Exemplar 13.7: Spinal Cord Injury

The following is the pathophysiology and etiology of spinal cord injuries. Drag and drop the correct answers for each blank box. Good luck. The brain and spinal cord are the 2 major components of the [blank_start]CNS.[blank_end] The spinal cord transports sensory signals from the body to the brain and from the brain to the body. The spinal cord consists of an [blank_start]H-shaped core[blank_end] of [blank_start]gray matter[blank_end], which is made of neurons, glia, and blood vessels, and a surrounding area of [blank_start]white matter[blank_end], which is made of myelin-coated axons. The gray matter is further divided into 4 regions: [blank_start]interneurons[blank_end] of the [blank_start]dorsal horn[blank_end] that connect to visceral and somatic sensory neurons in the [blank_start]dorsal root,[blank_end] and visceral and somatic motor neurons of the [blank_start]ventral horn[blank_end] that combine to form the [blank_start]ventral root[blank_end]. The dorsal and ventral roots combine on each side of the body to form the [blank_start]spinal nerve[blank_end]. The axons of the white matter make up the descending and ascending pathways. The descending pathways carry signals from the [blank_start]brain[blank_end] to the [blank_start]body[blank_end] and the ascending pathways carry signals from the [blank_start]sensory neurons[blank_end] to the brain. The 33 bones of the vertebral column encase and protect the spinal cord. Between the bones of the vertebral column are [blank_start]spinal disks[blank_end] that provide cushioning during movement, and the spinal nerves protrude from the spinal column [blank_start]between[blank_end] the vertebrae near the spinal disks.

This is about the pathophysiology of spinal cord injuries. Drag and drop the correct answers. Good luck! Most damage to the spinal cord occurs due to a [blank_start]sudden, traumatic force[blank_end] that distorts the normal structure of the [blank_start]vertebral column.[blank_end] Bruising or tearing of the nerves occur when displaced bone fragments, disc material, or ligaments connecting the vertebrae come into contact with the [blank_start]spinal cord[blank_end]. The force may also cause damage to the blood vessels in the [blank_start]gray matter[blank_end], causing bleeding that can spread to the [blank_start]white matter[blank_end] and nearby segments of the spinal cord. The initial trauma produces a series of events that kills neurons, demyelinates axons, and triggers inflammation, Reduction in [blank_start]blood flow[blank_end] related to damage, swelling, and edema decreases oxygen to the nutrient supply, causing neurons to die. The gray matter is particularly susceptible.[blank_start]Swelling and edema[blank_end] can also directly compress the nerves. [blank_start]Immune cells[blank_end] that are normally trapped in blood vessels leak into the spinal cord, where they cause an inflammatory response, scavenge debris, and fight infection. They may also secrete cytokines that damage the nerve cells and stimulate [blank_start]collagen[blank_end] production, forming scars. Release of neurotransmitters, especially [blank_start]glutimate[blank_end], from damaged neurons causes excitotoxicity, which kills surrounding neurons and oligodendrocytes. These processes, combined with other responses, result in the destruction of nerves. When nerves are destroyed, the individual experiences a loss of motor and sensory function..

You have a father and a daughter come into the ER via an ambulance following a head on collision with a minivan in their car. Neither of your patients were thrown from the vehicle. Select the spinal cord injuries that these 2 are most likely to sustain.

You have a patient in your ER who attempted suicide by jumping off a building. She landed on her feet, Select the spinal cord injury this patient would be most likely to have.

You have a patient in your ER who was literally stabbed in the back. He was stabbed in his thoracic region, at about T4-T5. Which of the following spinal cord injuries is he most likely to have sustained?

Select the individual that is MOST LIKELY to end up with a spinal cord injury,

You are teaching a group of people at the community center in a moderate-income neighborhood about how to prevent spinal cord injuries. Which of the following statements is INCORRECT?

Select the emergency signs and symptoms of spinal cord injury.

You have a young male patient who is in your emergency room following a motorcycle crash. You know that he has a spinal cord injury at C5. Select the symptoms that would indicate that he is going into spinal shock.

You are teaching the family of a young female potentially suffering from a spinal cord injury following a cheerleading accident. They want to know some basic facts about spinal cord injuries. Which of the following is INCORRECT information to give to this patient's family?

You have a patient with a spinal cord injury at C6. Which of the following side effects is he unlikely to get from an injury in this region of the spine?

You have a male patient that has a break in his L1 region, causing him to be a paraplegic. Which of the following additional side effects is he MORE likely to suffer from?

Your quadriplegic patient suddenly has a spike in blood pressure (215/110). He's sweating profusely, his face is flushed, and he has goosebumps on his arms. Select the FIRST intervention you would take when handling this patient.

You are speaking to the family of a patient that may be a quadriplegic for the rest of his life. The patient is in a coma, but his family has been informed about his affliction. They are concerned about taking care of him outside of the hospital. They want to know what potential complications he might face, and how to prevent these things from happening. You give them the information you know, and now you are assessing their knowledge. Select the CORRECT statements made by the patient's family.

In an emergency care situation all individuals who have trauma to the head, are unconscious, have penetrating injuries near the spine, or have suffered from a fall or motor vehicle crash should be treated as if they have a spinal cord injury.

You are assisting in an emergency room one night when you get a call from an ambulance that is about to arrive. The patient was in a car crash and potentially has a cervical spinal cord injury. Select all the appropriate interventions for IMMEDIATE care of this patient once he's delivered by the emergency medical personnel.