How do spinal fractures cause SCIs?The bone fragments pinch/sever the spinal cordHow does tissue damage cause SCIs?Swelling of tissue compresses the spinal cordHow does blood flow issues cause SCIs?Ischemia to the spinal cord causes cord cell deathWhat is a complete SCI?Total loss of sensory and motor function below the level of injuryIs a complete SCI permanent?YesWhat is an incomplete SCI?Some loss of sensory and motor function below the level of injuryWhich type of SCI is the most common: complete or incomplete?IncompleteWhat are the four types of incomplete SCI?Central cord Anterior cord Brown-Sequard Posterior cordWhat is central cord syndrome?Central injury to the spinal cordHow does central cord syndrome effect motor function?There is more weakness in the arms than the legsHow does central cord syndrome effect the bladder?There is bladder dysfunctionHow does central cord syndrome effect sensation?There is variable loss of sensationIs there more functional loss above or below the injury with central cord syndrome?Above the injuryWhat often causes central cord syndrome?Hyperextension of the spinal cordWhat is anterior cord syndrome?Anterior injury to the spinal cordHow does anterior cord syndrome effect motor functionThere is weakness and/or paralysis below the injuryWhat parts of sensation are lost with anterior cord syndrome?Pain Temperature Crude touch/pressureWhat parts of sensation are intact with anterior cord syndrome?Positional sense Fine touch/pressure VibrationWhat often causes anterior cord syndrome?Compression of the spinal cord from bony fragments or acute disk herniationWhat is posterior cord syndrome?Posterior injury to the spinal cordWhat sensations are lost with posterior cord syndrome?Positional sense Fine touch/pressure VibrationWhat sensations are intact with posterior cord syndrome?Pain Temperature Crude touch/pressureWhat often causes posterior cord syndrome?Compression of the spinal cord from bony fragments or acute disk herniationWhat is Brown-Sequard syndrome?A hemisection injury to the spinal cordHow does Brown-Sequard syndrome effect motor function?There is total loss on the same side of the injuryWhat parts of sensation are lost on the same side of the injury with Brown-Sequard syndrome?Positional sense VibrationWhat parts of sensation are lost on the opposite side of the injury with Brown-Sequard syndrome?Pain TemperatureOn which side of the injury will a patient feel pain and temperature with Brown-Sequard syndrome?The same sideOn which side of the injury will a patient have motor function with Brown-Sequard syndrome?The opposite sideWhat often causes Brown-Sequard syndrome?Penetrating injury Primary ischemia, infection, or hemorrhageWhich of the four incomplete SCIs is the most common?Central cord syndromeIf an SCI occurs above C4, what major function is lost?Ability to breatheWhy is ability to breathe lost with SCIs above C4?The phrenic nerve innervates the diaphragm in that areaIf an SCI occurs in the thoracic area, what major functions are lost?Trunk control Arm movementIf an SCI occurs in the lumbar and/or sacral area, what major functions are lost?Bowel Bladder SexualWhy is a neuro exam helpful with diagnosing an SCI?If it is purely an SCI, then there will be loss of neurological functionIf there is suspicion of an SCI, what is the first diagnostic test done?CT scanIf the team is unsure whether a patient has an SCI or not, what diagnostic test is done?X-rayIf a CT scan shows an SCI, what diagnostic test is done for further evaluation?MRIWhat is the best way to quickly diagnose a SCI?A CT scanWhy is an MRI avoided with SCIs?The patient has to lie still for a long time and it can be very painfulWhat should be the priority with any SCI?Maintaining the airwayWhat are the three priorities when treating SCIs?Airway patency Blood pressure Spinal immobilizationWhat are the two major surgeries done to treat SCIs?Decompression laminectomy Spinal fusionWhat is a halo brace used for?Maintaining cervical immobilizationWhat are the major complications associated with a halo brace?Pin infection Skin breakdown Loosening/movement of pins Swallowing problems Dural tearsHow often should pin site care be done with a halo brace?Once a shift and as neededCan a patient go home on a halo device?YesWhat should be used to clean around the pins with a halo brace?Normal salineWhy should alcohol never be used to clean around the pins with a halo brace?It will dry out the skin and increase the risk of infectionWhy is it important to assess vest placement with a halo brace?Improper vest fit can cause pressure injuriesWhat should be done if a pin is loose with a halo brace?Call the neurosurgeon immediatelyWhen would a halo brace be adjusted?If it is causing swallowing problems for the patientWhat is the main sign of dural tears caused by a halo brace?CSF leakage around the pin sitesWhat is spinal shock?The brain is unable to send signals to the muscle and organsWhat does spinal shock cause?Loss of sensation, movement, and other body functionsWhen does spinal shock occur?Immediately after the SCIWhat happens to spinal reflexes with spinal shock?There is complete loss or depression of the reflexesIs loss of spinal reflexes permanent with spinal shock?No it is temporaryWhat may happen to blood pressure with spinal shock?HypotensionWhat happens to the skeletal muscles with spinal shock?There is flaccid paralysisWhat happens to DTRs with spinal shock?They are absentWhat happens to positional sense with spinal shock?It is impairedWhat happens to visceral/somatic sensations with spinal shock?They are decreasedWhat happens to the urinary system with spinal shock?There is urinary retentionWhat happens to the GI system with spinal shock?There is fecal impaction caused by paralytic ileusWhat happens to sweat production with spinal shock?It is not producedHow long does spinal shock typically last?From 24 hours to 1-6 weeksWhat indicates the end of spinal shock?Return of reflex activity below the level of injuryAre spinal shock and neurogenic shock the same thing?NoWhy is spinal shock NOT true shock?It is not caused by an oxygenation issueWhen are long-term injuries assessed for with spinal shock?After reflexes return below the level of injuryDoes lactic acid increase with spinal shock?NoIs there vasodilation with spinal shock?NoWhat type of medication is given to treat spinal shock?SteroidsWhat type of shock is neurogenic shock?DistributiveWhat happens with neurogenic shock?Massive vasodilationWhat causes neurogenic shock?SCI to T6 and aboveWhat happens to the ANS with neurogenic shock?There is sudden loss of signals to smooth muscle in the vesselsWhat happens to cardiac output/cardiac index with neurogenic shock?They decreaseWhat happens to blood pressure with neurogenic shock?It decreasesWhat happens to heart rate with neurogenic shock?It decreasesWhy is there bradycardia rather than tachycardia with neurogenic shock?There is a loss of sympathetic innervation of the heartHow can you tell neurogenic shock from other types of shock?Severe bradycardia occurs rather than tachycardiaWhat are the priority treatments with neurogenic shock?1. Fluid resuscitation 2. Dopamine 3. Temporary pacemakerWhat has to be given for neurogenic shock before dopamine can be used?Fluid bolusesIf dopamine is not working to increase heart rate with neurogenic shock, what is the next option?Temporary pacemakerWhat is a last line medication given for neurogenic shock?AtropineHow is spinal shock and neurogenic shock different?Spinal shock is caused by an injury to any part of the spinal cord; neurogenic is caused by injury to T6 or aboveWhat happens to lactic acid with neurogenic shock?It increasesWhat indicates successful treatment of neurogenic shock?Increases in BP and COWhat is autonomic dysreflexia?Massive SNS response caused by a strong sensory inputWith what type of SCI does autonomic dysreflexia occur with?High SCIs above T5-T6When does autonomic dysreflexia start to occur?After the first year of injuryWhat are the most common causes of autonomic dysreflexia?Pain Distended bladder Rapid temperature change Infection Full rectumWhat causes the massive SNS response with autonomic dysreflexia?Strong sensory input is unable to reach the brain, so the input just keeps increasingWhat happens to the vessels with autonomic dysreflexia?Widespread vasoconstrictionWhat happens to blood pressure with autonomic dysreflexia?There is severe hypertensionWhat is a key sign of autonomic dysreflexia?Facial flushing above the injury and pale skin below the injuryWhy does facial flushing occur with autonomic dysreflexia?There is vasodilation above the injuryWhy is the skin pale with autonomic dysreflexia?There is vasoconstriction below the injuryWhy do patients with autonomic dysreflexia have nasal congestion?There is vasodilation in the noseWhy do patients with autonomic dysreflexia have headaches?Vasodilation causes cerebral edemaWhat happens with heart rate in autonomic dysreflexia?BradycardiaWhy is there bradycardia with autonomic dysreflexia?The heart slows down to compensate for high blood pressureWhat is a key sign with vitals of autonomic dysreflexia?Slowing heart rate that has no effect on severely high blood pressureWhat is the only way to treat autonomic dysreflexia?Resolving the problem causing massive SNS inputWhy do blood pressure medications NOT help with autonomic dysreflexia?The only way to lower BP is by solving the problem causing massive SNS inputWhat is the only medication that can somewhat treat BP with autonomic dysreflexia?HydralazineIs autonomic dysreflexia a medical emergency?YesHow often should BP be monitored in patients with autonomic dysreflexia?Every five minutesWhy is BP monitored so closely with autonomic dysreflexia?To watch for any change that signals the SNS input problem has been solvedWhat should the head of the bed be with autonomic dysreflexia patients?45 degrees or higherWhy does sitting a patient up help with autonomic dysreflexia?It causes blood to pool in the extremities, which may reduce BP somewhatWhy should all restrictive clothing be loosened immediately with autonomic dysreflexia?They can cause the massive SNS input responseWhy should catheterization be done immediately with autonomic dysreflexia?A distended bladder is a common cause of massive SNS inputWhy should a UA always be done with autonomic dysreflexia?To check for kidney infection that may be causing the massive SNS inputWhat are the most common signs of cervical injuries?Loss of motor function Difficulty breathing Loss of bowel/bladder function Numbness Weakness/paralysis Pain Sensory changes SpasticityWhat are the most common signs of thoracic injuries?Loss of bowel/bladder function Numbness Sensory changes Spasticity Pain Weakness/paralysisWhat are the most common signs of lumbar/sacral injuries?Loss of bowel/bladder function Numbness Pain Sensory changes Spasticity Weakness/paralysis

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physics

Three stars, each with the mass and radius of our sun, form an equilateral triangle $5.0 \times 10^9 \mathrm{~m}$ on a side. If all three are simultaneously released from rest, what are their speeds as they crash together in the center?

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chemistry

Propane is often used as a home fuel in areas where natural gas is not available. When 3.00 grams of propane, $\mathbf{C}_{3} \mathbf{H}_{8}(g)$ , are burned in excess oxygen in a bomb calorimeter that has a total heat capacity $32.7 \mathrm{kJ} \cdot \mathrm{K}^{-1}$ , the temperature of the calorimeter increases by 4.25 K. Calculate the standard enthalpy of combustion in kilojoules per gram and kilojoules per mole of propane. Assume that $\Delta H_{\mathrm{rxn}} \approx \Delta U_{\mathrm{rxn}}$ .

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chemistry

Write structural formulas of the type indicated: (a) bond-line formulas for seven constitutional isomers with the formula $\mathrm{C}_{4} \mathrm{H}_{10} \mathrm{O};$ (b) condensed structural formulas for two constitutional isomers with the formula $\mathrm{C}_{2} \mathrm{H}_{7} \mathrm{N} ;$ (c) condensed structural formulas for four constitutional isomers with the formula $\mathrm{C}_{3} \mathrm{H}_{9} \mathrm{N} ;$ (d) bond-line formulas for three constitutional isomers with the formula $\mathrm{C}_{5} \mathrm{H}_{12}.$