view all the answers
What is the primary vasculature effect observed below the level of a spinal cord injury?
What is the primary vasculature effect observed below the level of a spinal cord injury?
Signup and view all the answers
Which symptom is commonly associated with autonomic dysreflexia in patients with spinal cord injuries above T6?
Which symptom is commonly associated with autonomic dysreflexia in patients with spinal cord injuries above T6?
Signup and view all the answers
Which of the following is an acute emergency condition that can occur after spinal shock?
Which of the following is an acute emergency condition that can occur after spinal shock?
Signup and view all the answers
What is the expected heart rate condition associated with the parasympathetic response to high blood pressure in autonomic dysreflexia?
What is the expected heart rate condition associated with the parasympathetic response to high blood pressure in autonomic dysreflexia?
Signup and view all the answers
Which of the following complications is a high risk for patients with spinal cord injuries due to immobility?
Which of the following complications is a high risk for patients with spinal cord injuries due to immobility?
Signup and view all the answers
Cool and clammy extremities are indicative of which vascular condition post-spinal cord injury?
Cool and clammy extremities are indicative of which vascular condition post-spinal cord injury?
Signup and view all the answers
Which symptom may indicate that a patient with a spinal cord injury is experiencing autonomic dysreflexia?
Which symptom may indicate that a patient with a spinal cord injury is experiencing autonomic dysreflexia?
Signup and view all the answers
What could be a potential issue for patients with C4/C5 spinal injuries regarding autonomic dysreflexia?
What could be a potential issue for patients with C4/C5 spinal injuries regarding autonomic dysreflexia?
Signup and view all the answers
Study Notes
Spinal Cord Injuries
- Spinal cord injuries (SCIs) are categorized as either primary or secondary.
- The initial injury is considered the primary injury which is irreversible.
- Secondary injury is caused by factors such as inflammation, ischemia, and hemorrhage which are reversible.
- SCIs are more common in males and individuals under 30 years of age.
- Risk-taking behavior and drug or alcohol use can be contributing factors.
Causes
- Direct injury: direct trauma to the spinal cord, often from penetrating trauma, which is less common
- Indirect injury: caused by flexion, extension, or rotational injuries, leading to vertebral fractures, subluxations, or dislocations.
Manifestations of SCI
- Contusion: Bruising of the spinal cord, potentially leading to infarctions.
- Compression: Pressure on the spinal cord.
- Infarction: Lack of blood flow to the spinal cord, causing cell death.
- Laceration: A cut or tear in the spinal cord.
- Transection: Complete severance of the spinal cord.
- Tetraplegia: Paralysis in both arms and legs often associated with injuries above C4-C6.
- Paraplegia: Paralysis in the legs and lower body, usually associated with injuries below C4-C6.
Spinal Shock vs. Neurogenic Shock
-
Spinal Shock:
- Transient state (days to weeks) that occurs immediately after a spinal cord injury.
- Characterized by temporary loss of all voluntary and reflex activity below the level of injury.
- May involve loss of deep tendon reflexes (DTRs).
- Symptoms include flaccid paralysis, loss of sensation, and bowel dysfunction.
-
Neurogenic Shock:
- Occurs only with SCIs above T6.
- A type of circulatory shock caused by loss of autonomic nervous system (ANS) function.
- Characterized by loss of sympathetic nervous system (SNS) control.
Pathology
-
Primary Injury (Irreversible):
- Occurs at the time of the mechanical injury.
- Includes small hemorrhages in the grey matter of the spinal cord, edema in the white matter, and eventual necrosis of neural tissue.
-
Secondary Injury (Reversible):
- Occurs due to secondary inflammatory processes.
- Involves the spread of damage from the initial injury to surrounding neurons and white matter.
- Can lead to further damage from factors such as inflammation, excitotoxicity, ischemia, hemorrhage, and hypoxia.
Diagnostic Tests
- Spine X-rays: Assess for fractures.
- CT scan: Identifies fractures and other structural abnormalities in the spinal cord.
- MRI: Provides detailed imaging of the spinal cord, encompassing soft tissue injuries.
- Physical Examination: Neurological assessments to pinpoint the specific level and type of injury.
Concerns & Complications after SCI
- Hypotension and Bradycardia: Low blood pressure and slow heart rate due to the loss of sympathetic nervous system control.
- Pulmonary Embolism: Blood clot in the lungs, which can occur due to immobility.
- Peripheral Edema: Swelling of the extremities due to vascular dysfunction.
- Infections: Susceptibility to urinary tract infections ( UTIs), pneumonia, wound infections, and sepsis.
- Skin Breakdown: Pressure ulcers due to immobility and impaired circulation.
- Bowel, Bladder, Sexual Dysfunction: Caused by damage to the nerves controlling these functions.
- Poikilothermia: Inability to regulate body temperature.
- Autonomic Dysreflexia: Acute emergency condition that occurs after spinal shock, often with lesions above T6.
Autonomic Dysreflexia
- Occurs after the initial spinal shock period and can manifest even years after the initial injury.
- Triggered by a variety of stimuli such as:
- A full bladder
- Constipation
- Ingrown toenails
- The triggering stimulus initiates an exaggerated SNS response, causing vasoconstriction.
- This leads to increased blood pressure, a flushed face (vasodilation above the level of injury), cool clammy extremities (vasoconstriction below the level of the injury), and a headache.
Autonomic Dysreflexia (Clinical Manifestations)
- Severe headache
- Facial flushing
- Cool and clammy skin below the injury
- Nasal stuffiness
Autonomic Dysreflexia (Nursing Considerations)
- Nurse must recognize the signs of autonomic dysreflexia.
- Immediate intervention is crucial to prevent complications.
- Prompt assessment of the triggering stimulus to address the underlying issue.
- Cautious care for patients with C4/C5 spinal injuries, as they may struggle to communicate their headache due to speech difficulties.
SCI Injury Levels - Manifestations correlate to the level of injury and affect all levels below the injury
- Level of Injury C3 and Above: Loss of diaphragm function, requiring a mechanical ventilator.
- Level of Injury C4: Impaired breathing.
- Level of Injury C5: Difficulty with deep breathing and coughing.
-
Level of Injury C7/T1:
- The patient will be conscious and able to breathe.
- They will be unable to move their arms or legs.
SCI Classification: Complete vs. Incomplete
-
Complete Injury:
- Loss of all motor and sensory function below the level of injury, including bowel and bladder control.
- No movement, sensation of touch, sharp/dull, hot/cold, light/deep touch, vibration, or position sense.
-
Incomplete Injury:
- Preserves some motor or sensory function below the level of injury.
- Different types of incomplete injuries can lead to variations in motor and sensory function.
SCI Injury Types
- Anterior Cord Syndrome: Damage to the anterior section of the cord, affecting motor function but preserving touch and sensation.
- Central Cord Syndrome: Damage to the axons near the grey matter, primarily affecting the arms more than the legs.
- Brown-Sequard Syndrome: Damage to one side of the cord, resulting in motor function loss on the same side and loss of pain and temperature sensation on the opposite side.
What Nerves Innervate the Diaphragm?
- The phrenic nerve innervates the diaphragm.
- It originates from the cervical nerves, typically C3-C5.
- A C4 injury allows breathing but may impair coughing.
- C5 and below injuries will see deep breathing and coughing are less impaired.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the essential aspects of spinal cord injuries, including their classification into primary and secondary types. It explores the causes, manifestations, and risk factors associated with SCIs, particularly in different demographics. Test your knowledge on the implications and understanding of spinal cord injuries.
