A patient who fell presents with blood pressure 90/60, flaccid paralysis on one side, absent bowel sounds, no urine output, and a distended bladder. These findings most strongly indicate which condition?

A patient who fell presents with blood pressure 90/60, flaccid paralysis on one side, absent bowel sounds, no urine output, and a distended bladder. These findings most strongly indicate which condition?

• A. Paralysis
• B. Spinal shock
• C. High cervical injury
• D. Temporary hypovolemia

Answer: (B)

Spinal shock from an acute spinal cord injury causes a sudden loss of autonomic and motor function below the injury. This leads to low blood pressure due to loss of sympathetic tone (vasodilation), flaccid paralysis because reflexes below the lesion disappear, and a lack of bowel and bladder activity (absent bowel sounds and urinary retention with a distended bladder) from neurogenic ileus and neurogenic bladder. The combination of hypotension with ileus and urinary retention after trauma is classic for spinal shock, making it the best explanation for these findings.

Spinal shock from an acute spinal cord injury causes a sudden loss of autonomic and motor function below the injury. This leads to low blood pressure due to loss of sympathetic tone (vasodilation), flaccid paralysis because reflexes below the lesion disappear, and a lack of bowel and bladder activity (absent bowel sounds and urinary retention with a distended bladder) from neurogenic ileus and neurogenic bladder. The combination of hypotension with ileus and urinary retention after trauma is classic for spinal shock, making it the best explanation for these findings.