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30 Cards in this Set
- Front
- Back
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Two biggest causes of spinal cord injuries
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MVAs
Falls |
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Primary & secondary damage from SCI
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Primary is from the actual injury
Secondary is caused by ischemia, hypoxia, micro-hemorrhage, and edema |
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when will the extent of injury be determined
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at least 72 hrs or more after the injury
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potentially life-threatening complication affecting up to 85% of SCI pts with injury at T6 or higher
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autonomic dysreflexia
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S/S of autonomic dysreflexia
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incr BP above level of injury
flushed face headache JVD decr HR incr sweating all above are from vasodilation above the level of injury pale cool no sweating all below the level of injury |
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common causes of autonomic dysreflexia
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restrictive clothing
pressure ulcers full bladder/UTI fecal impaction ingrown toenail |
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complete injury to what level of spinal cord will require total care and mechanical ventilation
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C1-C3 - "high quad"
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complete injury to what level of spinal cord will require some personal/mechanical assistance and some ventilatory assistance
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C4-C6
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incomplete injury to the spinal cord will cause what to happen
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mixed pattern of motor/sensory functions below the level of injury
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ED management of SCI
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ABCs
prevention of secondary injury - stabilization (cervical collar, long board), log rolling neuro exam - initial for baseline data diagnostic workup incl CT (procedure of choice), full spine X-ray, MRI, Myelogram administration of methylprednisolone |
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why is methylprednisolone given to someone w/SCI
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to improve blood flow and decrease edema of spinal cord
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complications of giving methylprednisolone to someone w/SCI
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increases blood sugar & risk for infection
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premature death in people w/an SCI is usually a result of
a. kidney failure b. compromised respiratory function c. sepsis |
b. compromised respiratory function
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How many pairs of spinal nerves are in the spinal cord?
a. 31 b. 12 c. 8 |
a. 31
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an area of skin supplied by the nerve fibers originating from a single nerve root is called
a. an innervated nerve b. a myotome c. a dermatome |
b. a myotome
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in adults, the spinal cord ends around the level of
a. T1 and T10 b. T11 and T12 c. T12 and L1 |
c. T12 and L1
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the degree of spinal cord involvement from an injury is classified as
a. partial or central b. incomplete or complete c. central or lateral |
b. incomplete or complete
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a patient who presents w/a motor deficit and sensory loss in the upper extremities is likely to have
a. central cord syndrome b. anterior cord syndrome c. Brown-Sequard syndrome |
a. central cord syndrome
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according the American Spinal Injury Association impairment scale, when no motor or sensory function is preserved in S4-S5, the injury is graded as
a. A=complete b. B=incomplete c. C=normal |
a. A=complete
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Which of the following is the most prominent event post-SCI?
a. petechial hemorrhage b. inflammation c. ischemia |
c. ischemia
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Which type of shock is caused by the sudden disruption of the sympathetic nervous system that occurs w/an SCI?
a. vasogenic spinal shock b. neurogenic shock c. spinal shock |
b. neurogenic shock
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Injuries to which of the following areas would result in total loss of respiratory function.
a. C1 - C3 b. the lumbar vertebrae c. the sacral vertebrae |
a. C1 - C3
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which of the following respiratory complications is the second-leading cause of death in patients w/an SCI w/in the 1st year of injury?
a. atelectasis b. pulmonary embolism c. bacterial infection |
b. pulmonary embolism
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autonomic dysreflexia presents as
a. dramatic rise in BP b. dramatic drop in BP c. severe bradycardia |
a. dramatic rise in BP
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Oxybutynin (Ditropan) is used to
a. decrease spastic contraction of the bladder b. increase spastic contraction of the bladder c. stimulate peristalsis in the bowel |
a. decrease spastic contraction of the bladder
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Baclofen (Lioresal) may be ordered to
a. increase contraction of the muscles b. reduce muscle spasticity c. control pain |
b. reduce muscle spasticity
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If autonomic dysreflexia occurs, which of the following interventions should be used
a. lower HOB b. raise HOB c. place an abdominal binder on pt |
b. raise HOB
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which of the following diagnostic tests can detect abnormalities like blockage & infection in the spinal canal structures?
a. CT b. MRI c. myelography |
c. myelography
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after applying additional weight to the patient in skeletal traction, which diagnostic test should be ordered?
a. lateral X-ray b. CT c. MRI |
a. lateral X-ray
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skeletal traction is used for a pt w/an SCI primarily to
a. immobilize him b. properly align his spine c. decrease pressure to his spine |
b. properly align his spine
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