Share This Link

“You will have more normal function when spinal shock resolves and the reflex arc returns.” While reflexes may return after spinal shock, function is not guaranteed to improve. This statement risks giving false reassurance rather than acknowledging the uncertain prognosis.

“When your condition is more stable, MRI will be done to reveal the extent of the cord damage.” MRI is helpful in visualizing structural damage but cannot always predict functional recovery. This response focuses too narrowly on a test and does not address the role of secondary injury processes.

“Because long-term rehabilitation can affect the return of function, it will be years before we can tell what the complete effect will be.” Rehabilitation does influence recovery, but functional outcomes are usually more predictable within weeks to months, not years. This response is unnecessarily discouraging and inaccurate.

Loss of all respiratory muscle function. This occurs with injuries at or above C4, where even diaphragmatic control is lost. Because this patient’s injury is below C4, the diaphragm remains functional.

Decreased response of the sympathetic nervous system. Autonomic dysfunction occurs with higher thoracic injuries, but it is not the most immediate threat compared to compromised breathing mechanics. The priority remains respiratory monitoring and support.

GI hypomotility with paralytic ileus and gastric distention. Gastrointestinal effects do occur after SCI, but they are not the primary concern in the acute phase. Airway and breathing always take precedence.

SpO₂ of 92%. Although slightly low, this oxygen saturation is not immediately life-threatening compared to severe bradycardia. Supplemental oxygen can be provided while more urgent cardiac concerns are addressed.

Blood pressure of 88/60 mm Hg. Hypotension is common in neurogenic shock, but by itself it is less critical than profound bradycardia. Severe hypotension usually develops in combination with bradycardia, but a heart rate of 42 bpm poses the more immediate risk.

Loss of motor and sensory function in arms and legs. While neurologic deficits are significant for long-term disability, they are not life-threatening in the acute phase. Cardiovascular instability takes precedence in the emergency setting.

Rehabilitation measures cannot be initiated until spinal shock has resolved. Rehabilitation can and should begin early to maintain mobility, prevent complications, and support patient adjustment. Waiting for spinal shock to resolve would delay essential interventions.

The patient will need continuous monitoring for hypotension, tachycardia, and hypoxemia. These findings are associated with neurogenic shock, not spinal shock. Spinal shock primarily involves loss of motor, sensory, and reflex activity rather than hemodynamic instability.

The patient will have complete loss of motor and sensory functions below the level of the injury but autonomic functions are not affected. In spinal shock, autonomic functions are also suppressed. Bladder, bowel, and sexual reflexes are absent until the condition resolves.

He is most likely to have reflexogenic erections and may experience orgasm if ejaculation occurs. Reflexogenic erections require intact sacral reflex arcs, which are destroyed in LMN lesions. Therefore, this option does not apply to this type of injury.

He may have uncontrolled reflex erections but orgasm and ejaculation are usually not possible. Reflex erections are possible in upper motor neuron lesions, but not in LMN lesions, because the reflex centers are damaged. This statement inaccurately describes the effect of LMN lesions.

He has a lesion with the greatest possibility of successful psychogenic erection with ejaculation and orgasm. Psychogenic erections may occur in incomplete LMN lesions, but they are unlikely in complete lesions. The disruption of both descending pathways and reflex arcs makes this option incorrect.