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236 Exam 4 questions with complete solutions graded A+
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236 Exam 4 questions with complete solutions graded A+
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236 Exam 4Most common risk factor of a spinal cord injury - correct answer ✔✔Car accidents
Characteristics of spinal column - correct answer ✔✔Provides support & protection for spinal cord
Cervical, thoracic, lumbar/sacral
Primary injuries - correct answer ✔✔Initial insult or trauma usually permanent; injury to the vertebrae
or spinal column
Ex: diving injury
Secondary injuries - correct answer ✔✔Contusion or tear injury nerve fibers begin to swell and
distentigrate
Produces ischemia, hypoxia, edema & hemorrhagic lesions
Ex: sports injury, fall
Flexion injuries - correct answer ✔✔Excessive forward motion of the spine
Chin to chest
Ex: backward fall - head is point of impact
Hyper extension injuries - correct answer ✔✔Excessive backward motion of the spine
Forward fall with chin or face as point of impact
Axial loading injury - correct answer ✔✔Vertical compression injury of the cervical or lumbar spine
Ex: diving accident, falling from great height onto butt
Dermatomes - correct answer ✔✔Sensation connected to spinal cord
Helps to determine level of injury based on sensation
,Compression injuries - correct answer ✔✔Vertebral bones shatter, compress, or burst from high velocity
below or on the top of the head or when landing forcefully on feet
Diving- cervical injury
Fall- thoracic damage
Osteoporosis
Axial rotational injury - correct answer ✔✔Two forces exerted on spinal column causing tearing of
tendons and ligaments
Twisting force, cervical & lumbar injuries
Very unstable
Laceration - correct answer ✔✔Tearing of the neural tissues
Reversible if minor damage
Permanent loss of function if spinal tracts are disrupted
Complete spinal cord injury - correct answer ✔✔Tracts in the cord are disrupted
Permanent loss of function
Total motor & sensory loss below the injury
Incomplete spinal cord injury - correct answer ✔✔Some tracts in the spinal cord remain intact
Varying degrees of motor and sensory function
Incomplete spinal cord lesions - correct answer ✔✔Central, anterior & lateral cord syndromes
Partial paralysis
Complete spinal cord lesions - correct answer ✔✔Total loss of sensation & voluntary muscle control
below lesion
Paraplegia, quadriplegia
,Central cord syndrome
Cause
Characteristics - correct answer ✔✔Injury or edema of central cord; cervical area
S/sx: motor defecits, sensory loss >in upper body, possible bowel/bladder dysfunction
Anterior cord syndrome
Cause
Characteristics - correct answer ✔✔Damage to anterior spinal artery, acute disc herniation, or hyper
flexion injuries
S/sx loss of pain, temp, loss of motor function below lesion, light touch intact, vibration & sensation
intact
Lateral cord syndrome
Brown-sequard - correct answer ✔✔Ipsilateral paralysis or paresis
Loss of touch, pressure, and vibration, loss of pain & temp
Cause- knife, Missile injury, fracture dislocation
What diagnostic is done first in the case of a spinal injury - correct answer ✔✔Cross table lateral X-ray
for c-spine while still immobilized
Diagnostics done if spinal injury can't be determined with X-ray - correct answer ✔✔CT, MRI, myelogram
Acute phase: oxygenation
Nursing - correct answer ✔✔Resp insufficiency often apparent 24-36 hours after injury
Observe for fatigue, altered resp patterns, ability to cough & remove secretions
Every pt gets O2
Resp support: fiber optic NT intubation or trach
Acute phase: perfusion
Nursing - correct answer ✔✔Decreased cardiac output
, Vasovagal reflex
Hypertension secondary to vasodilation
Vasovagal reflex - correct answer ✔✔Suctioning causes hypoxia (increased HR,RR, anxiety)
Vagal stimulation leads to decreased pulse
Cardiac arrest follows bc no sympathetic response
Acute phase:circulation
Nursing - correct answer ✔✔Hypotension (careful w/IV fluid)
Dopamine (increase CO)
Atropine to tx bradycardia
Teds, SCDs, change positions slowly
Acute phase: meds - correct answer ✔✔Solumedrol
Given within 8 hours of injury
Suppresses breakdown of cellular injury
Decrease edema
Improve blood supply to injured area
Acute phase:immobilization - correct answer ✔✔Cervical traction
Skull tongs & skeletal traction
Use of cervical traction - correct answer ✔✔Reduce dislocations and realign spine and vertebral column
Types of cervical traction - correct answer ✔✔Crutch field tongs: maintain alignment/compression
injuries
Gardner-wells
Vinkle tongs
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