MCQ 10 A patient has been admitted with spinal cord injury at T4 level.During assessment the nurse finds that the patient's blood pressure as 80/60 mm Hg and pulse 40 beats per min.The nurse understands that the patients is experiencing:

A.An absolute hypovolemia due to inernal bleeding at the site of injury
B.Cardiogenic shock resulting from bradycardia
C.Neurogenic shock resulting from low blood flow
D.Neurogenic shock resulting from maldistribution of blood flow

The correct answer is D:Neurogenic shock resulting from maldistribution of blood flow

Neurogenic shock is a haemodynamic phenomenon often seen in spinal cord injury at T5 and above.The injury results in a massive vasodilatation without compensation as a consequence of loss of the sympathetic nervous system vasoconstrictor tone.The massive vasodilatation leads to the poooling of blood in the vessels,manifestated as hypotension.Unopposed action of parasympathetic nervous system leads to the bradycardia.So neuroenic shock from maldistribution of blood flow due to massive vasoldilatation and not from low blood flow.
Spinal cord injury is unlikely to cause severe internal hemorrhage resulting into absolute hypovolemia.Cardiogenic shock reults from conditions where heart actually fails to act as a pump