4 SPINAL CORD INJURY EXAM
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Sports
MVA
diving
GSW - ANS spinal cord injuries in kids are most commonly caused by:
Autonomic Dysreflexia - ANS (potentially life threatening emergency!) HOB elevate 90
degrees, loosen constrictive clothing, *assess for full bladder or bowel impaction*, (trigger)
administer antihypertensives (may cause stroke, MI, seizure)
skin breakdown
paralytic ileus
autonomic dysreflexia
pneumonia
orthostatic hypotension
spinal shock
neurogenic shock - ANS spinal cord injury complications:
t6 - ANS In Autonomic dysreflexia where is the injury usually above?
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,hypertension
bradycardia
diaphoretic - ANS s/s of autonomic dysreflexia: (bladder distention)
16-30 - ANS *Young adult* men between ages ___ years have the greatest risk for SCI.
•Eighty-one percent of people with SCI are male.
90 - ANS •Almost ___% of patients with SCI are discharged from the hospital to home or
another non-institutional residence.
*42% motor vehicle collisions*
*27% falls*
15% violence
7% sports injuries
8% other miscellaneous cases - ANS causes of spinal cord injuries:
Bone displacement
Interruption of blood supply
Traction from pulling on cord - ANS SCI due to cord compression by:
tearing, transection - ANS •Penetrating trauma, such as gunshot and stab wounds, can result
in ___ and ____.
primary injury - ANS The initial mechanical disruption of axons as a result of stretch or
laceration is referred to as the __. The insult may be due to cord compression by bone
displacement, interruption of blood supply to the cord, or traction resulting from pulling on the
cord. Penetrating trauma, such as gunshot and stab wounds, can result in tearing and
transection of the spinal cord.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Secondary injury - ANS ___ refers to the ongoing, progressive damage that occurs after the
initial injury which may include ischemia, hypoxia, hemorrhage, or edema. The mechanism for
this injury involves a cascade of metabolic and cellular events that creates a decrease in overall
spinal cord blood flow. This results in tissue hypoxia and secondary injury.
Free radical formation
Uncontrolled calcium influx
Ischemia
Lipid peroxidation - ANS ¡Several theories on what causes ongoing damage at molecular and
cellular levels:
Apoptosis - ANS ___ (cell death) occurs and sometimes may continue for weeks or months
after the initial injury.
transection - ANS Cross sectioning of spinal cord at any level results in total motor and
sensory loss in regions inferior to cut.
autodestruction - ANS Complete cord damage related to ___.
Hemorrhages appear within 1 hour
Infarction by 4 hours
RBC and PLT aggregation
Release NE, Epi, Serotonin
Vasoconstriction & Thrombosis
SCBF
*or*
Breakdown RBCs
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Hgb and Iron released
Increase free radical formation
*or*
Neutrophils
Leukotriene production
Kallikrein System
Vasospasm and Edema
SCBF - ANS Secondary injury pathophysiology:
*At high levels, these vasoactive substances cause vasospasms and hypoxia, leading to
subsequent necrosis.*
edema - ANS By 24 hours or less, permanent damage may occur because of the development
of ___. The edema secondary to the inflammatory response is particularly harmful because of
lack of space for tissue expansion. Therefore compression of the spinal cord occurs. Edema
extends above and below the injury, thus increasing the ischemic damage.
72 - ANS Prognosis cannot be determined for at least ___ hours.
↓ Reflexes
Loss of sensation
Flaccid paralysis below level of injury - ANS S/S of spinal shock:
This syndrome lasts days to months and may mask postinjury neurologic function.
*Temporary*!!
Neurogenic shock - ANS ____, in contrast to spinal shock, is due to the loss of vasomotor
tone caused by injury and is characterized by *hypotension and bradycardia*
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Sports
MVA
diving
GSW - ANS spinal cord injuries in kids are most commonly caused by:
Autonomic Dysreflexia - ANS (potentially life threatening emergency!) HOB elevate 90
degrees, loosen constrictive clothing, *assess for full bladder or bowel impaction*, (trigger)
administer antihypertensives (may cause stroke, MI, seizure)
skin breakdown
paralytic ileus
autonomic dysreflexia
pneumonia
orthostatic hypotension
spinal shock
neurogenic shock - ANS spinal cord injury complications:
t6 - ANS In Autonomic dysreflexia where is the injury usually above?
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,hypertension
bradycardia
diaphoretic - ANS s/s of autonomic dysreflexia: (bladder distention)
16-30 - ANS *Young adult* men between ages ___ years have the greatest risk for SCI.
•Eighty-one percent of people with SCI are male.
90 - ANS •Almost ___% of patients with SCI are discharged from the hospital to home or
another non-institutional residence.
*42% motor vehicle collisions*
*27% falls*
15% violence
7% sports injuries
8% other miscellaneous cases - ANS causes of spinal cord injuries:
Bone displacement
Interruption of blood supply
Traction from pulling on cord - ANS SCI due to cord compression by:
tearing, transection - ANS •Penetrating trauma, such as gunshot and stab wounds, can result
in ___ and ____.
primary injury - ANS The initial mechanical disruption of axons as a result of stretch or
laceration is referred to as the __. The insult may be due to cord compression by bone
displacement, interruption of blood supply to the cord, or traction resulting from pulling on the
cord. Penetrating trauma, such as gunshot and stab wounds, can result in tearing and
transection of the spinal cord.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Secondary injury - ANS ___ refers to the ongoing, progressive damage that occurs after the
initial injury which may include ischemia, hypoxia, hemorrhage, or edema. The mechanism for
this injury involves a cascade of metabolic and cellular events that creates a decrease in overall
spinal cord blood flow. This results in tissue hypoxia and secondary injury.
Free radical formation
Uncontrolled calcium influx
Ischemia
Lipid peroxidation - ANS ¡Several theories on what causes ongoing damage at molecular and
cellular levels:
Apoptosis - ANS ___ (cell death) occurs and sometimes may continue for weeks or months
after the initial injury.
transection - ANS Cross sectioning of spinal cord at any level results in total motor and
sensory loss in regions inferior to cut.
autodestruction - ANS Complete cord damage related to ___.
Hemorrhages appear within 1 hour
Infarction by 4 hours
RBC and PLT aggregation
Release NE, Epi, Serotonin
Vasoconstriction & Thrombosis
SCBF
*or*
Breakdown RBCs
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Hgb and Iron released
Increase free radical formation
*or*
Neutrophils
Leukotriene production
Kallikrein System
Vasospasm and Edema
SCBF - ANS Secondary injury pathophysiology:
*At high levels, these vasoactive substances cause vasospasms and hypoxia, leading to
subsequent necrosis.*
edema - ANS By 24 hours or less, permanent damage may occur because of the development
of ___. The edema secondary to the inflammatory response is particularly harmful because of
lack of space for tissue expansion. Therefore compression of the spinal cord occurs. Edema
extends above and below the injury, thus increasing the ischemic damage.
72 - ANS Prognosis cannot be determined for at least ___ hours.
↓ Reflexes
Loss of sensation
Flaccid paralysis below level of injury - ANS S/S of spinal shock:
This syndrome lasts days to months and may mask postinjury neurologic function.
*Temporary*!!
Neurogenic shock - ANS ____, in contrast to spinal shock, is due to the loss of vasomotor
tone caused by injury and is characterized by *hypotension and bradycardia*
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
