Autonomic Dysreflexia

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Spinal Cord Injury with Complication of Autonomic Dysreflexia

Ashley Audette, Shelby LeBel, and Jocelyn Neufeld

Nurs 361 Nursing of Adults

Sandra Fritz and JoDee Wentzel

March 14, 2014

Autonomic dysreflexia is a complication of spinal cord injuries. “It is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous system” (Lewis, 2014, p.1784). There are many factors that need to be explored in relation to the complication of autonomic dysreflexia in spinal cord injuries. These factors include etiology, pathophysiology, clinical manifestations, diagnostics, and collaborative care.
Lewis (2014) states “ spinal cord injuries are generally the direct
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Pathophysiology Dunn (2004) gives a good physiological explanation as to how AD presents itself in the body. Starting with a stimulus, a sensory input is carried by undamaged sensory peripheral nerves to the spinal cord. Next the impulses travel up the spinal cord where sympathetic reflexes are stimulated. Upon these nerves being stimulated this causes vasoconstriction in the peripheral arteries. This vasoconstriction causes a sudden increase in blood pressure where the baroreceptors, which are located in the carotids and aortic arch, send the increased blood pressure information to the brain stem. These baroreceptors are triggered due to the increase in blood pressure and try to act as a buffer to the vasoconstriction by dilating the vascular bed above the injury (Krassioukov et al, 2007). The brain stem then tries to decrease the blood pressure by slowing the heart rate. Inhibitory sympathetic messages are attempted to be sent down the spinal cord (Dunn, 2004). These messages will not be successful in decreasing the blood pressure due to the spinal cord injury occurring at or above T6 (Dunn, 2004). Efferent impulses cannot pass through the spinal cord lesion, which in result the peripheral and visceral vessels do not dilate, resulting
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