NSER 7410 MOD 2 ACTUAL EXAM WITH COMPLETE SOLUTIONS
Define neurogenic shock
A consequence of an acute spinal cord injury above the level of T6.
A form of distributive shock. Causes a dysfunction of the autonomic nervous system and
impaired communication between the CNS and the ANS
Causes a loss of sympathetic control resulting in unopposed parasympathetic stimulation
What are the symptoms of neurogenic shock
Bradycardia,
Hypotension,
Poikilothermia - Body temp varies with environment. Inability to regulate temp
Outline the pathophysiology of bradycardia in neurogenic shock
Loss of sympathetic innervation of the heart.
Body is unable to compensate for hypovolemia by inducing tachycardia
Outline the pathophysiology of hypotension in neurogenic shock
Loss of vasomotor tone causing vasodilation.
, Blood pools in the visceral and peripheral blood vessels, leading to decreased preload and
CO, which ultimately leads to a decrease in blood pressure
Outline the pathophysiology of poikilothermia in neurogenic shock
Body temperature varies with the environment.
Vasodilation from the lack of sympathetic tone leads to loss of body heat.
Sweat glands are activated by sympathetic stimulation, so when blocked the body is not
able to use this mechanism to cool the body.
Paralysis from an SCI can prevent shivering
Outline the goals of treatment of neurogenic shock, and the common medications
Maintain heart rate between 60-100 beats per minute
Maintain SBP over 90-100 mmHg with urine output above 30 mL/hour
Keep temperature between 36.5-37.5 °C
Vasopressors including phenylephrine, dopamine, or norepinephrine for their potent alpha-
1 agonist effect of peripheral arterial vasoconstriction.
Atropine for hemodynamically unstable bradycardia.
Define neurogenic shock
A consequence of an acute spinal cord injury above the level of T6.
A form of distributive shock. Causes a dysfunction of the autonomic nervous system and
impaired communication between the CNS and the ANS
Causes a loss of sympathetic control resulting in unopposed parasympathetic stimulation
What are the symptoms of neurogenic shock
Bradycardia,
Hypotension,
Poikilothermia - Body temp varies with environment. Inability to regulate temp
Outline the pathophysiology of bradycardia in neurogenic shock
Loss of sympathetic innervation of the heart.
Body is unable to compensate for hypovolemia by inducing tachycardia
Outline the pathophysiology of hypotension in neurogenic shock
Loss of vasomotor tone causing vasodilation.
, Blood pools in the visceral and peripheral blood vessels, leading to decreased preload and
CO, which ultimately leads to a decrease in blood pressure
Outline the pathophysiology of poikilothermia in neurogenic shock
Body temperature varies with the environment.
Vasodilation from the lack of sympathetic tone leads to loss of body heat.
Sweat glands are activated by sympathetic stimulation, so when blocked the body is not
able to use this mechanism to cool the body.
Paralysis from an SCI can prevent shivering
Outline the goals of treatment of neurogenic shock, and the common medications
Maintain heart rate between 60-100 beats per minute
Maintain SBP over 90-100 mmHg with urine output above 30 mL/hour
Keep temperature between 36.5-37.5 °C
Vasopressors including phenylephrine, dopamine, or norepinephrine for their potent alpha-
1 agonist effect of peripheral arterial vasoconstriction.
Atropine for hemodynamically unstable bradycardia.
