Spinal Cord Injury Overview

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Questions and Answers

What is a primary injury in the context of spinal cord injuries?

  • Ischemia causing nerve tissue destruction
  • Secondary effects due to drug use
  • Initial trauma to the spinal cord (correct)
  • Complications arising from spinal shock

Which of the following factors is not considered a risk factor for spinal cord injury?

  • Sex
  • Substance abuse
  • Age
  • Exercise frequency (correct)

Which condition is characterized by paralysis affecting the legs only?

  • Tetraplegia
  • Spinal shock
  • Neurogenic shock
  • Paraplegia (correct)

What describes the effects of neurogenic shock?

<p>Decreased blood pressure and cardiac output (B)</p> Signup and view all the answers

What is secondary injury typically a result of?

<p>Hypoxia and ischemia (C)</p> Signup and view all the answers

What is the most common cause of autonomic dysreflexia after spinal shock has resolved?

<p>Distended bladder (A)</p> Signup and view all the answers

Which intervention is most appropriate immediately when a patient is experiencing autonomic dysreflexia?

<p>Place the patient in a sitting position (D)</p> Signup and view all the answers

Which of the following statements about spinal shock is accurate?

<p>It is characterized by a sudden depression of reflex activity. (A)</p> Signup and view all the answers

Which of the following is NOT a potential complication associated with spinal cord injury?

<p>Chronic fatigue syndrome (A)</p> Signup and view all the answers

To improve mobility in patients with spinal cord injuries, which practice is recommended?

<p>Maintaining proper body alignment (C)</p> Signup and view all the answers

Flashcards

Spinal Cord Injury (SCI)

Damage to the spinal cord tissue, ranging from concussion to complete transection.

Primary SCI injury

Initial damage caused by the trauma itself.

Secondary SCI injury

Damage caused by factors like ischemia, hypoxia and hemorrhage, after the initial injury.

Incomplete SCI

Some nerve function remains below the injury level.

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Paraplegia

Paralysis affecting the legs.

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Spinal shock

A sudden decrease in reflex activity below the spinal cord injury level.

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Autonomic dysreflexia

A serious emergency caused by exaggerated autonomic responses in spinal cord injuries above T6.

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Autonomic dysreflexia trigger

Full bladder, constipation, or skin irritation are common causes.

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Autonomic Dysreflexia Intervention

Immediately sit patient, assess and relieve cause, empty bladder, and examine skin/rectum.

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Preventing Spinal Mobility Issues

Maintain proper body alignment, turn with support, passive range of motion, use brace if needed.

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Study Notes

Spinal Cord Injury (SCI) Overview

  • SCI results from trauma like concussion, contusion, laceration, compression, or transection of the spinal cord.
  • Primary injury is the immediate trauma.
  • Secondary injury, often from ischemia, hypoxia, and hemorrhage, damages nerve tissue further.
  • Treatment is needed to prevent initial damage from becoming permanent.
  • Injury severity is categorized as incomplete or complete.
  • Paraplegia affects legs; quadriplegia (tetraplegia) affects arms and legs.

Spinal Shock

  • Spinal shock is a sudden decrease in reflex activity below the injury level.
  • Symptoms include muscular flaccidity, loss of sensation, and absent reflexes.
  • This is a temporary phenomenon.

Neurogenic Shock

  • Neurogenic shock affects autonomic nervous system function below the injury.
  • Symptoms include decreased blood pressure, heart rate, and cardiac output.
  • Peripheral vasodilation leads to pooling of venous blood.
  • Skin in the affected areas loses sweating ability.

Complications of SCI

  • Venous thromboembolism (VTE): Blood clots.
  • Orthostatic hypotension: Low blood pressure when standing up.
  • Autonomic dysreflexia: Exaggerated autonomic nervous system response.
  • Pressure injuries: Bedsores.
  • Infections: Urinary, respiratory, or around surgical sites.

Improving Mobility

  • Maintain proper body alignment.
  • Move only as instructed and when spine is stable.
  • Perform passive range-of-motion exercises at least four times daily.
  • Use neck braces as prescribed.
  • Move slowly to an upright position.

Autonomic Dysreflexia (AD)

  • An acute emergency condition that occurs after spinal shock resolves.
  • Affects individuals with SC lesions above T6.
  • AD features exaggerated autonomic responses, and triggers include a full bladder, bowel issues, skin irritation.
  • Symptoms include severe headache, elevated blood pressure, profuse sweating, nausea, congestion, and bradycardia.

Autonomic Dysreflexia Interventions

  • Immediately sit the patient up to lower blood pressure.
  • Quickly identify and address the cause of the episode.
  • Empty the bladder with a urinary catheter.
  • Assess the rectum, skin, and other possible triggers.
  • Antihypertensives may be required.
  • Document the risk of AD in the medical record.
  • Educate patients on AD prevention and management strategies.

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