Which physical finding suggests a cause of hypotension other than spinal cord injury?

The presence of deep tendon reflexes suggests a cause of hypotension other than spinal cord injury because it indicates intact spinal cord reflex arcs. In the context of hypotension, spinal cord injury typically leads to the loss of reflexes due to the disruption of neural pathways. If deep tendon reflexes are present, it implies that the spinal cord remains functional at some level, reducing the likelihood that spinal shock or complete loss of sympathetic tone due to spinal cord injury is responsible for the hypotension.

In contrast, other findings listed—such as priapism, bradycardia, or the ability to flex but not extend the forearms—can be associated with spinal cord injuries, particularly at cervical levels, where autonomic dysregulation often leads to hypotension, bradycardia, and altered reflexes. Priapism, for instance, is a classic sign of spinal cord injury known to affect important autonomic functions. Bradycardia may suggest increased vagal tone commonly seen in spinal injury cases, while a pattern of flexor and extensor control can indicate differential weaknesses seen in upper motor neuron injuries. Thus, the presence of deep tendon reflexes serves as a key distinction suggesting a non-spinal mechanism for hypotension.