Saturday, February 23, 2019
SCI Case Study
1. why did Allens heart rate and line of credit compact fall in this cadence of emergency (i.e. at a time when youd expect just the opposite homeostatic response)? Pg. 969 This occurred be pull in Allens spinal anaesthesia anesthesia cord has decrease perfusion out-of-pocket to damage, and a broken vertebral bone. Also, at that place has been a disruptions of the sympathetic fibers of his autonomic nervous system therefore it fuck no longer stimulate the heart. Allen likely has spinal take awayend.2. Upon admission to the hospital, Allens breathing was rapid and shallow, can you explain why? Pg. 969 Due to Allens fall he likely has an incompetent diaphragm due to injuring a cervical segment. This would alter effect the lower push neurons and external intercostal musculuss. This would cause his chest x-ray to show a decreased lung expansion. This may have caused Allen to have to take rapid shallow breaths to maintain oxygenation. Overall, break of serve of spinal innerva tion to the respiratory muscles would also explain his acidotic state.3. Why did Allen lose some sensation to his arms and all sensation from the fastness trunk down? This is because Allens C5 segment was injured. so, the dorsal column tracts and spinothalamic tracts were altered. This would cause Allen to have lost and decreased sensations.4. Why did Allen have dry strip down and a fever upon admission to the hospital? pg. 970 The rationale for the dry scratch and fever is that Allen had lack of sympathetic and hypothalamic control. Therefore, his body adapted to the temperature of the milieu as wells as attempting to increase extracellular fluid. Overall, spinal shock would result in these symptoms along with decreased sweat production resulting from decreased sympathetic motor neuron stimulation.5. Based on the physical interrogatory findings, which vertebral bone do you think was faultingd? Give reasons for your answers? Pg. 969 Based on the physical findings I would say Allens fracture occurred at C5. I believe this iswhere the fracture occurred because Allen had minimal biceps brachial grasp reflex, was satisfactory to tog out his shoulders and tighten them, and could tighten his biceps.In addition Allen could not raise his arms against gravity, had sonant lower extremities, and was without triceps or wrist extensor reflexes, and other muscle stretch reflexes were absent. If the fracture was at C4-5 Allen would not be able to shrug his shoulders and if the fracture was at C7 he could extend his flexed arms. Top of FormBottom of Form6. What is the usual pH of blood? Why was Allens blood pH below normal? Pg. 970-971. The normal blood pH is between 7.35 and 7.45. Allens blood was acidotic due to a decrease in lung expansion and an alteration in the perfusion to his spinal cord. He also has an alteration in spinal innervation to the respiratory muscles including the phrenic nerve that controls the diaphragm. This would further cause Allen to not be able to adequately take in enough oxygen and blow off enough CO2 to adequately have gas exchange, within the alveoli. respiratory failure.7. What is the primary muscle of respiration? What nerve initiates this muscle? The primary muscle of respiration is the diaphragm. The nerve that initiates this muscle is the phrenic nerve.8. Which spinal neurons to the nerve you named in question 7? Pg. 969. The cervical spinal nerve C3-5 innervate the phrenic nerve. These are the lower motor neurons.9. By four days afterward the injury, some of Allens signs and symptoms had changed. Allens arm muscles were still flaccid, yet his stage muscles had become spastic and exhibited exaggerated stretch reflexes. Use your knowledge of motor neural pathways to explain these findings. Pg. 969. Allen is experiencing these signs and symptoms because he is his spinal shock is now resolved. Therefore his lower motor neurons will then be able to awaken impulses unlike the upper motor neurons due to the i njury being at C5. Therefore, due to his cervical injury muscle spasticity, bladder activity, and reflex activity will begin. This is called spastic paralysis.10. Why did Allen suffer from urinary incontinence? Pg. 970. Allen suffered from urinary incontinence because of autonomic dysfunction. Initially autonomic dysfunction causes an areflexic bladder, also cognize as a neurogenic bladder. This means his bladder had zero top executive to contract. Autonomic dysfunction then leads to urinary retention.