Exemplar 13.7: Spinal Cord Injury

Question 1 of 16

15

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 ❌ 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 ❌ of ❌, which is made of neurons, glia, and blood vessels, and a surrounding area of ❌, which is made of myelin-coated axons.

The gray matter is further divided into 4 regions: ❌ of the ❌ that connect to visceral and somatic sensory neurons in the ❌ and visceral and somatic motor neurons of the ❌ that combine to form the ❌. The dorsal and ventral roots combine on each side of the body to form the ❌.

The axons of the white matter make up the descending and ascending pathways. The descending pathways carry signals from the ❌ to the ❌ and the ascending pathways carry signals from the ❌ to the brain.

The 33 bones of the vertebral column encase and protect the spinal cord. Between the bones of the vertebral column are ❌ that provide cushioning during movement, and the spinal nerves protrude from the spinal column ❌ the vertebrae near the spinal disks.

Drag and drop to complete the text.

H-shaped core

H-shaped capsule

Blot-shaped

gray matter

white matter

interneurons

connecting neurons

dorsal horn

dorsal root,

ventral horn

ventral root

spinal nerve

spinal tract

spinal cord

brain

body

sensory neurons

motor neurons

spinal disks

spinal cartilage

between

inside

around

CNS.

Explanation

Question 2 of 16

10

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 ❌ that distorts the normal structure of the ❌ Bruising or tearing of the nerves occur when displaced bone fragments, disc material, or ligaments connecting the vertebrae come into contact with the ❌. The force may also cause damage to the blood vessels in the ❌, causing bleeding that can spread to the ❌ 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 ❌ related to damage, swelling, and edema decreases oxygen to the nutrient supply, causing
neurons to die. The gray matter is particularly susceptible.❌ can also directly compress the nerves.

❌ 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 ❌ production, forming scars.

Release of neurotransmitters, especially ❌, 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..

Drag and drop to complete the text.

sudden, traumatic force

slow, traumatic force

slow process

vertebral column

vertebral cartilage

spinal cord

gray matter

white matter

blood flow

nerve transmission

Swelling and edema

Swelling

Edema

Blood loss

Immune cells

Macrophages

Neutrophils

collagen

cartilage

glutimate

norepinephrine

dopamine

Explanation

Question 3 of 16

1

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.

Select one or more of the following:

Hyperflexion causing a C5-C7 injury.
Hyperextension causing T12 injury.
Compression of the spinal cord.
Rotational injuries
Transection at T4

Explanation

Question 4 of 16

1

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.

Select one of the following:

Hyperflexion at C5-C7
Hyperextension at L1
Compression
Rotational injury
Transection at S1

Explanation

Question 5 of 16

1

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 one of the following:

Hyperflexion
Hyperextension
Compression
Rotational
Transection

Explanation

Question 6 of 16

1

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

Select one of the following:

A 22 year old, unmarried, African American male.
A 22 year old, unmarried, white male.
A 65 year old, widowed, white male.
A 22 year old, unmarried, white, female diver.
A 25 year old Asian male that likes to drive ATVs.

Explanation

Question 7 of 16

1

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 one of the following:

"Always drive defensively and wear a seat belt."
"Make sure you put your children in child seats that are appropriate for their height and weight."
"Ask your doctor, pharmacist, or even a nurse if dizziness is a side effect of a new medication."
"Always check the water depth before you dive into an above ground pool."
"Wear helmets, knee pads, and other safety gear when playing sports."
"If playing sports like football or baseball, avoid sliding in head first, even if you are wearing a helmet."

Explanation

Question 8 of 16

1

Select the emergency signs and symptoms of spinal cord injury.

Select one or more of the following:

Extreme pain/pressure in the patient's neck and back.
Weakness, paralysis, or lack of sensation in any part of body.
Loss of bladder/bowel control
Impaired breathing
Oddly positioned/twisted back or neck.
Vomiting
Dilated pupils
Nystagmus

Explanation

Question 9 of 16

1

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.

Select one or more of the following:

Sudden hypotension
Complete inability to move.
Loss of spinal reflexes (i.e., patellar reflexes).
Severe and sudden bradypnea.
Muscle spasms

Explanation

Question 10 of 16

1

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?

Select one of the following:

"Her spinal cord injury can be complete or incomplete."
"She has a better chance of regaining motor and sensory function if the injury is incomplete."
"There are 6 main types of incomplete spinal cord syndromes: central cord, anterior cord, Brown-Sequard, Conus medullaria, posterior cord, and cauda equina syndromes."
"Your daughter's symptoms and prognosis varies, depending on where the injury is."

Explanation

Question 11 of 16

1

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?

Select one of the following:

Tetraplegia
Neurogenic pain
Urinary and bowel incontinence
Loss of control of all 4 muscles needed for respiration.
Hypotension and bradycardia
Arrythmias

Explanation

Question 12 of 16

1

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?

Select one of the following:

Hemiplegia.
Problems with respiratory function.
Bradycardia and arrythmias
Sexual dysfunction

Explanation

Question 13 of 16

1

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.

Select one of the following:

Empty the bladder
Empty the bowels.
Remove any tight clothing.
Lay the patient on his side.

Explanation

Question 14 of 16

1

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.

Select one or more of the following:

"We can avoid autonomic dysreflexia by keeping him on a toileting and turning schedule."
"We can avoid strokes and heart attacks by giving him his prescribed Warfarin."
"We should not bother the doctor if he experiences shortness of breath and pale skin. These are normal findings for spinal cord injury patients."
"If he receives a wound, it will likely heal slower, so we should treat it and not worry about it too much."
"He may go through the steps of grief once he hears that he might be a quadriplegic for life. He may need additional psychological care or medication to help him."

Explanation

Question 15 of 16

1

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.

Select one of the following:

True
False

Explanation

Question 16 of 16

1

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.

Select one or more of the following:

Prepare to assist the physician in applying a cervical brace.
Prepare to assist with the insertion of an artificial airway.
Move the client from the stretcher to the hospital bed with the backboard still in place.
Monitor vital signs
Monitor ABGs
Monitor any devices used to assist with breathing.
Treat skin wounds and bone fractures
Insert an indwelling catheter.

	Created by Olivia McRitchie over 6 years ago

NCLEX Nursing (Medical-Surgical) Quiz on Exemplar 13.7: Spinal Cord Injury, created by Olivia McRitchie on 09/04/2018.

Exemplar 13.7: Spinal Cord Injury

Question 1 of 16

Drag and drop to complete the text.

Explanation

Question 2 of 16

Drag and drop to complete the text.

Explanation

Question 3 of 16

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.

Select one or more of the following:

Explanation

Question 4 of 16

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.

Select one of the following:

Explanation

Question 5 of 16

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 one of the following:

Explanation

Question 6 of 16

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

Select one of the following:

Explanation

Question 7 of 16

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 one of the following:

Explanation

Question 8 of 16

Select the emergency signs and symptoms of spinal cord injury.

Select one or more of the following:

Explanation

Question 9 of 16

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.

Select one or more of the following:

Explanation

Question 10 of 16

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?

Select one of the following:

Explanation

Question 11 of 16

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?

Select one of the following:

Explanation

Question 12 of 16

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?

Select one of the following:

Explanation

Question 13 of 16

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.

Select one of the following:

Explanation

Question 14 of 16

Select one or more of the following:

Explanation

Question 15 of 16

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.

Select one of the following:

Explanation

Question 16 of 16

Select one or more of the following:

Explanation