Mon22November1200AM 5

Clinical feature of quadriplegia of 48 hours duration include:

True / False

Hypotension from controlled ventilation Incorrect answer selected

Bradycardia Correct

Deranged temperature control Correct

Adductor spasms of the legs Correct

Urinary retention Correct

Explanation

Quadriplegia is the partial or absolute loss of function of all four limbs. It is typically caused by damage to the cervical spinal cord (C1-C8) by trauma or conditions such as transverse myelitis, polio or muscular dystrophy.

Motor, sensory and autonomic function is innervated by each segment of the spinal cord and its corresponding spinal nerve. Function below the level of spinal cord injury will be either lost or impaired.

Cardiovascular instability is a cardinal feature of spinal cord injury (SCI). Hypotension frequently results from a number of factors:

Loss of sympathetic innervation to arteriolar and venous resistance vessels below the level of the lesion leading to vasodilatation and pooling of blood

Loss of venous return to the heart

Interruption of the sympathetic innervation of the heart (T1-T4)

Unopposed parasympathetic innervation of the heart leading to a bradycardia, and

Potential for cardiac arrest especially when the patient has a stimulus applied (tracheal suction, bladder distension or hypoxia).

Autonomic dysreflexia may result in both hypotension or hypertension. The hypotension can be exacerbated by positive pressure ventilation. Autonomic dysfunction can lead to a derangement of temperature control.

Victims of SCI often develop a neurogenic bladder. This bladder dysfunction can be flaccid or spastic. Symptoms include overflow incontinence, frequency, urge incontinence, urgency and urinary retention. Patients run the risk of secondary complications (e.g. recurrent UTIs, vesicoureteral reflux and autonomic dysreflexia). Diagnosis involves imaging and cystoscopy or urodynamic testing. Treatment involves catheterization or measures to trigger urination.

Adductor spasms are a chronic feature of SCI with 65-78% of patients developing troublesome spacticity. Spasticity is characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex.

Answer Statistics

Not enough data to display the statistics

Average score: 78.58%

Times answered: 267