Pathophysiology

Pathophysiology Study Guide

©2018 of 131 Facial Trauma Facial trauma refers to traumatic injury to the face that involves injuries to the soft tissues. These injuries include burns, lacerations, fractures of the bones of the face, nose fracture, injuries to eyes, and bruising. The mechanism of these injuries involves severe falls, collision with motor vehicles, sports-based injuries, assault, war injuries, and animal attacks. Symptoms relate to the type of injury. For instance, the fractures of facial bones are associated with pain, bruising, and edema of the surrounding facial tissues. Nasal fractures have symptoms of profuse nose bleeding, deformity of the nose, bruising, and swelling. Similarly, mandibular fractures involve pain when opening the mouth and numbness in the lip as well as the chin. Spinal Cord Spinal cord traumatic injury is the damage to the nerves at the end of the spinal canal, or any part along the spinal cord, which causes temporary, but more often permanent, changes in the sensation, strength, and overall body function. The cause of these injuries includes damage to the spinal cord, vertebrae, ligaments, or disk of the spinal column. It can occur due to a sudden and traumatic blow to the spinal cord that leads to fracturing, dislocating, crushing, or compressing of various tissues of the spinal cord. Common causes of spinal cord injury are accidents from motor vehicles, steep falls, violent encounters, sports injuries, alcohol, and diseases such as cancer, osteoporosis, and arthritis. Some traumatic spinal cord injuries are mentioned below. Spinal Shock Spinal injury caused by trauma is generally termed as spinal shock. It is characterized by the temporary or permanent inability of the nervous system to transmit signals. This causes impaired movements, sensations, and normal functioning of the body. The shock generally begins to show a few moments after the occurrence of spinal injury and may take up to a few weeks or months to recover from the state of shock. In the case of spinal shock, the reflexes in the caudal spinal cord that is below the site of injury get depressed, causing hyporeflexia, or becomes fully absent causing areflexia. The reflexes above the site of the injury, known as rostral reflexes, are generally not influenced by spinal shock. The cause of spinal shock involves the loss of conduction of electrical signals, which generally occurs due to movement of potassium from intracellular to extracellular spaces. Symptoms of spinal shock involve hypotension due to low contraction of blood vessels and bradycardia. Other signs include pounding headache, excessive sweating, nasal congestion, anxiety, and cognitive impairment. Autonomic Dysreflexia Autonomic dysreflexia is a syndrome characterized by spinal cord injury. It leads to acute and uncontrolled life- threatening hypertension. It occurs in the sixth thoracic vertebral level or above. It leads to imbalance of the reflex sympathetic discharge, which has the potential to cause seizures, retinal hemorrhage, cerebral hemorrhage, renal insufficiency, pulmonary edema, myocardial infarction, and even death. Episodes of autonomic dysreflexia can be caused by bladder distention, calculus, UTI, cystoscopy, bowel distention, gallstones, hemorrhoids, gastric ulcers, gastritis, urodynamic study, scrotal compression, bowel impaction, colonoscopy, invasive testing, anal fissure, Achieve Page 91