Which sign is associated with neurogenic shock?

• A. Hypertension with tachycardia
• B. Hypotension with cool clammy skin
• C. Hypertension with warm skin
• D. Hypotension with warm dry skin, possible bradycardia

Answer: (D)

Neurogenic shock happens when a spinal injury disrupts sympathetic nerve output, especially above the mid-thoracic level. The loss of sympathetic tone causes widespread vasodilation, so systemic vascular resistance drops and blood pressure falls despite circulating blood volume. Because the sympathetic drive to the heart is reduced, heart rate tends to be bradycardic or at least not elevated. vasodilation also means the skin becomes warm and dry rather than cool and clammy. So the combination of low blood pressure with warm, dry skin and the possibility of bradycardia best fits neurogenic shock. The other patterns—high blood pressure with tachycardia, or low blood pressure with cool, clammy skin, or high blood pressure with warm skin—don’t align with the loss of sympathetic tone characteristic of this condition.