Spinal Cord Injury Quiz: Test Your Knowledge

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Questions and Answers

What type of stroke results from a blood vessel breaking open and causing blood to leak into the brain?

Transient ischemic attack

Stroke in evolution

Hemorrhagic stroke (correct)

Ischemic stroke

Which stage of stroke development involves progressive development of stroke symptoms over hours to days?

Transient ischemic attack

Completed stroke

Stroke in evolution (correct)

Acute stroke

What is the main nursing intervention during the acute stage of a stroke?

Immediate surgery

Encouraging early ambulation

Monitoring vital signs and neuro checks (correct)

Administration of antibiotics

Which diagnostic test can reveal lesion in the brain following a stroke?

CT and brain scan Signup and view all the answers

What is the physiopathological consequence of interrupting cerebral blood flow for 5 minutes or more?

Death of neurons with irreversible loss of function Signup and view all the answers

What are the typical signs of spinal shock that may be observed in a patient?

Flaccid paralysis Signup and view all the answers

What is a common cause of spinal cord injury?

Motor vehicle accidents Signup and view all the answers

Which technique can help decrease frustration in clients with expressive language deficits?

Listening and watching carefully Signup and view all the answers

In which type of spinal cord injury is visual neglect more common?

Left hemiplegics Signup and view all the answers

What is a key characteristic of sensory/perceptual deficits in left hemiplegics?

Impulsiveness Signup and view all the answers

Which is a common mechanism of spinal cord injury that involves a force exerted straight up or down the spinal column?

Axial loading Signup and view all the answers

What is the classification for spinal cord injury based on the location of the injury?

Level of injury Signup and view all the answers

What is the purpose of using cervical tongs (Crutchfield) in the medical management of spinal cord injuries?

To maintain cervical alignment and reduce the risk of further damage Signup and view all the answers

Which nursing intervention is crucial to prevent complications related to immobility in spinal cord injury patients?

Encouraging frequent changes in position Signup and view all the answers

Which of the following best describes a sign of spinal shock in a patient with a spinal cord injury?

Lack of temperature control Signup and view all the answers

In spinal cord injuries, what level of injury typically results in respiratory paralysis?

C1-C8 Signup and view all the answers

What is the primary cause of autonomic dysreflexia in spinal cord injury patients?

Overdistended bladder or bowel Signup and view all the answers

What difference distinguishes quadriplegia from paraplegia in spinal cord injuries?

Quadriplegia involves paralysis of all 4 extremities, while paraplegia involves the lower half of the body. Signup and view all the answers

What is the primary purpose of skeletal traction with halo traction in spinal cord injury management?

To maintain alignment and stabilize the spine Signup and view all the answers

What is the main characteristic of a complete cord transection in spinal cord injuries?

Absence of all reflexes below the level of injury Signup and view all the answers

What is the immediate intervention to alleviate autonomic dysreflexia in a patient with a spinal cord lesion above T6?

Raise the patient to a sitting position Signup and view all the answers

What is the rationale behind the immediate removal of fluid from the bladder in autonomic dysreflexia?

To prevent further sympathetic response Signup and view all the answers

Study Notes

Stroke Pathophysiology

Ischemic stroke: a blood vessel breaks open, causing blood to leak into the brain
Hemorrhagic stroke: blood flow is stopped for longer than a few seconds, causing brain cells to die and permanent damage
Brain cells can die, causing permanent damage, if blood flow is stopped for longer than 5 minutes

Stages of Stroke Development

Transient ischemic attack (TIA): a brief period of neurologic deficit, lasting less than 24 hours, with complete resolution of symptoms
Stroke in evolution: progressive development of stroke symptoms over a period of hours to days
Completed stroke: neurologic deficit remains unchanged for a 2- to 3-day period

Assessment of Stroke

Generalized signs: headache, vomiting, seizures, confusion, disorientation, decreased LOC, nuchal rigidity, fever, hypertension, slow bounding pulse, Cheyne-Stokes respirations
Focal signs: hemiplegia, sensory loss, aphasia, homonymous hemianopsia

Diagnostic Tests for Stroke

CT and brain scan: reveal lesion
EEG: abnormal changes
Cerebral arteriography: may show occlusion or malformation of blood vessels

Nursing Interventions for Stroke

Acute stage:
- Maintain patent airway and adequate ventilation
- Monitor vital signs, neuro checks, and observe for signs of increased ICP, shock, hyperthermia, and seizures
- Provide complete bed rest as ordered
- Maintain F&E balance and ensure adequate nutrition

Fracture Dislocation

May affect anterior and posterior ligaments, compression of spinal cord, and spinal cord and its roots
Concussion, contusion, compression, or laceration by fracture/dislocation, penetrating (e.g. GSW, missile)

Axial Loading

Fall from a height, landing on one's feet, is typical of this fracture
Axial loading applied to intravertebral disc results in increased pressure and stresses, causing a large central posterior-superior fragment

Pathophysiology of Spinal Cord Injury

Hemorrhage and edema → ischemia → necrosis and destruction of cord

Medical Management of Spinal Cord Injury

Immobilization and maintenance of normal spine alignment to promote fracture healing
Surgery: decompression laminectomy, spinal fusion

Assessment of Spinal Cord Injury

Spinal shock: temporary condition lasting from several days to 3 months, characterized by absence of reflexes below the level of lesion, flaccid paralysis, lack of temperature control, hypotension with bradycardia, retention of urine and feces
Level of injury:
- Quadriplegia: cervical injuries (C1-C8) → paralysis of all 4 extremities
- Paraplegia: thoracolumbar injuries (T1-L4) → paralysis of the lower half of the body involving both legs
Extent of injury:
- Complete cord transection: loss of all voluntary movement and sensation below the level of injury
- Incomplete lesions: varying degrees of motor or sensory loss between the level of the lesion, depending on which neurologic tracts are damaged and which are spared

Nursing Interventions for Spinal Cord Injury

Emergency care:
- Assess ABC, do not move patient during assessment
- Perform a quick head-to-toe assessment, check for LOC, signs of trauma, and leakage of fluid from ear
- Immobilize client
- Assist in immobilizing head and neck with cervical collar and place on spinal board
Acute care:
- Maintain optimum respiratory function
- Maintain optimal cardiovascular function
- Maintain fluid and electrolyte balance and nutrition
- Maintain immobilization and spinal alignment
- Prevent complications of immobility
- Maintain urinary elimination
- Maintain bowel elimination
- Monitor temperature control
- Observe for and prevent infection
- Observe for and prevent stress ulcers

Autonomic Dysreflexia

Rise in blood pressure, sometimes to fatal levels, in response to stimulation of the sympathetic nervous system
Occurs in clients with cord lesions above T6
Symptoms: severe headache, hypertension, bradycardia, sweating, goose bumps, nasal congestion, blurred vision, convulsions
Interventions: raise client to sitting position to decrease BP

Language Deficits

Left hemisphere dominance for language
Receptive: give simple, slow directions, give one command at a time, gradually shift topics, use nonverbal techniques of communication
Expressive: listen and watch carefully, anticipate client's needs, decrease frustration and feelings of helplessness, allow sufficient time for client to answer

Sensory/Perceptual Deficits

More common in left hemiplegics
Characterized by impulsiveness, unaware of disabilities, visual neglect
Interventions:
- Assist with self-care
- Provide safety measures
- Initially arrange objects in environment of unaffected side
- Gradually teach clients to take care of the unaffected side and to turn frequently and look at affected side

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Description

Test your knowledge on spinal cord injuries including fracture dislocation effects, compression, and associated forces. Explore the pathophysiology behind various types of spinal cord injuries.

Spinal Cord Injuries Quiz

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