N205 Spinal Injury Case Study questions and accurate answers with a grade of A+

Why did Allen's heart rate and blood pressure fall in this time of emergency (at a time when you'd expect just the opposite homeostatic response? - ANS+Blood loss: however with this heart rate should increase to try to elevate B/P +Injury above T-6 decreases the influence of the sympathetic nervous system which results in bradycardia, peripheral vasodilation and decreased cardiac output. +Paralysis and loss of sensation indicates damage to spinal cord. +This results in spinal shock Sympathetic motor neurons exit the cord from T 1- L 2 - ANS+Damage above results in loss of stimulation to heart to increase rate and strength of contractions and loss of ability to vasoconstrict. B/P can drop below 40 mm Hg. +Gradually autonomic and somatic reflexes return as lower motor neurons regain their excitability but may become exaggerated Upon admission to the hospital, Allen's breathing was rapid and shallow. Can you explain this? - ANS+C 3-5 supply the diaphragm +T 1-12 supply external intercostal muscles +The rapid breathing is an attempt to compensate for shallow breathing. Why did Allen lose some sensation in his arms and all sensation from the upper trunk down? - ANS+The spinothalamic tracts and dorsal columns tract were damaged bilaterally at about C-5 segment. spinothalamic tract - ANStransmits to brain about pain, temperature and crude touch to skin Dorsal columns tract - ANStransmits to brain about touch, vibration and proprioception on the skin Why did Allen have dry skin and a fever upon admission to the hospital? - ANSThe spinal shock and resultant loss of sympathetic motor neuron stimulation to the sweat glands makes it difficult to sweat and release heat produced by the body Based upon the physical exam findings, which vertebral bone do you think was fractured? - ANS+Sensory and respiratory findings suggest C 5 segment of the spinal cord was damaged +Can raise shoulders: C 3 and C 4 segments (supply trapezius muscles) intact. +Unable to raise arms against gravity: weakness of deltoid supplied by C 5 and C 6 +This suggests incomplete lesion to C 5 and/or C 6 ( areas where the lower motor neurons located.