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Emergency Medicine: Spinal Trauma
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Emergency Medicine: Spinal Trauma
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25 Questions

1. Gastrocnemius (Ankle plantar flexion)

2. Pain seeming to radiate from the spine to extend outward - Due to a single spinal nerve root irritation

3. Test anogenital reflexes -> ______ with preservation o fthe reflexes denotes an incomplete spinal cord level - even if patient has complete sensory/motor loss

4. Serious spinal cord damage and disruption of tracts w/o a fx - Most common in children - Flexion - hyperextension - longitudinal distraction - and ischemia causing complete - severe - or partial cord lesions

5. Men:Women = 4:1 - Mean age 40 years - Occurs on weekends / holidays

6. Most susceptable spinal region in MVA and falls from a height injuries

7. Chest Muscles

8. Most damaging of all injuries - Compression - flexion - distraction - rotation - shearing forces -> failure of ALL 3 columns - Causes subluxation or dislocation - Grossly unstable spine T11 -> L2

9. Complete neurologic lesion as the absence of sensory and motor function below the level of injury - Minimal chance of recovery

10. Abdominal Muscles

11. Injury to C/T spinal cord -> Peripheral sympathetic denervation - Patients are warm - peripherally vasodilated - hypotensive - relative bradycardia

12. Canadian C-Spine Criteria (3)

13. The temporary loss or depression of spinal reflex activity that occurs below a complete or incomplete spinal cord injury - Loss of neuro function w/ this can cause an incomplete spinal cord injury to mimic a complete cord injury - Duration of days ->

14. Quadriceps (Knee extension)

15. Hand intrinsics (Finger Abduction) Flexor Digitorum Profundus (Hand Grasp)

16. Transverse hemisection of the spinal cord - unilateral cord compression - Ipsilateral spastic paresis - loss of prorioception / vibratory senation - Contralateral loss of pain / temp sensations - Good prognosis

17. Caused by seat belt-type injuries (particularly lap belt only) - Middle and Posterior column failure - Increased height and/or fx of posterior vertebral body - posterior opening of disc space - Chance fx - Unstable

18. Hamstrings (Knee flexion)

19. Persistent irrection - Implies a complete spinal cord injury

20. Direct _____ compression - flexion of the cervical spine - Thrombosis of anterior spinal artery. - Complete paralysis below the lesion - loss of pain / temp sensation - Preservation of proprioception and vibratory function - Poor prognosis

21. High speed MVC (>35 mph)- Fatal MVC- Ped vs Auto- Fall from >10 ft- Significant or serious closed head injury - Neuro signs/symptoms referable to C-Spine - Pelvic of multiple extremity injuries - ICH seen on CT

22. Illiopsoas (Hip Flexion)

23. Caused by axial loading and flexion - with subsequent failure of the anterior column - Middle column remains intact - Stable unless > 50% decrease in vertebral height - unlikely to be directly responsible for neuro damage

24. Triceps (Elbow extension)

25. Caused by significant external forces - frequently involve other C-spine injuries - Dens projection

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