AHN 447 TEST 3 STUDY GUIDE
Cervical traction is contraindicated in - Answers - unstable hyperextension injuries
Cervical spine clearance - Answers - done by an ER, neuro, or orthopedic physician
Occiput to T1 need to be cleared
No need for xray if patient is:
Awake and oriented
Has no distracting injuries
Has no drugs on board
No neck pain
Neurologically intact
MRI - Answers - shows tumors and soft tissues (herniated discs) very well
May be used to clear c-spine in comatose patients
CT scan - Answers - good in acute situations
Shows bone very well
Soft tissues (discs, spinal cord) are poorly visualized
Do not give contrast in trauma patients
Methylprednisolone (solu-medrol) - Answers - only used if started within 8 hours of
injury
Exclusion criteria: cauda equina syndrome, GSW, pregnant, younger than 13, patient is
on maintenance steroids
Management of SCI in hospital - Answers - NGT to suction-prevents aspiration and
decompresses the abdomen (paralytic ileus is common in first days)
Foley-urinary retention is common
Central Cord Syndrome - Answers - cervical spine cord involvement with arms more
affected than legs.
May occur w/ trauma, tumors, infections, etc
Traumatic lesions improve in 1-2 weeks
Surgical decompression may be indicated if there is spinal stenosis
, Cardiovascular assessment for SCI - Answers - hypotension
Bradycardia
Vasovagal reflex
Poikilothermy (temp fluctuation)
Venous thrombosis
GU assessment of SPI - Answers - autonomic hyperreflexia (above T6)-life
threatening. BP shoots high, sweat profusely, goosebumps, anxious, and can be
brought on by having bladder that is too full
UTI
GI assessment of SPI - Answers - gastric atony and ileus
Cushings ulcers
Abdominal trauma
Stool softeners to prevent constipation
Neurogenic shock - Answers - seen in cervical injuries
Due to interruption of sympathetic input from hypothalamus to the cardiovascular
centers
Hallmark is hypotension due to vasodilation and is associated w/ bradycardia due to
inability to convey the information to the vasomotor centers in spinal cord
Spinal shock - Answers - mainly a loss of reflexes (flaccid paralysis)
What are signs of a L1-L5 lesion - Answers - flaccid paralysis
Abdominal/cremasteric reflexes
Ankle/plantar reflexes
How do you test L5? - Answers - dorsiflex big toe
EHL
Plagia - Answers - complete lesion
Cervical traction is contraindicated in - Answers - unstable hyperextension injuries
Cervical spine clearance - Answers - done by an ER, neuro, or orthopedic physician
Occiput to T1 need to be cleared
No need for xray if patient is:
Awake and oriented
Has no distracting injuries
Has no drugs on board
No neck pain
Neurologically intact
MRI - Answers - shows tumors and soft tissues (herniated discs) very well
May be used to clear c-spine in comatose patients
CT scan - Answers - good in acute situations
Shows bone very well
Soft tissues (discs, spinal cord) are poorly visualized
Do not give contrast in trauma patients
Methylprednisolone (solu-medrol) - Answers - only used if started within 8 hours of
injury
Exclusion criteria: cauda equina syndrome, GSW, pregnant, younger than 13, patient is
on maintenance steroids
Management of SCI in hospital - Answers - NGT to suction-prevents aspiration and
decompresses the abdomen (paralytic ileus is common in first days)
Foley-urinary retention is common
Central Cord Syndrome - Answers - cervical spine cord involvement with arms more
affected than legs.
May occur w/ trauma, tumors, infections, etc
Traumatic lesions improve in 1-2 weeks
Surgical decompression may be indicated if there is spinal stenosis
, Cardiovascular assessment for SCI - Answers - hypotension
Bradycardia
Vasovagal reflex
Poikilothermy (temp fluctuation)
Venous thrombosis
GU assessment of SPI - Answers - autonomic hyperreflexia (above T6)-life
threatening. BP shoots high, sweat profusely, goosebumps, anxious, and can be
brought on by having bladder that is too full
UTI
GI assessment of SPI - Answers - gastric atony and ileus
Cushings ulcers
Abdominal trauma
Stool softeners to prevent constipation
Neurogenic shock - Answers - seen in cervical injuries
Due to interruption of sympathetic input from hypothalamus to the cardiovascular
centers
Hallmark is hypotension due to vasodilation and is associated w/ bradycardia due to
inability to convey the information to the vasomotor centers in spinal cord
Spinal shock - Answers - mainly a loss of reflexes (flaccid paralysis)
What are signs of a L1-L5 lesion - Answers - flaccid paralysis
Abdominal/cremasteric reflexes
Ankle/plantar reflexes
How do you test L5? - Answers - dorsiflex big toe
EHL
Plagia - Answers - complete lesion
