NURS 2900 2920 Exam 3: ICP, CVA, TBI, Fractures,
SCI, Chest & Abdominal Trauma Questions with
Correct Answers
Spinal shock
-Complete but temporary loss of motor, sensory, reflex, and autonomic
function immediately after injury- lasts less than 48hrs- weeks
-s/s: flaccid, bradycardia, hypotension, paralytic ileus
Neurogenic shock
Circulatory failure caused by paralysis of the nerves that control the size
of the blood vessels, leading to widespread dilation; seen in patients with
spinal cord injuries.
Complete cord involvement
Total loss of sensory and motor function below level of injury
Incomplete cord involvement
-Mixed loss of voluntary motor activity and sensation and leaves some
tracts intact:
-Central cord syndrome
Brown-Sequard Syndrome
,Central Cord Syndrome
-Loss of function in upper extremities caused by injury to the middle
portion of the spinal cord
Brown-Sequard Syndrome
Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
Brown-Sequard Syndrome (Lateral Damage)
Results when only one side of the cord is damaged, as in a stabbing or
gunshot injury. Motor paralysis and deficits in kinesthesia and
proprioception occur below the level of injury, on the ipsilateral side.
Loss of pain, temperature, and touch sensation occurs on the
contralateral side.
dermatome
Area of skin supplied by a single spinal nerve
, SCI Clinical Manifestations: Respiratory
-Generally, the higher up, the more affected respiratory is and the more
support will be needed.
-C3 or above, need respiratory support/mechanical resp. b/c all resp.
function ceases
-C4, diaphragmatic need assistance breathing if phrenic nerve remains
intact
-Rest of cervical: loss of abdominal and intercostal muscle innervation,
deep breathing ability: complications: atelectasis and pneumonia
SCI Clinical Manifestations: Cardiovascular
At T5 or above, risk of neurogenic shock, leading to hypotension and
bradycardia
SCI Clinical Manifestations: Urinary
-Retention leads to infection
-Neurogenic bladder leads to urgency, frequency, incontinence or
inability to void
SCI Clinical Manifestations: GI
Above T5
-Decreased mobility leads to paralytic ileus and distention
-Stress ulcers from HCL acid
-Neurogenic bowel with loss to all or portions, associated with
incontinence, constipation, or both
-Autonomic dysreflexia: reaction by CV system to return of reflexes
after spinal shock. Massive vasoconstriction leads to profound HTN
(over 300 systolic), baroreceptors in carotid sinus stimulate
SCI, Chest & Abdominal Trauma Questions with
Correct Answers
Spinal shock
-Complete but temporary loss of motor, sensory, reflex, and autonomic
function immediately after injury- lasts less than 48hrs- weeks
-s/s: flaccid, bradycardia, hypotension, paralytic ileus
Neurogenic shock
Circulatory failure caused by paralysis of the nerves that control the size
of the blood vessels, leading to widespread dilation; seen in patients with
spinal cord injuries.
Complete cord involvement
Total loss of sensory and motor function below level of injury
Incomplete cord involvement
-Mixed loss of voluntary motor activity and sensation and leaves some
tracts intact:
-Central cord syndrome
Brown-Sequard Syndrome
,Central Cord Syndrome
-Loss of function in upper extremities caused by injury to the middle
portion of the spinal cord
Brown-Sequard Syndrome
Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
Brown-Sequard Syndrome (Lateral Damage)
Results when only one side of the cord is damaged, as in a stabbing or
gunshot injury. Motor paralysis and deficits in kinesthesia and
proprioception occur below the level of injury, on the ipsilateral side.
Loss of pain, temperature, and touch sensation occurs on the
contralateral side.
dermatome
Area of skin supplied by a single spinal nerve
, SCI Clinical Manifestations: Respiratory
-Generally, the higher up, the more affected respiratory is and the more
support will be needed.
-C3 or above, need respiratory support/mechanical resp. b/c all resp.
function ceases
-C4, diaphragmatic need assistance breathing if phrenic nerve remains
intact
-Rest of cervical: loss of abdominal and intercostal muscle innervation,
deep breathing ability: complications: atelectasis and pneumonia
SCI Clinical Manifestations: Cardiovascular
At T5 or above, risk of neurogenic shock, leading to hypotension and
bradycardia
SCI Clinical Manifestations: Urinary
-Retention leads to infection
-Neurogenic bladder leads to urgency, frequency, incontinence or
inability to void
SCI Clinical Manifestations: GI
Above T5
-Decreased mobility leads to paralytic ileus and distention
-Stress ulcers from HCL acid
-Neurogenic bowel with loss to all or portions, associated with
incontinence, constipation, or both
-Autonomic dysreflexia: reaction by CV system to return of reflexes
after spinal shock. Massive vasoconstriction leads to profound HTN
(over 300 systolic), baroreceptors in carotid sinus stimulate
