Neuro: SCI

Question 1

explain spinal shock

Answer 1

transient flaccid period
areflexia, loss of voluntary motor, sensory function after cord is injured

Question 2

what is an important prognostic indicator after end of spinal shock

Answer 2

motor and sensory function

Question 3

bowel and bladder are what spinal levels

Answer 3

S2-S4

Question 4

UMN neurogenic (Reflexive) bowel

Answer 4

Intact reflex center → pt cant control it voluntarily

Suppository insertion then digital stim to reflexively empty

Constipation

Increased sphincter tone

Question 5

LMN flaccid (areflexive) bowel:

Answer 5

Non intact reflex center
Manual evacuation

Question 6

what is a high risk for LMN flaccid bowel

Answer 6

High risk of constipation and incontinence b/c no reflexive emptying

Question 7

UMN- neurogenic (reflexive) bladder

Answer 7

Unable to empty

Bladder program: intermittent catheterization (fluid monitored), foley catheter, suprapubic catheter

Bladder can reflexively contract but pt cant control urination voluntarily

Issues: urinary retention, reflex voiding, UTI risk, bladder spasm

Question 8

why is fluid intake monitored for bladder dysfunctions

Answer 8

Fluid intake is monitored to control bladder volume

Question 9

LMN: flaccid (areflexive) bladder what type of incontinece

Answer 9

Bladder empties as it fills - overflow incontinence

Question 10

what is the LMN: flaccid (areflexive) bladder bladder program

Answer 10

timed voids - fluids monitored

Question 11

what is the bladder program for UMN- neurogenic (reflexive) bladder

Answer 11

Bladder program: intermittent catheterization (fluid monitored), foley catheter, suprapubic catheter

Question 12

sexual dysfunction female vs males

LMN vs UMN

Answer 12

Males have lower fertility rates
UMN: can generate erection - reflexogenic erections
LMN: unable to generate erection
Female fertility rate unaffected

Question 13

pressure relief

Answer 13

turn every 2 hrs in bed, weight shifts every 30 mins for 2 minutes in WC

Question 14

contractures common location

Answer 14

hip
knees
elbows

Question 15

autonomic dysreflexia affects who

Answer 15

injury T6 and above

Question 16

autonomic event that can occur due to disconnection between brain and sympathetic neurons in the thoracolumbar spine

Answer 16

autonomic dysreflexia

Question 17

autonomic dysreflexia signs and symptoms

Answer 17

BP elevation (20 mmHg or more above normal) with bradycardia

severe HA

skin flushing above lesion

sweating or piloerection above lesion

anxiety

paresthesias in head, neck, upper chest

visual changes

nasal congestion

Question 18

common causes of AD

Answer 18

bladder distension
constipation/impaction
skin issues

Question 19

AD caused by noxious stimulus ___ the level of injury

Answer 19

below

Question 20

AD action steps if AD is suspected

Answer 20

sit pt upright in w/c or raise bed to 90 degrees, lower legs

remove compression garments

check foley

ask last time intermittent cath

bowel program?

loosen tight clothes

consider skin issues

call 911!!!

Question 21

higher lesions interrupt innervation to mms involved in both

Answer 21

inhalation and exhalation

Question 22

lower lesions leave most of the mms of inhalation intact, but interfere with functioning of mms used to

Answer 22

force exhalation

Question 23

most common cause of death following SCI

Answer 23

pneumonia

Question 24

if loss of abdominal musculature, pt breathe easier in what position

Answer 24

supine

Question 25

common cause of mortality in people with SCI ___ due to?

Answer 25

CVD sedentary, higher body fat, increased diabetes

Question 26

signs of PE

Answer 26

chest pain SOB tachycardia sweating apprehension fever cough