NURS 405B EXAM 4 SPINAL CORD INJURY QUESTIONS AND
ANSWERS
About how many people in the US live with disability from spinal cord injury (SCI)? - CORRECT
ANSWER✅✅276,000
What are some common causes of SCI? - CORRECT ANSWER✅✅MVAs
Falls
Violence (gunshot wounds)
Sports-related injuries
What percentage of SCIs do males account for? - CORRECT ANSWER✅✅80%
What is the average age of spinal cord injury? - CORRECT ANSWER✅✅42
What are some risk factors for spinal cord injury? - CORRECT ANSWER✅✅Young age
Male gender
Alcohol and drug use
What is the best treatment for spinal cord injury? - CORRECT ANSWER✅✅Primary prevention
What will determine how a spinal cord injury presents? - CORRECT ANSWER✅✅Where the injury is in
the spinal cord
What should be done when an accident occurs? - CORRECT ANSWER✅✅Urine drug screen to see if
there are substances on board that will impact treatment
What are spinal cord injuries the result of? - CORRECT ANSWER✅✅Concussion, contusion, laceration,
or compression of the spinal cord
- Bone compression, ischemia, abnormal traction on the cord
,- Spinal cord injury can result from 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 cause tearing and transection
What is primary injury? - CORRECT ANSWER✅✅The result of the initial trauma and usually permanent
- The initial mechanical disruption of axons as a result of stretch or laceration
What does secondary injury include? - CORRECT ANSWER✅✅Edema and hemorrhage
May be reversible
Why is treatment of spinal cord injury needed? - CORRECT ANSWER✅✅To prevent partial injury from
developing into more extensive, permanent damage
What is the spinal cord wrapped in? - CORRECT ANSWER✅✅Tough layers of dura
- Rarely torn or transected by direct trauma
What are we worried about with spinal cord injury? - CORRECT ANSWER✅✅Worried about bleeding,
edema, secondary injury to cord during initial time frame
What can edema with spinal cord injury do? - CORRECT ANSWER✅✅Cause permanent damage in 24
hours depending on the degree of ischemia, etc.
How many hours does it usually take after spinal cord injury to accurately determine the extent of
injury? - CORRECT ANSWER✅✅72 hours or more
When are the greatest improvements in patient condition after SCI usually seen? - CORRECT
ANSWER✅✅3-6 months after injury
What are some possible causes of secondary injury with SCIs? - CORRECT ANSWER✅✅Vascular changes
due to hemorrhage, vasospasm, thrombosis, loss of autoregulation, breakdown of the blood-brain
barrier, and infiltration of inflammatory cells that cause ischemia, edema, and cellular necrosis
,- Lactate metabolites and an increase in vasoactive substances, including norepinephrine, serotonin, and
dopamine, occur
What do high levels of vasoactive substances (including norepinephrine, serotonin, and dopamine)
cause? - CORRECT ANSWER✅✅Vasospasms and hypoxia with subsequent necrosis
Does the spinal cord have much ability to adapt to vasospasm? - CORRECT ANSWER✅✅No, the spinal
cord has minimal ability to adapt to vasospasm
What can lead to neuronal cell death and reduced spinal cord blood flow? - CORRECT ANSWER✅✅Free
radical formation, lipid peroxidation, release of glutamate, and disruption of the ionic balance of
potassium, sodium, and calcium
What is spinal shock characterized by? - CORRECT ANSWER✅✅Decreased reflexes
Loss of sensation
Absent thermoregulation
Flaccid paralysis below the level of injury
(neurological impacts immediately after injury; symptoms can resolve)
How long can spinal shock last? - CORRECT ANSWER✅✅Days to weeks
- S/S may improve or become permanent
What is neurogenic shock characterized by? - CORRECT ANSWER✅✅Hypotension
Bradycardia
What does the loss of SNS innervation that occurs with neurogenic shock cause? - CORRECT
ANSWER✅✅Peripheral vasodilation
Venous pooling
, Decreased cardiac output
Where is the injury usually located with neurogenic shock? - CORRECT ANSWER✅✅T6 or higher injury
How long can neurogenic shock last? - CORRECT ANSWER✅✅Days to weeks
What are SCIs classified by? - CORRECT ANSWER✅✅- Mechanism of injury (How did it occur?)
- Level of injury (T6, C4, etc.?)
- Degree of injury (totally paralyzed, partially paralyzed, etc.?)
What does the C for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Cervical
What does the T for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Thoracic
What does the L for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Lumbar
What level of SCI usually requires a ventilator? - CORRECT ANSWER✅✅C4 ventilaTOR
What are the major mechanisms of injury for spinal cord injuries? - CORRECT ANSWER✅✅Flexion
Hyperextension
Flexion-rotation
Extension-rotation
Compression
Which mechanism of SCI is the most unstable and why? - CORRECT ANSWER✅✅Flexion-rotation injury
is the most unstable because ligaments that stabilize the spine are torn
Which mechanism of injury most often contributes to neurologic deficits? - CORRECT
ANSWER✅✅Flexion-rotation injury
ANSWERS
About how many people in the US live with disability from spinal cord injury (SCI)? - CORRECT
ANSWER✅✅276,000
What are some common causes of SCI? - CORRECT ANSWER✅✅MVAs
Falls
Violence (gunshot wounds)
Sports-related injuries
What percentage of SCIs do males account for? - CORRECT ANSWER✅✅80%
What is the average age of spinal cord injury? - CORRECT ANSWER✅✅42
What are some risk factors for spinal cord injury? - CORRECT ANSWER✅✅Young age
Male gender
Alcohol and drug use
What is the best treatment for spinal cord injury? - CORRECT ANSWER✅✅Primary prevention
What will determine how a spinal cord injury presents? - CORRECT ANSWER✅✅Where the injury is in
the spinal cord
What should be done when an accident occurs? - CORRECT ANSWER✅✅Urine drug screen to see if
there are substances on board that will impact treatment
What are spinal cord injuries the result of? - CORRECT ANSWER✅✅Concussion, contusion, laceration,
or compression of the spinal cord
- Bone compression, ischemia, abnormal traction on the cord
,- Spinal cord injury can result from 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 cause tearing and transection
What is primary injury? - CORRECT ANSWER✅✅The result of the initial trauma and usually permanent
- The initial mechanical disruption of axons as a result of stretch or laceration
What does secondary injury include? - CORRECT ANSWER✅✅Edema and hemorrhage
May be reversible
Why is treatment of spinal cord injury needed? - CORRECT ANSWER✅✅To prevent partial injury from
developing into more extensive, permanent damage
What is the spinal cord wrapped in? - CORRECT ANSWER✅✅Tough layers of dura
- Rarely torn or transected by direct trauma
What are we worried about with spinal cord injury? - CORRECT ANSWER✅✅Worried about bleeding,
edema, secondary injury to cord during initial time frame
What can edema with spinal cord injury do? - CORRECT ANSWER✅✅Cause permanent damage in 24
hours depending on the degree of ischemia, etc.
How many hours does it usually take after spinal cord injury to accurately determine the extent of
injury? - CORRECT ANSWER✅✅72 hours or more
When are the greatest improvements in patient condition after SCI usually seen? - CORRECT
ANSWER✅✅3-6 months after injury
What are some possible causes of secondary injury with SCIs? - CORRECT ANSWER✅✅Vascular changes
due to hemorrhage, vasospasm, thrombosis, loss of autoregulation, breakdown of the blood-brain
barrier, and infiltration of inflammatory cells that cause ischemia, edema, and cellular necrosis
,- Lactate metabolites and an increase in vasoactive substances, including norepinephrine, serotonin, and
dopamine, occur
What do high levels of vasoactive substances (including norepinephrine, serotonin, and dopamine)
cause? - CORRECT ANSWER✅✅Vasospasms and hypoxia with subsequent necrosis
Does the spinal cord have much ability to adapt to vasospasm? - CORRECT ANSWER✅✅No, the spinal
cord has minimal ability to adapt to vasospasm
What can lead to neuronal cell death and reduced spinal cord blood flow? - CORRECT ANSWER✅✅Free
radical formation, lipid peroxidation, release of glutamate, and disruption of the ionic balance of
potassium, sodium, and calcium
What is spinal shock characterized by? - CORRECT ANSWER✅✅Decreased reflexes
Loss of sensation
Absent thermoregulation
Flaccid paralysis below the level of injury
(neurological impacts immediately after injury; symptoms can resolve)
How long can spinal shock last? - CORRECT ANSWER✅✅Days to weeks
- S/S may improve or become permanent
What is neurogenic shock characterized by? - CORRECT ANSWER✅✅Hypotension
Bradycardia
What does the loss of SNS innervation that occurs with neurogenic shock cause? - CORRECT
ANSWER✅✅Peripheral vasodilation
Venous pooling
, Decreased cardiac output
Where is the injury usually located with neurogenic shock? - CORRECT ANSWER✅✅T6 or higher injury
How long can neurogenic shock last? - CORRECT ANSWER✅✅Days to weeks
What are SCIs classified by? - CORRECT ANSWER✅✅- Mechanism of injury (How did it occur?)
- Level of injury (T6, C4, etc.?)
- Degree of injury (totally paralyzed, partially paralyzed, etc.?)
What does the C for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Cervical
What does the T for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Thoracic
What does the L for level of spinal cord injury stand for? - CORRECT ANSWER✅✅Lumbar
What level of SCI usually requires a ventilator? - CORRECT ANSWER✅✅C4 ventilaTOR
What are the major mechanisms of injury for spinal cord injuries? - CORRECT ANSWER✅✅Flexion
Hyperextension
Flexion-rotation
Extension-rotation
Compression
Which mechanism of SCI is the most unstable and why? - CORRECT ANSWER✅✅Flexion-rotation injury
is the most unstable because ligaments that stabilize the spine are torn
Which mechanism of injury most often contributes to neurologic deficits? - CORRECT
ANSWER✅✅Flexion-rotation injury
