Why did Allen's heart rate and blood pressure fall in this time of emergency (at a time when you'd expect just the opposite homeostatic response? Correct Answer-+Blood loss: however with this heart rate should increase to try to elevate B/P
+Injury above T-6 decreases the influence of the sympathe...
N205 Spinal Injury Case Study
Why did Allen's heart rate and blood pressure fall in this time of
emergency (at a time when you'd expect just the opposite homeostatic
response? Correct Answer-+Blood loss: however with this heart rate
should increase to try to elevate B/P
+Injury above T-6 decreases the influence of the sympathetic nervous
system which results in bradycardia, peripheral vasodilation and
decreased cardiac output.
+Paralysis and loss of sensation indicates damage to spinal cord.
+This results in spinal shock
Sympathetic motor neurons exit the cord from T 1- L 2 Correct Answer-
+Damage above results in loss of stimulation to heart to increase rate
and strength of contractions and loss of ability to vasoconstrict. B/P can
drop below 40 mm Hg.
+Gradually autonomic and somatic reflexes return as lower motor
neurons regain their excitability but may become exaggerated
Upon admission to the hospital, Allen's breathing was rapid and shallow.
Can you explain this? Correct Answer-+C 3-5 supply the diaphragm
+T 1-12 supply external intercostal muscles
+The rapid breathing is an attempt to compensate for shallow breathing.
Why did Allen lose some sensation in his arms and all sensation from
the upper trunk down? Correct Answer-+The spinothalamic tracts and
dorsal columns tract were damaged bilaterally at about C-5 segment.
, spinothalamic tract Correct Answer-transmits to brain about pain,
temperature and crude touch to skin
Dorsal columns tract Correct Answer-transmits to brain about touch,
vibration and proprioception on the skin
Why did Allen have dry skin and a fever upon admission to the hospital?
Correct Answer-The spinal shock and resultant loss of sympathetic
motor neuron stimulation to the sweat glands makes it difficult to sweat
and release heat produced by the body
Based upon the physical exam findings, which vertebral bone do you
think was fractured? Correct Answer-+Sensory and respiratory findings
suggest C 5 segment of the spinal cord was damaged
+Can raise shoulders: C 3 and C 4 segments (supply trapezius muscles)
intact.
+Unable to raise arms against gravity: weakness of deltoid supplied by C
5 and C 6
+This suggests incomplete lesion to C 5 and/or C 6 ( areas where the
lower motor neurons located.
Skeletal muscles Correct Answer-+not receiving lower motor neuron
impulses, can't contract and are flaccid
+Triceps and wrist reflexes along with absent lower torso and extremity
reflexes are consistent with spinal shock.
+All this suggests injury at about C 5 segment
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