Which type of shock results from spinal cord injury and is marked by massive vasodilation below the level of injury, with warm skin and a non-tachycardic pulse?

• A. Hypovolemic shock
• B. Septic shock
• C. Neurogenic shock
• D. Anaphylactic shock

Answer: (C)

Neurogenic shock occurs when a spinal cord injury disrupts the pathways that normally maintain vascular tone, causing widespread vasodilation below the level of injury. That dilation lowers systemic vascular resistance and pooling of blood reduces venous return, leading to hypotension. Because the sympathetic input to the heart is diminished, the heart rate often stays normal or slows (bradycardia) rather than speeding up, which is why the pulse is non-tachycardic. The skin feels warm due to the increased blood flow from the vasodilation, rather than cool and clammy skin seen with volume loss.

This pattern helps differentiate it from other shocks: hypovolemic shock typically presents with cold, clammy skin and a fast heart rate due to compensation for low volume; septic shock can have warm skin initially but is tied to infection and usually presents with tachycardia and fever; anaphylactic shock involves airway symptoms and often rapid airway compromise along with hypotension and tachycardia. The key clues here are the spinal cord injury context, massive vasodilation below the injury, warm skin, and a non-tachycardic pulse, pointing to neurogenic shock.