TCRN Spinal Cord and Vertebral Trauma Flashcards

Autonomic dysreflexia is a potentially life-threatening complication that occurs primarily in patients with spinal cord injuries at what level or above?

Answer: T6

Autonomic dysreflexia occurs with injuries at T6 or above because the splanchnic sympathetic outflow (T6-L2) can no longer be modulated by descending supraspinal inhibitory signals.

When caring for a patient in a halo vest cervical stabilization device, what item is MOST critical to keep immediately at the bedside at all times?

Answer: A wrench or tool to quickly remove the anterior vest bolts for chest access

A wrench must be immediately accessible to rapidly remove the anterior halo vest bolts and access the chest for CPR in the event of cardiac arrest.

A patient with a complete T2 SCI is 48 hours post-injury. Which early complication poses the GREATEST immediate threat to life?

Answer: Deep vein thrombosis and pulmonary embolism

DVT and PE are leading causes of early mortality in acute SCI due to complete venous stasis from lower extremity paralysis; prophylaxis should be initiated within 72 hours.

Spinal shock is defined as which of the following phenomena following acute spinal cord injury?

Answer: Transient depression of all spinal reflexes and flaccid paralysis below the injury level

Spinal shock is a transient state of depressed cord function below the injury, characterized by flaccidity and absent reflexes; return of the bulbocavernosus reflex marks its resolution.

A ventilator-dependent C5 SCI patient develops increased secretions and diminished breath sounds in the right lower lobe. What is the PRIORITY nursing intervention?

Answer: Perform chest physiotherapy and assisted (quad) cough technique

Pulmonary hygiene with chest physiotherapy and assisted coughing is the priority nursing intervention to clear secretions in high-level SCI patients who have lost the independent ability to cough.

In the acute trauma setting, which imaging modality is MOST appropriate for initial evaluation of suspected thoracic vertebral injury in a hemodynamically unstable patient?

Answer: CT scan of the chest and thoracic spine

CT is preferred for acute spinal trauma evaluation because it is faster, more sensitive for bony injury, and readily available alongside standard trauma imaging protocols.

A patient with a complete C6 SCI is preparing for discharge. Which functional skill is a realistic independent goal for this injury level?

Answer: Independent intermittent self-catheterization using a tenodesis grip technique

C6 preserves wrist extension, enabling the tenodesis grip — a passive hand closure when the wrist is extended — which allows patients to perform self-catheterization and other ADLs independently.