Question

A client with a cervical spinal cord injury is experiencing a loss of motor function below the level of injury with sensation, touch, position, and vibration intact. The nurse recognizes that the client has damage in which area of the following areas? A. Anterior cord injury B. Posterior cord injury C. Central cord injury D. Brown-Sequard's paralysis

Short answer

Answer: Posterior cord injury.

Step-by-step solution

Understanding the options

First, let's learn about each type of injury briefly: A. Anterior cord injury: Damage to the front of the spinal cord, results in motor function loss along with loss of pain and temperature sensations. B. Posterior cord injury: Damage to the back of the spinal cord, results in the loss of proprioception, vibration, and deep touch sensations. C. Central cord injury: Damage to the center of the spinal cord, most common in older people. Resulting symptoms may include variable motor function loss and sensory loss. D. Brown-Sequard's paralysis: Damage to one side of the spinal cord, which leads to motor function loss on the same side and pain/temperature sensation loss on the opposite side of the body.

Matching symptoms with options

Analyzing the question, we know that the client's symptoms are: Motor function loss Intact touch, position, and vibration senses Intact sensation Now, let's match this symptom set with the options: A. Anterior cord injury: Motor function loss matches, but pain and temperature sensations should be lost, which is not the case; hence, this isn't the correct option. B. Posterior cord injury: Touch, position, and vibration senses are intact, which matches the symptoms, and it doesn't mention motor function loss; thus, this is the correct option. C. Central cord injury: This option would imply some sensory loss, which is not present in the case; thus, it's not the correct option. D. Brown-Sequard's paralysis: Motor function loss matches, but pain and temperature sensation loss on the opposite side of the body is not mentioned as a symptom; thus, this isn't the correct option.

Final answer

After analyzing the information and matching the symptoms with the options, it is clear that option B, Posterior cord injury, is the correct answer.

Key concepts

Cervical Spinal Cord Injury

A cervical spinal cord injury occurs when there is damage to the cervical portion of the spinal cord, which is located in the neck. Its ramifications can be severe because this section of the spinal cord controls signals to the rest of the body below the level of injury. This means that injuries to this area can affect arms, legs, and potentially vital functions such as breathing.

Patients with cervical spinal cord injuries often face a range of symptoms depending on the severity and exact location of the injury. These symptoms can include quadriplegia, which is paralysis of all four limbs, or paraplegia, which involves paralysis of the lower limbs. Sensory changes, such as loss of sensation or altered sensations, can also occur. Managing these injuries requires comprehensive care, including acute management, rehabilitation, and long-term care strategies to prevent complications and maximize function. It's also crucial for nurses and other healthcare providers to closely monitor for changes in neurologic status, respiratory function, and other vital signs.

Anterior Cord Syndrome

When we talk about Anterior Cord Syndrome, we are referring to a type of spinal cord injury that affects the anterior part of the spinal cord, where the motor and sensory pathways are located. This condition typically results in a loss of motor function and loss of the ability to sense pain and temperature below the level of the injury.

In a clinical setting, a nurse might ascertain that a patient has Anterior Cord Syndrome if the patient presents with motor paralysis or weakness below the injury level while still retaining some sensation of touch, pressure, and proprioception. This can be a confusing presentation for both patients and healthcare providers because the preservation of certain sensations may contrast with the profound loss of others. Treatment requires careful management to prevent further injury and to support the patient through recovery or adaptation.

Brown-Sequard Syndrome

Lastly, we explore Brown-Sequard Syndrome, also known as hemisection of the spinal cord. This syndrome results from damage to one side of the spinal cord, which causes a unique pattern of symptoms. On the side of the injury, the patient experiences a loss of motor function and position sense, while the opposite side of the body experiences a loss of pain and temperature sensation.

This asymmetrical pattern of symptoms can be puzzling to assess, but understanding the neuroanatomy of the spinal cord helps to explain why these specific deficits occur. Treatment of Brown-Sequard Syndrome focuses on stabilizing the spinal column, preventing secondary damage, and maximizing neurologic recovery through rehabilitation. Nurses play an integral role in observing and managing these patients’ progress over time.