week 4 - Mobility PowerPoint (Spinal Cord Injuries)

Question 1

we are giving high doses of _______ to patients with spinal cord injuries.

Answer 1

steroids

Question 2

A paralyzed patient with a C4 injury is _______________.

Answer 2

tetraplegic or quad

Question 3

A paralyzed patient with a C6 injury is ___________.

Answer 3

tetraplegic or quad

Question 4

A paralyzed patient with a T6 and down or an L1 injury is __________.

Answer 4

paraplegic

Question 5

If a patient has any preserved motor or sensory function below the level of the injury, their spinal cord injury is __________, and their sacrum was spared.

Answer 5

incomplete

Question 6

which spinal cord injury/ syndrome is being described?

-loss of motor, pain, temperature sensation below the level of the injury, bilaterally
-vibration + proprioception are intact
-usually occurs due to a hyperFLEXION injury or an injury to the anterior spinal artery

Answer 6

Anterior Cord Syndrome (ACS)

Question 7

which spinal cord injury/ syndrome is being described?

-loss of pain sensation + proprioception, bilaterally
-motor function is intact
-biggest issue with this one is sitting, wounds, burns, because they’re not able to feel

Answer 7

Posterior Cord Syndrome (PCS)

Question 8

which spinal cord injury/ syndrome is being described?

-sensory + motor deficit, bilaterally
-upper extremities are more affected than lower extremities
-usually a hyperEXTENSION injury or, common in older adults w/ a pre-existing cervical injury/ disease
-most common

Answer 8

Central Cord Syndrome (CCS)

Question 9

which spinal cord injury/ syndrome is being described?

-IPSILATERAL loss of motor, vibration + proprioception
-CONTRALATERAL loss of pain + temperature sensation
-usually occurs due to a penetrating trauma or lateral cord compression

Answer 9

Brown-Sequard Syndrome
AKA
Lateral Cord Syndrome (LCS)

Question 10

A complete spinal cord injury is a complete severing of the spinal cord. Which locations of the spinal cord are most prone/ most common to have an injury due to these locations having a greater range of motion?

Answer 10

C5, C6, C7
T12
L1

Question 11

In a patient with a complete spinal cord injury, the primary injury is caused by _________, and secondary injury is caused by _________ or ____________.

Answer 11

trauma; edema or hemorrhage

Question 12

With a T6 and above spinal cord injury, what is our biggest priority?

Answer 12

ABC’S, breathing/ respiratory

Question 13

A complete spinal cord injury at C4 and above means total ___________.

Answer 13

paralysis

Question 14

_______ cord syndrome is a deficit to the upper extremities, sensory function will vary and there will be bladder and bowel dysfunction, and the cause is usually hyperextension.

Answer 14

central

Question 15

________ cord syndrome is the loss of motor, pain and temperature sensation at the point of injury and below, bilaterally. Some causes of this include, disc herniation, hyperflexion or a fracture.

Answer 15

anterior

Question 16

_______ cord syndrome or Brown-Sequard syndrome is ipsilateral paralysis loss of touch, pressure vibration and motor, and contralateral loss of pain and temperature. - usually due to trauma or lateral cord compression.

Answer 16

lateral

Question 17

usually with an incomplete _______ cord syndrome/ injury, patients can possibly recover with some movement.

Answer 17

anterior

damage is towards the front of the spinal cord

Question 18

With an incomplete __________ cord injury/ syndrome, depending on the case, some arm, bladder/ bowel function may be preserved. And it is possible to recover from this injury, it usually will start with the legs and ascend gradually.

Answer 18

central

damage is in the center of the spinal cord

Question 19

with an incomplete _________ cord syndrome/ injury, one side will have pain and temperature sensation with impaired loss/ movement. then the other side will have functioning movement with no pain or temperature sensation.

Answer 19

lateral (brown-Sequard)

damage is toward one side of the spinal cord

Question 20

usually with an incomplete _________ cord syndrome/ injury, this patient may have good muscle strength, pain and temperature sensation but they’d have difficulty coordinating movement; but it can also be loss of pain + proprioception sensations and intact motor function

Answer 20

posterior

**damage is towards the back of the spinal cord **

Question 21

what are some of the signs and symptoms of a spinal cord injury?

Answer 21

-difficulty breathing, coughing or clearing secretions
-no movement or mobility
-loss/ altered sensation
-no bowel or bladder control
-spasms
-changes in sexual function
-intense pain or other uncomfortable sensations

Question 22

a ________ spinal cord injury is all feeling and movement is lost below the site of the injury.

Answer 22

complete

Question 23

an ________ spinal cord injury is when you have some feeling and movement below the site of injury; this can vary

Answer 23

incomplete

Question 24

tetraplegia AKA quadriplegia is when:
1.
2.
3.
4.
are all affected by the injury

Answer 24

1.arms
2.legs
3.trunk
4.pelvic organs

Question 25

paraplegia affects some or all of the: 1. 2. 3.

Answer 25

1.trunk 2.legs 3.pelvic organs

Question 26

what are the 4 main ways we need to manage a patients care ESPECIALLY with a spinal cord injury?

Answer 26

ABCs pressure injuries pain temperature

Question 27

____________ shock results from a spinal cord injury and disrupts the body's ability to regulate BP, HR + temperature; this type of shock is characterized by sudden hypotension and bradycardia **we need to manage BP w/ fluids and vasopressors**

Answer 27

neurogenic

Question 28

_________ shock occurs immediately following the spinal cord injury and is characterized by immediate flaccid paralysis, loss of sensation/ reflexes, loss of bladder/ bowel control and may have hypotension and bradycardia as well.

Answer 28

spinal

Question 29

_________ ________ is a condition resulting from many different conditions like SCI, stroke, MS, tumor, etc. and the signals are disrupted and don't make it to the bladder, so urination is difficult.

Answer 29

neurogenic bladder

Question 30

what is the medical management for neurogenic bladder?

Answer 30

suprapubic tube NOT a foley - and fluids

Question 31

when giving peri care to patients with urinary catheters (Q8 hours), why is it important to twist the catheter to the left and right?

Answer 31

so that the tube doesn't stick to the urethral wall and cause damage

Question 32

___________ _________ is an overstimulation of the sympathetic nervous system as a result of a stimulus below the level of injury (usually when the SCI is at or above T6)

Answer 32

autonomic dysreflexia **AKA autonomic hyperreflexia**

Question 33

what are 10 of the sudden s/s of autonomic dysreflexia?

Answer 33

-flushing -pounding headache -goosebumps -sweating -high BP -anxiety -bradycardia -blurry vision -dilated pupils -SOB

Question 34

what are 5 complications related to autonomic dysreflexia a patient with a SCI can develop?

Answer 34

1. DVT (antiembolism therapy) 2. bladder/ bowel distension 3.retinal hemorrhage/ CVA due to HTN 4. severe bradycardia 5. pain/ pressure injuries

Question 35

when a patient is experiencing bradycardia from autonomic dysreflexia for example, what medication will we give them to bring the HR up?

Answer 35

atropine