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213 > Spinal Cord Injury Med Surg Book > Flashcards

Spinal Cord Injury Med Surg Book Flashcards

1
Q

Average age of Sci

A

16-18 yr old men

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2
Q

SCI risk factors

A

High risk physical activities, substance use, not using protective gear in sports. Falls, especially in old age

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3
Q

Most common SCI injure locations

A

C4,C5,C6,T12

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4
Q

Most common causes of SCI

A

Mostly auto motive accidents (56%). Falls, acts of violence, sports

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5
Q

How are SCI divided into?

A

Complete and incomplete injuries

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6
Q

A complete SCI

A

Total loss of motor and sensory function below level of injury

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7
Q

Incomplete SCI

A

Incomplete structural damage with some function below injury.

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8
Q

Central cord syndrome

A

Most common incomplete SCI. Hyperextension injury with central cord swelling

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9
Q

Central cord syndrome clinical manifestation

A

Functional motor loss greater in arms than legs, bladder dysfunction, variable loss in sensation.

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10
Q

Anterior cord syndrome

A

Anterior compression from bony fragments or disk herniation

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11
Q

Anterior cord syndrome clinical manifestation

A

Loss of motor function, pain, temp, crude touch and pressure, below level of I jury, preserved sense of proposition. Fine touch and pressure and vibration

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12
Q

Posterior cord syndrome

A

Acute compression

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13
Q

Posterior cord syndrome clinical manifestations

A

Loss of proprioceptuon, fine touch, and pressure, temperature, and crude touch and pressure

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14
Q

Brown sequaed syndrome

A

Hemisection of the spinal cord resulting from penetrating injury, may occur from ischemia or hemorrhage.

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15
Q

Brown sequard syndrome clinical manifestation

A

Same side loss of motor function, loss of proprioceptuon and vibration. Loss of pain and temp on opposite side of injury.

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16
Q

Cervical spine injury that affects breathing ability

A

C4 and above

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17
Q

Lumbar and sacral injury’s cause

A

Decrease control of legs, bowels, bladder and sexual function

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18
Q

Other effects from spinal injury’s

A

Chronic pain, low BP, inability to sweat below I jury, decreased temp control.

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19
Q

C1- C4 injury

A

Quadriplegia with loss of respiration status.

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20
Q

C4-C5 Ijury

A

Quadriplegic with possible respiration

21
Q

C5 and C6 injury

A

Quadriplegic with gross arm movement

22
Q

C6 and C7 injury

A

Quadriplegic with biceps intact.

23
Q

C7-C8 injury

A

Quadriplegic with triceps bicept and wrist control

24
Q

T1 to T5

A

Paraplegic with normal arm movement.

25
Q

T6 to T12 injury

A

Paraplegic with fair ability to control balance and bowel and bladder control

26
Q

Below L1

A

Variable motor and sensory loss in lower extremities.

27
Q

Loss of auto regulation in SCI causes what

A

Cardiac disrythmea, hypotension, decreased blood tone, reduced cardiac output, changes in heart rate and beat.

28
Q

What SCI have the most profound clinical manifestations

A

High thoracic and cervical injuries due to involvement of cardiac nerves and breathing nerve.

29
Q

Why does circulation need to be monitored post SCI and how is it treated

A

Loss of vasomotor tone causes blood to pool and pressures to drop. IV fluids, Vasopressors and I opted are used to keep pressures and rates normal.

30
Q

What meds are not used in SCI

A

corticosteroids because they don’t work and have negative SE

31
Q

Most common cause of death in patients with SCI

A

Respiratory disease and cardiac events

32
Q

Spinal shock

A

Complete or temporary of all or most spinal reflexes as well as sensory and motor function below injury,

33
Q

Spinal shock symptoms

A

Hypotension, paralysis of all skeletal muscles, absent deep tendon reflexes, impaired proprioception, decreased sensation, penile reflex and bowel and bladder retention. Also inability to sweat. Last from 24 hours to 6 weeks

34
Q

What is neurogenic shock

A

Loss is vasomotor tone which drops cardiac output and causes blood to pull in vessels causing hypotension.

35
Q

Neurogenic shock symptoms

A

Hypotension, BRADYCARDIA, temp instability, multiorgan damage

36
Q

Autonomic dysreflexia

A

Massive imbalance of reflex sympathetic discharge that occurs in 80% if patients with a T5 or above SCI. Often occurs within 1 year post spinal shock

37
Q

Most common causes of autonomic dysreflexia

A

Bladder or bowel problems

38
Q

S/s of AD

A

Hypertension, bradycardia, flush face, sweating, impending doom, nasal congestion, chest pain.

39
Q

Halo brace and traction complications

A

Infection, skin breakdown, loosening or movement of pins, swallowing problems and dural tears

40
Q

How often do pin site infections happen

A

20% of the time

41
Q

Pin site infection

A

Most common halo trac complication and occurs up to 60% of the time

42
Q

Pin site migration s/s

A

Redness, swelling, loss of immobilization, neck pain,

43
Q

What to do Incase halo tract is loose

A

Put customer in hard c collar after calling provider. Do neuro assessment to assess for new neuro symptoms. Also contact radiology for imaging of spine.

44
Q

AD interventions

A

Monitor BP every 5 minutes

HOB atleast 45• to decrease HTN.

Remove restrictive clothing

Check the bladder, possibly catheter the pt Incase of retention

Check for bowel impacting

Check for other sources of pain such as pressure wounds

45
Q

What can cause pressure injury’s with HALO device

A

Poor vest sizing, application, padding, not turning patient

46
Q

Surgical management of SCI

A

Laminectomy, bone grafts and rods to stabilize spine.

47
Q

SCI interventions

A

Suction at bedside

Effective cough
Maintain spine immobilization
Passive ROM
REPOSITION
Routine pin site care

48
Q

SCI teachings

A

Clinical manifestations of respiratory distress

Manifestations of autonomic dysreflexia

Skin care, don’t stay still too long

213 (6 decks)

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