1. Why did Allen’s heart rate and blood pressure fall in this time of emergency (i.e. at a time when you’d expect just the opposite homeostatic response)? Pg. 969 This occurred because Allen’s spinal cord has decreased perfusion due to damage, and a broken vertebral bone. Also, there has been a disruptions of the sympathetic fibers of his autonomic nervous system therefore it can no longer stimulate the heart. Allen likely has spinal shock.
2. Upon admission to the hospital, Allen’s breathing was rapid and shallow, can you explain why? Pg. 969 Due to Allen’s fall he likely has an incompetent diaphragm due to injuring a cervical segment. This would alter effect the lower motor neurons and external intercostal muscles. 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, interruption of spinal innervation 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 upper trunk down? This is because Allen’s C5 segment was injured. Therefore, 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 skin and a fever upon admission to the hospital? pg. 970 The rationale for the dry skin and fever is that Allen had lack of sympathetic and hypothalamic control. Therefore, his body adapted to the temperature of the environment 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 exam findings, which vertebral bone do you think was fractured? Give reasons for your answers? Pg. 969 Based on the physical findings I would say Allen’s fracture occurred at C5. I believe this is where the...
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