Question 4#

Which of the following is TRUE in spinal shock?

A. Is defined as a spinal cord concussion associated with paralysis, hypotonia and hyperreflexia
B. Usually lasts for 3 days
C. Ends when the bulbocavernosus reflex returns
D. The bladder should only be managed by CISC
E. Is more common in women

Correct Answer is C


Answer C

Spinal shock involves a spinal cord concussion, which usually involves a period of paralysis, hypotonia and areflexia. All reflex activity below the level of the lesion is abated. At its conclusion there may be hyperreflexia, hypertonicity and clonus. It can last for up to 12 weeks, but the time period is variable. Return of reflex activity below the level of injury indicates the end of spinal shock.

The bulbocavernosus reflex (anal sphincter contraction in response to squeezing the glans penis or tugging on the urethral catheter) involves the S2, S3 nerve roots and is a spinal cord mediated reflex. Initial management of spinal shock involves urethral catheterisation with the aim of converting the patient over to intermittent catheterisation (self or by carer) as soon as possible.

Be careful not to mix up spinal shock and autonomic dysreflexia.