Term
| the vertebral column consists of 33 vertebrae |
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Definition
| 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, 4 fused coccygeal |
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Term
| Vertebrae separated by disks which serve as shock absorbers for the vertebral column |
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Definition
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Term
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Definition
| anulus fibrosus and nucleus pulposus |
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Term
| : ring of tissue; encircles nucleus pulposus |
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Definition
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Term
| : saclike structure with a gelatinous filling that has a high-water content and acts as a shock absorber |
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Definition
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Term
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Definition
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Term
| spinal cord is surrounded by 3 proctective meningeal layers which are |
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Definition
| dura mater, arachnoid, pia mater |
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Term
| Middle layer: spaces containing CSF |
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Definition
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Term
| Innermost layer: directly covers the spinal cord |
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Definition
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Term
| trauma in which the skin and meningeal covering that surround the spinal cord remain intact |
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Definition
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Term
| damage to the protective skin and meninges |
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Definition
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Term
| complete spinal cord injury occurs when the cord has been |
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Definition
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Term
| incomplete spinal cord injury results from |
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Definition
| partial cutting of the cord |
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Term
| common causes of closed injuries include |
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Definition
| compression, flexion, hyperextension, rotation and blunt trauma |
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Term
| the higher the level of injury the more encompassing of the |
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Definition
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Term
| high cervical spine injuries, loss of motor and sensory function in all four extremities |
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Definition
| quadripleiga or tetraplegia |
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Term
| injuries at or below _ may cause paralysis of the lower part of the body (paraplegia) |
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Definition
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Term
| injuries at or above the level of _ may result in instant death because the nerves that control _ are interrupted |
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Definition
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Term
| the diaphragm is innervated by the _ nerve which is formed by the nerve roots of _ |
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Definition
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Term
| cervical injuries below the level fo _ spare the diaphragm but can involve impairment of _ |
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Definition
| c4, intercostal and abdominal muscles |
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Term
| injuries at or above the level of C5 are called |
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Definition
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Term
| many patients with high cervical injuries _ before reaching the hospital |
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Definition
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Term
| An immediate, transient response to injury in which reflex activity BELOW the level of the injury temporarily ceases (flaccid state |
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Definition
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Term
| spinal shock may appear as early as _ after the injury and may persist for _ |
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Definition
| 30-60 min, days, weeks or months |
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Term
| resolution of spinal shock is marked by |
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Definition
| involuntary movement of the extremity |
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Term
| injections are administered _ the level of paralysis |
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Definition
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Term
| one of the most serious and potentially dangerous problems for the spinal cord–injured patient (an emergent situation, thus an accurate hx must be obtained) |
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Definition
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Term
| Exaggerated response of autonomic nervous system to noxious (painful) stimuli |
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Definition
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Term
| in autonomic dysreflexia the _ is stimulated but an appropriat _ response cannot be elicited because of thespinal cord injury that separates the two divisions of the _ |
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Definition
| sympathetic nervous system, parasympathetic mudlation, autonomic nervous system |
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Term
| autonomic dysreflexias involves injury at or above the levelof |
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Definition
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Term
| In an attempt to reduce BP, regulatory mechanisms cause blood vessels to dilate but only ABOVE the level of the injury causing the following s/sx: |
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Definition
Superficial vasodilation, flushing and profuse sweating ABOVE the level of injury occurs
Increased BP also stimulates the vagus nerve causing bradycardia
Vessels are constricted BELOW the injury causing cold skin and “goose flesh |
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Term
| autonomic dyreflexias signs and Sx |
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Definition
Sudden HTN
Pounding HA
Anxiety
Flushed Face
Diaphoresis
Nasal Congestion
Bradycardia
Increased spasticity
Blurred vision
Nausea
Erection of body hair
Vasoconstriction BELOW LESION- Cold skin and “goose flesh”
Vasodialation ABOVE LEISION-Warm moist skin |
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Term
| autonomic dysreflexia involves excessive stimulation of sensory receptros _ the level of the injury preciptates |
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Definition
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Term
| stimuli that triggers autonomic dysreflexia |
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Definition
Distended bladder
Constipation
Renal calculi
Ejaculation
Uterine contractions
Pressure sores
Skin rash
Enemas
Even sudden position changes |
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Term
| common causes of closed injuries include |
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Definition
| compression, flexion, hyperextension, rotation, and blunt trauma |
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Term
| muscle tone is evelauated by assessing the amount of resistance to |
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Definition
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Term
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Definition
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Term
| after _ years after autonomic dyreflexia there is a gradual reduction in spastic episodes |
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Definition
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Term
| meds used to decrease spasms |
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Definition
| valium, lioresal, dantrium |
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Term
| During spinal shock, all bladder and bowel function |
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Definition
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Term
| Once spinal shock resolves, reflex activity |
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Definition
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Term
| nursing care for impaired bladder function r/t autonomic dysreflexia |
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Definition
Bladder retraining programs
Meticulous cath care
Increase oral intake (limit dairy- urinary calculi)
Admin Mandelamine a antiseptic for UTI
Vitamin C decrease urine pH |
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Term
| catheter is remvoed as soon as |
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Definition
| the pt fluid status is stabilized |
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Term
| first day or two after SCI may require insertionof NG tube for |
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Definition
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Term
| Pirstaliss usually returns by _ post injury day |
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Definition
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Term
| nursing care for pt with impaired temp regulation |
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Definition
Maintain environment temp to avoid chilling or overheating (room 70o)
Prevent hypothermia (provide adequate clothing and blankets)
Change wet clothes immediately
Prevent hyperthermia (avoid outdoors when very hot – use water spray bottle and fan) |
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Term
| spinal levels that control sexual function |
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Definition
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Term
| women with SCI can have sexual intercourse but lack _ sensation |
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Definition
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Term
| when a pt is in the wheel chair they should be repositioned every |
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Definition
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Term
| The three major medical goals for spinal injury patients: |
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Definition
Save the patient’s life
Prevent further injury to the cord
Preserve as much cord function as possible |
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Term
| preferred method of opening the airway for SCI pt |
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Definition
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Term
| Secured just above the ears; doesn’t actually penetrate skull |
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Definition
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Term
| Applied directly to the skull just behind the hairline |
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Definition
| Crutchfield tongs (less commonly used) |
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Term
| Immobilizes and aligns cervical vertebrae; placed when surgery is done to internally stabilize fractures and relieve the compression of nerve roots |
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Definition
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Term
| continually rotates the patient from side to side (prevents pulmonary complications by mobilizing secretions) |
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Definition
| kinectic bed (roto rest bed) |
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Term
| : flotation devices placed on standard hospital beds |
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Definition
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Term
| Air-fluidized and flotation beds may be used _ the spine has been stabilized |
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Definition
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Term
| : canvas and metal frame bed that may be used to help turn the patient |
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Definition
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Term
| Types of cushions include those inflated with |
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Definition
| air, flotation devices, and gel pads |
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Term
| air fluidized and flotation are never used whne a patient is in _ because of the potential damage that could occur if the bed should unexpectedly deflate |
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Definition
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Term
| types of cushions used for chairs |
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Definition
| ROHO cushion, bye bye decubiti, jay cushion, AKRO cusion anD varilite CUSION |
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Term
| ways methylprednisolone helps with SCI |
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Definition
Reduces the damage to the cellular membrane
Optimal administered time is within the first 8 hours of injury
Completely paralyzed patients often regain about 20% of function
Partially paralyzed have regained up to 75% of function |
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Term
| Involves removing all or part of the posterior arch of the vertebra for the sake of preserving cord funciton |
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Definition
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