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3. Assuming that Jimmy's sensory and motor deficits are due to a spinal cord injury, at what level do you expect to find a spinal cord lesion? Clinical Case Study Autonomic Nervous System On arrival at Holyoke Hospital, Jimmy Chin, a 10-year-old boy, is immobilized on a rigid stretcher so that he is unable to move his head or trunk. The paramedics report that when they found him some 50 feet from the bus, he was awake and alert, but crying and complaining that he couldn't "get up to find his mom" and he had a "wicked headache." He has severe bruises on his upper back and head, and lacerations of his back and scalp. His blood pressure is low, body temperature is below normal, lower limbs are paralyzed, and he is insensitive to painful stimuli below the nipples. Although still alert on arrival, Jimmy soon begins to drift in and out of unconsciousness. Jimmy is immediately scheduled for a CT scan, and an operating room is reserved. Relative to Jimmy's condition: 4. Two days after his surgery, Jimmy is alert and his MRÍ scan shows no residual brain injury, but pronounced swelling and damage to the spinal cord at T. On physical examination, Jimmy shows no reflex activity below the level of the spinal cord injury. His blood pressure is still low. Why are there no reflexes in his lower limbs and abdomen? 5. Over the next few days, his reflexes return in his lower limbs and become exaggerated. He is incontinent. Why is Jimmy hyperreflexive and incontinent? On one occasion, Jimmy complains of a massive headache and his blood pressure is way above normal. On examination, he is sweating intensely above the nipples but has cold, dammy skin below the nipples and his heart rate is very slow. 1. Why were his head and torso immobilized for transport to the hospital? 6. What is this condition called and what precipitates it? 2. What do his worsening neurological signs (drowsiness, incoherence, etc.) probably indicate? Relate this to the type of surgery that will be performed. 7. How does Jimmy's excessively high blood pressure put him at risk?

3. Assuming that Jimmy's sensory and motor deficits are due to a spinal cord injury, at what level do you expect to find a spinal cord lesion? Clinical Case Study Autonomic Nervous System On arrival at Holyoke Hospital, Jimmy Chin, a 10-year-old boy, is immobilized on a rigid stretcher so that he is unable to move his head or trunk. The paramedics report that when they found him some 50 feet from the bus, he was awake and alert, but crying and complaining that he couldn't "get up to find his mom" and he had a "wicked headache." He has severe bruises on his upper back and head, and lacerations of his back and scalp. His blood pressure is low, body temperature is below normal, lower limbs are paralyzed, and he is insensitive to painful stimuli below the nipples. Although still alert on arrival, Jimmy soon begins to drift in and out of unconsciousness. Jimmy is immediately scheduled for a CT scan, and an operating room is reserved. Relative to Jimmy's condition: 4. Two days after his surgery, Jimmy is alert and his MRÍ scan shows no residual brain injury, but pronounced swelling and damage to the spinal cord at T. On physical examination, Jimmy shows no reflex activity below the level of the spinal cord injury. His blood pressure is still low. Why are there no reflexes in his lower limbs and abdomen? 5. Over the next few days, his reflexes return in his lower limbs and become exaggerated. He is incontinent. Why is Jimmy hyperreflexive and incontinent? On one occasion, Jimmy complains of a massive headache and his blood pressure is way above normal. On examination, he is sweating intensely above the nipples but has cold, dammy skin below the nipples and his heart rate is very slow. 1. Why were his head and torso immobilized for transport to the hospital? 6. What is this condition called and what precipitates it? 2. What do his worsening neurological signs (drowsiness, incoherence, etc.) probably indicate? Relate this to the type of surgery that will be performed. 7. How does Jimmy's excessively high blood pressure put him at risk?

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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Clinical Case Study: Autonomic Nervous System

3. Assuming that Jimmy's sensory and motor deficits are due to a spinal cord injury, at what level do you expect to find a spinal cord lesion? Clinical Case Study Autonomic Nervous System On arrival at Holyoke Hospital, Jimmy Chin, a 10-year-old boy, is immobilized on a rigid stretcher so that he is unable to move his head or trunk. The paramedics report that when they found him some 50 feet from the bus, he was awake and alert, but crying and complaining that he couldn't "get up to find his mom" and he had a "wicked headache." He has severe bruises on his upper back and head, and lacerations of his back and scalp. His blood pressure is low, body temperature is below normal, lower limbs are paralyzed, and he is insensitive to painful stimuli below the nipples. Although still alert on arrival, Jimmy soon begins to drift in and out of unconsciousness. Jimmy is immediately scheduled for a CT scan, and an operating room is reserved. Relative to Jimmy's condition: 4. Two days after his surgery, Jimmy is alert and his MRÍ scan shows no residual brain injury, but pronounced swelling and damage to the spinal cord at T. On physical examination, Jimmy shows no reflex activity below the level of the spinal cord injury. His blood pressure is still low. Why are there no reflexes in his lower limbs and abdomen? 5. Over the next few days, his reflexes return in his lower limbs and become exaggerated. He is incontinent. Why is Jimmy hyperreflexive and incontinent? On one occasion, Jimmy complains of a massive headache and his blood pressure is way above normal. On examination, he is sweating intensely above the nipples but has cold, dammy skin below the nipples and his heart rate is very slow. 1. Why were his head and torso immobilized for transport to the hospital? 6. What is this condition called and what precipitates it? 2. What do his worsening neurological signs (drowsiness, incoherence, etc.) probably indicate? Relate this to the type of surgery that will be performed. 7. How does Jimmy's excessively high blood pressure put him at risk?
Transcribed Image Text:3. Assuming that Jimmy's sensory and motor deficits are due to a spinal cord injury, at what level do you expect to find a spinal cord lesion? Clinical Case Study Autonomic Nervous System On arrival at Holyoke Hospital, Jimmy Chin, a 10-year-old boy, is immobilized on a rigid stretcher so that he is unable to move his head or trunk. The paramedics report that when they found him some 50 feet from the bus, he was awake and alert, but crying and complaining that he couldn't "get up to find his mom" and he had a "wicked headache." He has severe bruises on his upper back and head, and lacerations of his back and scalp. His blood pressure is low, body temperature is below normal, lower limbs are paralyzed, and he is insensitive to painful stimuli below the nipples. Although still alert on arrival, Jimmy soon begins to drift in and out of unconsciousness. Jimmy is immediately scheduled for a CT scan, and an operating room is reserved. Relative to Jimmy's condition: 4. Two days after his surgery, Jimmy is alert and his MRÍ scan shows no residual brain injury, but pronounced swelling and damage to the spinal cord at T. On physical examination, Jimmy shows no reflex activity below the level of the spinal cord injury. His blood pressure is still low. Why are there no reflexes in his lower limbs and abdomen? 5. Over the next few days, his reflexes return in his lower limbs and become exaggerated. He is incontinent. Why is Jimmy hyperreflexive and incontinent? On one occasion, Jimmy complains of a massive headache and his blood pressure is way above normal. On examination, he is sweating intensely above the nipples but has cold, dammy skin below the nipples and his heart rate is very slow. 1. Why were his head and torso immobilized for transport to the hospital? 6. What is this condition called and what precipitates it? 2. What do his worsening neurological signs (drowsiness, incoherence, etc.) probably indicate? Relate this to the type of surgery that will be performed. 7. How does Jimmy's excessively high blood pressure put him at risk?
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