Autonomic Dysreflexia Flashcards
What is the autonomic dysreflexia
is a condition that emerges after a spinal cord injury, usually when the damage has occurred above the T6 level. Higher and complete spine inj have higher risk Dysregulation of the autonomic nervous system leads to an uncoordinated sympathetic response that may result in a potentially life-threatening hypertensive ( more than 25 at least above the baseline significant is 40 above the pt baseline or simply 150 ) episode when there is a noxious stimulus below the level of the spinal cord injury.- it’s happening after the spinal shock, writhing 1 year after the inj
What is the stimulus of autonomic dysreflexia
about 85% of cases, this stimulus is from a urological source such as a UTI, a distended bladder, or a clogged Foley catheter. There is a significantly increased risk of stroke by 300% to 400%.
What is the sign and symptoms of autonomic dysreflexia?
It is usually accompanied by a severe headache, bradycardia, and facial flushing, along with pallor, cold skin, and sweating in the lower part of the body.
The initial presenting complaint is usually a severe headache, typically described as throbbing. Susceptible individuals, usually with spinal cord lesions at or above T6, who complain of a severe headache should immediately have their blood pressure checked. If elevated, a presumptive diagnosis of autonomic dysreflexia can be made
What is another name of autonomic dysreflexia
It is also sometimes known as autonomic hyperreflexia, hypertensive autonomic crisis, sympathetic hyperreflexia, autonomic spasticity, paroxysmal hypertension, mass reflex, and viscero-autonomic stress syndrome. (Autonomic dysfunction, autonomic neuropathy, and dysautonomia refer to general dysfunction of the autonomic nervous system, which is a distinctly different entity.)
Pr has spinal inj at T6 or above , and now he complain of sever headache, what is the first thing you gonna do ?
Immediately check his BP if high that mean he has AD ~~> irrigate or change the fomey cath
What is the pathophysiology of autonomic dysreflexia ?
Cutaneous or visceral stimulation below the level of the injury initiates afferent impulses to the intermediolateral grey
columns of the spinal cord that elicit abnormal reflex sympathetic nervous system activity from T6 to L2. The
sympathetic response is exaggerated due to a lack of compensatory descending parasympathetic stimulation and
intrinsic post-traumatic hypersensitivity. This leads to diffuse vasoconstriction, typically to the lower two-thirds of the
body, and a significant rise in blood pressure despite maximum parasympathetic vasodilatory efforts above the level of
injury.
Dose the autonomic dysreflexia can happend in ot has inj below T10 ?
Spinal cord injuries below T10 rarely result in autonomic dysreflexia because the splanchnic innervation remains intact
and allows for compensatory parasympathetic dilation of the splanchnic vascular network.[16] Detrusor sphincter
dyssynergia is common in patients with spinal cord injuries at risk for autonomic dysreflexia. Such patients would have
lesions at or above T6 and void only in small amounts.
