TCRN Neurological Trauma 2

Question 1

A patient with a C5 spinal cord injury is most likely to experience which respiratory complication?

Accepted Answer

Diaphragmatic breathing only with impaired intercostal and accessory muscle function, requiring close monitoring

Answer

C5 injuries spare the diaphragm (C3-C5) but impair intercostal and accessory muscles, leaving patients at high risk for respiratory fatigue.

Question 2

Neurogenic shock following spinal cord injury is characterized by which hemodynamic pattern?

Accepted Answer

Hypotension with bradycardia and warm, vasodilated extremities

Answer

Loss of sympathetic tone in neurogenic shock produces vasodilation and bradycardia, distinguishing it from hypovolemic shock.

Question 3

Autonomic dysreflexia in a patient with a spinal cord injury above T6 is most commonly triggered by which cause?

Accepted Answer

A distended bladder or bowel

Answer

Bladder distension is the most common trigger of autonomic dysreflexia, causing massive sympathetic stimulation below the injury level.

Question 4

Which intervention is the priority when a spinal cord injury patient develops autonomic dysreflexia with BP 220/130 mmHg?

Accepted Answer

Sit the patient upright and identify and remove the triggering stimulus immediately

Answer

Sitting the patient upright uses gravity to lower BP while rapid identification and removal of the offending stimulus is the definitive treatment.

Question 5

Diffuse axonal injury (DAI) is best diagnosed by which imaging modality?

Accepted Answer

MRI of the brain

Answer

MRI is far superior to CT for detecting the small axonal shearing injuries characteristic of DAI, especially in white matter.

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