NCS Spinal Cord Injury 3

Question 1

Autonomic dysreflexia (AD) most commonly occurs in individuals with spinal cord injuries at or above which neurological level?

Accepted Answer

T6

Answer

Autonomic dysreflexia occurs at T6 or above because injuries at this level disrupt supraspinal control of the splanchnic sympathetic outflow.

Question 2

The FIRST intervention when a patient with tetraplegia presents with sudden severe hypertension and pounding headache suggestive of autonomic dysreflexia is to:

Accepted Answer

Sit the patient upright and lower the legs to reduce blood pressure

Answer

Sitting the patient upright uses orthostatic hypotension reflexively to lower blood pressure while the noxious stimulus source is identified.

Question 3

Which of the following is the MOST common trigger for autonomic dysreflexia?

Accepted Answer

Bladder distension or urinary retention

Answer

Bladder distension from urinary retention or a blocked catheter is the most frequent precipitating cause of autonomic dysreflexia.

Question 4

How does neurogenic shock differ from hypovolemic shock in acute spinal cord injury?

Accepted Answer

Neurogenic shock features bradycardia and vasodilation; hypovolemic features tachycardia and vasoconstriction

Answer

Neurogenic shock results from loss of sympathetic tone causing vasodilation and bradycardia, while hypovolemic shock causes compensatory tachycardia and vasoconstriction.

Question 5

Spinal shock following acute SCI is best characterized by:

Accepted Answer

Transient areflexia, flaccidity, and loss of autonomic function below the injury

Answer

Spinal shock is a transient physiological depression of spinal cord function presenting with flaccidity, areflexia, and autonomic dysfunction below the injury level.

(NCS) Neurologic Clinical Specialist Practice Test

(NCS) Neurologic Clinical Specialist Practice Test

NCS Spinal Cord Injury 3