Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adult Health l > Problems of the CNS: The Spinal Cord > Flashcards

Problems of the CNS: The Spinal Cord Flashcards

(74 cards)

Start Studying
1
Q

What is lumbosacral back pain (Low Back Pain)

A

Herniated nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are preventative measures

A 
Good posture
Proper lifting
Exercise
Ergonomics 
Equipment that can be used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are nonsurgical management

A 
Positioning
Drug therapy
Heat therapy
Physical therapy
Weight control
Complementary and alternative therapies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Minimally invasive surgery

A

Percutaneous lumbar diskectomy
Thermodiskectomy
Laser-assisted laparoscopic lumbar diskectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Conventional open surgical procedures

A

Diskectomy
Laminectomy
Spinal fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Postoperative care

A 
Prevention/assessment of complications
Neurologic assessment; vital signs
Patient’s ability to void
Pain control
Wound care
CSF check
Patient positioning/mobility
Discharge teaching
(Home care management
Community resources)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cervical neck surgical management

A

Anterior cervical diskectomy

Fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Spinal cord secondary injuries

A 
Hemorrhage
Metabolic (Inflammatory Processes)
Cellular changes
Vasoconstriction/Thrombosis
Vasospasms/Edema
Decreased spinal cord blood flow
Spinal cord ischemia and hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Spinal cord injuries

A

Hyperflexion
Hyperextension
Axial loading or vertical compression (e.g., caused by jumping)
Excessive head rotation beyond its range
Penetration (e.g., caused by bullet or knife)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Frequently seen at C5 & C6
Deceleration motion
Head-on collisions

A

HYPERFLEXION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperflexion results in

A

Compression of cord from fractures

Rupture or tearing of muscles or ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Back and downward motion of the head
Rear-end collisions (Whiplash)
Diving accidents

A

HYPEREXTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperextension results in

A

Spinal cord is stretched and distorted resulting in contusion or ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Displacement of spinal column
Tearing of the posterior ligaments & displacement of the spinal column
Occurs along with extension flexion injuries

A

ROTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rotation results in

A

May disrupt ligaments, vessels, tissue, bone, and related organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vertical force on cord
Long fall landing on feet or buttocks
Burst fractures (Bony fragments into spinal canal)

A

Axial Loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Axial loading results in

A

vertical compression that may result in such force on the vertebral body to cause a “burst” fracture with fragments that impinge upon the cord.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Knife or Gun shot wounds

Cut cord

A

PENETRATING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Penetrating results in

A

May partially or completely severe the vertebra, cord, ligaments, and blood supply or indirectly cause injury by heat or shock wave.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Total loss of sensory and motor function below level of injury

A

Complete injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of complete injury

A

Tetraplegia (Quadriplegia)

Paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Paralysis of both arms and legs
Injury to cervical region C1-C8
Airway management
Paralysis of diaphragm if injury above C3
Requires wheelchair with breath, head or shoulder control

A

Tetraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Paralysis of both legs
Injury to thoracolumbar region T2-L1
May have full use of arms
May require wheelchair or have some limited use lower extremities
May have some respiratory compromise (varying degrees of intercostals and abdominal muscle paralysis

A

Paraplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mixed loss of voluntary motor activity and sensation below level of injury

A

Incomplete Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Types of incomplete injuries
Brown-Sequard Syndrome Central Cord Syndrome Anterior Cord Syndrome Posterior Cord Syndrome
26
Transection/Damage of one side of spinal cord
Brown-Sequard
27
Below injured site cord Loss voluntary motor function (same side as Injury) Loss of pain, temperature, & sensation (opposite side of injury)
Brown-Sequard
28
Associated with cervical flexion/extension injury | Hematoma formation in center of cervical cord
Central Cord Syndrome
29
``` Motor weakness (upper extremities weaker than lower) Sensory function varies Varying degrees bowel and bladder dysfunction ```
Central Cord Syndrome
30
Acute compression of anterior portion of spinal cord | Associated with flexion injuries or acute herniation of an intervertebral disc
Anterior Cord Syndrome
31
Loss motor function below site of injury | Loss pain, temperature,& crude sensation
Anterior Cord Syndrome
32
Associated with cervical hyperextension injury | Damage to the posterior column
Posterior Cord Syndrome
33
Loss position sense, vibration, and pressure (May not have ability to walk) Motor function, pain and temperature sensation intact
Posterior Cord Syndrome
34
Assessment findings of injures
Pain at level of injury Numbness/weakness, loss of sensation below level of injury Complete/incomplete Respiratory distress Alterations in bowel and bladder function Alterations in temperature control
35
Initial period of flaccid paralysis and loss of sensation and reflexes Lasts between 48 hrs to several weeks
Spinal shock
36
Occurs within days to weeks | Hyperreflexic and spastic
Muscle spasms
37
Nursing Diagnosis for spinal cord injuries
Respiratory Circulation (CO, Tissue Perfusion, Dysrhythmias, Emboli) Skin Integrity
38
Airway management of spinal cord injuries
Goal: Maintain patent airway If unresponsive insert oral airway, keeping neck in neutral position Jaw thrust method to open airway Provide oxygen/ventilator IF injury above C3 need mechanical ventilation Monitor ABG’s, suction prn
39
Circulation management of spinal cord injuries
Cardiac output: Sympathetic nervous system interrupted Loss of vasomotor response Blood vessels cannot constrict (Hypotension, venous pooling, decreased CO) Tissue perfusion: Orthostatic hypotension, DVT prophylaxis Loss of thermoregulation
40
Cervical immobilization of spinal cord injuries
Immobilize and stabilize in neutral position Sandbags, cervical collars, and backboards Body should be correctly aligned, log roll
41
Surgical stabilization of cervical immobilization
Laminectomy, Spinal fusion, Rods
42
Spinal cord injury management
Cervical traction using skull tongs Traction provided by pulley system and weights Cleanse pin sites twice a day Halo traction
43
Halo vest management
Cervical traction using specially designed jacket Allows greater mobility Inspect skin under jacket for breakdown Keep Allen wrench taped to jacket Body shells for stable thoracolumbar injuries
44
Management of cord edema
``` Corticosteroids High dose Methylprednisolone IV Administer within 8 hours of injury Start bolus, then, continuous drip for 24-48 hours Complications from this therapy? ```
45
What is neurogenic shock
Loss of vasomotor tone & sympathetic innervation of heart Hypovolemia, vasodilitation, ↓SVR, ↓Venous Return, ↓Stroke Volume, ↓CO, ↓Preload, Inhibited Baroreceptor response Blood vessels unable to constrict Low HR Poikilothermic Skin warm & dry
46
Neurogenic shock management
Careful fluid resuscitation Vasopressors Maintain normothermia Position to avoid orthostasis
47
Spinal cord injury nursing goals
Altered elimination pattern Bladder Retention urine due to loss of autonomic and reflex control of bladder and sphincter. Results in over-distention and may reflux into kidney Bowel Prevent spasms
48
Management of altered elimination pattern (initial)
indwelling catheter
49
Management of altered elimination pattern (long term)
intermittent catheterization
50
How to prevent UTI's
cranberry, apple, and grape juice
51
Management of bowel
Constipation due to loss of voluntary and involuntary evacuation.
52
How to prevent bowel problems
``` Scheduled bowel program Encouraging food high in fiber Increase fluid intake Suppository and stool softeners Digital stimulation for UMN injuries Enemas ```
53
How to relieve spasms
warm baths, muscle relaxants, antispasmodics
54
How to prevent contractures and decubiti
Turn Q2h OOB to Chair ASAP Specialty beds that provide side-to-side lateral rotation
55
How to prevent DVTs
anitcoagulants
56
Complications
Autonomic Dysreflexia/Hyperflexia
57
Exaggerated autonomic response to stimuli resulting in profound hypertension Occurs mostly in tetraplegics
Autonomic Dysreflexia/Hyperflexia
58
Autonomic Dysreflexia/Hyperflexia is caused by
Distended bladder or rectum | Stimulation of skin, pain
59
A condition where the blood pressure in a person with a spinal cord injury (SCI) above T5-6 becomes excessively high due to the over activity of the Autonomic Nervous System.
Autonomic Dysreflexia, also known as Hyperreflexia
60
Autonomic Dysreflexia is usually caused when
a painful stimulus occurs below the level of spinal cord injury. The stimulus is then mediated through the Central Nervous System (CNS) and the Peripheral Nervous System (PNS).
61
Autonomic Dysreflexia/Hyperreflexia findings
``` Severe HTN (SBP may be 300) Bradycardia Severe HABlurred vision Nausea, Restlessness Skin Flushed above injury, Pale below Distended bladder, bowel ```
62
Priority Problems for Long-Term Management
Difficulty breathing Impaired physical mobility (safety) Spastic or flaccid bladder and bowel Impaired adjustment
63
Types of spinal cord tumors
Primary Intramedullary Extramedullary
64
Surgical management
emergency surgery
65
Nonsurgical management
radiation, chemotherapy
66
Autoimmune disorder characterized by plaque in the white matter of the CNS
Multiple Sclerosis
67
Types of Multiple Sclerosis
Relapsing-remitting Primary progressive Secondary progressive Progressive-relapsing
68
MS risk factors & triggers
``` Viruses or infectious agents Cold climate Physical injury Emotional stress Pregnancy Overexertion Temperature extremes Hot shower/bath ```
69
MS symptoms
``` Fatigue Pain or paresthesia Diplopia Tinnitus Dysphagia Muscle spasticity Ataxia Bladder dysfunction ```
70
Medications to treat medications
``` Immunosuppressive agents (Azathioprine & cyclosporine) Corticosteroids (Prednisone) Immunomodullators (Interferon beta) Anticonvulsants (Carbamazepine) Antispasmodics (Dantrolene, baclofen) ```
71
``` Lou Gehring’s disease Progressive motor neuron disease Upper & lower motor neurons Destruction of motor neurons Brain Anterior gray horns of the spinal cord Sensory pathways not effected Etiology unknown ```
Amytrophic Lateral Sclerosis (ALS)
72
ALS findings
``` Muscle weakness, wasting, atrophy Muscle spasticity & hyperreflexia Fasciculations Brain stem signs (Dysarthria, dysphagia) Dyspnea, respiratory paralysis Fatigue ```
73
How to diagnosis ALS
``` History Neuro exam Electromyogram (EMG) CPK elevated Muscle biopsy ```
74
Management of ALS
No known cure Riluzole (slows the progression, hepatotoxic risk) Anti-spasmodics Physical therapy, Speech therapy, Occupational therapy Nutrition Enteral feedings Monitor for progression (Airway, trach, home vents) Counseling, support groups End of life discussions

Adult Health l (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions