10/16/24, 2:15 Spinal cord injury - Lecture notes Lecture
PM notes
MEDICAL SURGICAL NURSING: NEURO 1.9. 10 NURSE ANGIE 2018
SpinaL Cord InjUry
Trauma to the spine that results in full or partial severance, this leads to loss of mobility
Emergency Assessment
management •
Cervical: injury at C2 or C3 is
• Always suspect spinal injury
fatal, injury above C4 causes
Trauma to the spinal cord causes disruption of the when trauma occurs respiratory difficulty and paralysis
nerve tracts and neurons. A spinal cord injury can • Assess and maintain a patent in all extremities. Client may move
airway and assess respirations. shoulder and have decreased
result in edema, total or partial severance of the
• Prevent head flexion, extension respiratory reserve with injury to
cord causing paralysis. or rotation. C5-C8.
Common affected vertebrae • Log-roll the client. •
Thoracic: Loss of movement in
• Cervical : C5-C7 • Never twist or turn the client. the trunk, chest, bowel, bladder and
• Do not allow them to sit. legs. Paraplegia may occur,
• Thoracic: T 12 • In the emergency department, autonomic dysreflexia in injuries
• Lumbar: L 1 place the patient immediately
above T6. Distended bladder or
in skeletal traction. To reduce
fracture and dislocation.
impacted rectum, bradycardia,
hypertension and goosebumps.
• Lumbar: Loss of movement or
sensation in the lower extremities,
injury to S2 or S3 can cause
neurogenic bladder. Injury above
S2 in males enables them to still
experience erection but not
ejaculate due to sympathetic nerve
damage. Injury at S2-S4 will
result in inability to obtain an
erection or ejaculate.
Types
Transection of the
INTERVENTION
‣
INTERVENTIONS SYNDROMES cord:
FOR AUTONOMIC S Complete severance of the spinal
cord, results in total loss of
Central cord syndrome: Is a result
DYSREFLEXIA of a lesion on the central portion of • Immediately stabilize the spine
‣
sensation, movement, and reflexes.
Partial
the spinal cord. Motor function loss is • Assess neuro function
Transection : The cord is
apparent in the upper extremities, • Assess respiratory function every partially severed, symptoms
• Raise the head of the bed some sensation remains intact. hour depend on the extent of the
• Loosen tight clothes Anterior syndrome: Results from • Monitor secretions and breath damage, early treatment may result
injury to the anterior portion of sounds
• Administer in avoidance of permanent damage.
gray and white matter. Motor • Monitor 02 saturation
antihypertensives function, pain sensation and • Assess cardiovascular function
• Document occurrence temperature are lost below the area
every hour
Complications
treatment and response. of injury. • Respiratory failure
• Monitor blood pressure
Posterior Syndrome: Results from • Death
damage to the posterior portion of the • If there is a pulmonary catheter in
monitor inform the HCP of a • Autonomic dysreflexia
Autonomic gray and white matter in the spinal
cord. Motor function remains intact, decrease in right atrial pressure, • Spinal shock
dysreflexia: but the patient will experience a loss pulmonary artery pressure, • Extensive cord damage
of sense of vibration , crude touch, systemic vascular resistance, or
• Severe hypertension and position sensation. pulmonary wedge pressure as this
• bradycardia Brown-Sequard syndrome: Is a could indicate neurogenic shock Effects
• severe headache result of a penetrating injury that • Monitor GI status • Tetraplegia: Injury between C1
• nasal stuffiness cause injury to half the cord. and C2. paralysis involving all
• Monitor intake and output
• and flushness. Sensation, temperature and pain extremities.
• Avoid uriniary retention to avoid
are affected on the opposite • Paraplegia: Injury between
autonomic dysreflexia
side of the injury. T1 and L4 paralysis only
• Monitor for dvt
• Frequent skin assessments involving lower
• Begin rehab as soon as possible extremities.
• Provide emotional support
1
about:bl 1
PM notes
MEDICAL SURGICAL NURSING: NEURO 1.9. 10 NURSE ANGIE 2018
SpinaL Cord InjUry
Trauma to the spine that results in full or partial severance, this leads to loss of mobility
Emergency Assessment
management •
Cervical: injury at C2 or C3 is
• Always suspect spinal injury
fatal, injury above C4 causes
Trauma to the spinal cord causes disruption of the when trauma occurs respiratory difficulty and paralysis
nerve tracts and neurons. A spinal cord injury can • Assess and maintain a patent in all extremities. Client may move
airway and assess respirations. shoulder and have decreased
result in edema, total or partial severance of the
• Prevent head flexion, extension respiratory reserve with injury to
cord causing paralysis. or rotation. C5-C8.
Common affected vertebrae • Log-roll the client. •
Thoracic: Loss of movement in
• Cervical : C5-C7 • Never twist or turn the client. the trunk, chest, bowel, bladder and
• Do not allow them to sit. legs. Paraplegia may occur,
• Thoracic: T 12 • In the emergency department, autonomic dysreflexia in injuries
• Lumbar: L 1 place the patient immediately
above T6. Distended bladder or
in skeletal traction. To reduce
fracture and dislocation.
impacted rectum, bradycardia,
hypertension and goosebumps.
• Lumbar: Loss of movement or
sensation in the lower extremities,
injury to S2 or S3 can cause
neurogenic bladder. Injury above
S2 in males enables them to still
experience erection but not
ejaculate due to sympathetic nerve
damage. Injury at S2-S4 will
result in inability to obtain an
erection or ejaculate.
Types
Transection of the
INTERVENTION
‣
INTERVENTIONS SYNDROMES cord:
FOR AUTONOMIC S Complete severance of the spinal
cord, results in total loss of
Central cord syndrome: Is a result
DYSREFLEXIA of a lesion on the central portion of • Immediately stabilize the spine
‣
sensation, movement, and reflexes.
Partial
the spinal cord. Motor function loss is • Assess neuro function
Transection : The cord is
apparent in the upper extremities, • Assess respiratory function every partially severed, symptoms
• Raise the head of the bed some sensation remains intact. hour depend on the extent of the
• Loosen tight clothes Anterior syndrome: Results from • Monitor secretions and breath damage, early treatment may result
injury to the anterior portion of sounds
• Administer in avoidance of permanent damage.
gray and white matter. Motor • Monitor 02 saturation
antihypertensives function, pain sensation and • Assess cardiovascular function
• Document occurrence temperature are lost below the area
every hour
Complications
treatment and response. of injury. • Respiratory failure
• Monitor blood pressure
Posterior Syndrome: Results from • Death
damage to the posterior portion of the • If there is a pulmonary catheter in
monitor inform the HCP of a • Autonomic dysreflexia
Autonomic gray and white matter in the spinal
cord. Motor function remains intact, decrease in right atrial pressure, • Spinal shock
dysreflexia: but the patient will experience a loss pulmonary artery pressure, • Extensive cord damage
of sense of vibration , crude touch, systemic vascular resistance, or
• Severe hypertension and position sensation. pulmonary wedge pressure as this
• bradycardia Brown-Sequard syndrome: Is a could indicate neurogenic shock Effects
• severe headache result of a penetrating injury that • Monitor GI status • Tetraplegia: Injury between C1
• nasal stuffiness cause injury to half the cord. and C2. paralysis involving all
• Monitor intake and output
• and flushness. Sensation, temperature and pain extremities.
• Avoid uriniary retention to avoid
are affected on the opposite • Paraplegia: Injury between
autonomic dysreflexia
side of the injury. T1 and L4 paralysis only
• Monitor for dvt
• Frequent skin assessments involving lower
• Begin rehab as soon as possible extremities.
• Provide emotional support
1
about:bl 1
