New York State Emergency Medical Technician (EMT) Practice Exam

What is the primary cause of neurogenic shock?

1. Failure of the nervous system causes widespread vasodilation

2. The spinal cord is severed and causes massive hemorrhaging

3. There is too much blood to fill a smaller vascular container

4. Massive vasoconstriction occurs distal to a spinal cord injury

The correct answer is: Failure of the nervous system causes widespread vasodilation

The primary cause of neurogenic shock is the failure of the nervous system, particularly the autonomic nervous system, which leads to widespread vasodilation. This occurs most often in the context of a spinal cord injury, especially when the injury is at or above the level of T6. When the sympathetic nervous system is disrupted, the body's ability to maintain vascular tone is compromised, causing blood vessels to dilate uncontrollably. As a result, the systemic vascular resistance decreases, leading to a drop in blood pressure and inadequate perfusion to vital organs. This explanation provides insight into the physiological changes during neurogenic shock, highlighting how the autonomic nervous system's failure can lead to significant hemodynamic instability. Understanding this process is crucial for EMTs and other medical providers as it informs appropriate interventions, such as fluid resuscitation and mechanisms to support blood pressure.