Study sets, textbooks, questions
Upgrade to remove ads
Emergency Medicine - Unit 5 - Spinal Cord Injuries
Terms in this set (37)
MC spinal region injured
The ability to exclude a spinal injury is relatively straight forward in a patient who does not have: (4)
- neurological deficit
- pain or tenderness along the spine
- drug or alcohol intoxication
- distracting injury
T or F - if a patient is neurologically intact and there is no pain or tenderness along the spine, you are able to clear the spine without x-rays
(given no intoxication or distraction injury)
what nerve innervates the diaphragm? what spinal level?
phrenic nerve; C3-5
this area of the spinal cord is more vulnerable to injury; fulcrum is created due to differing types of vertebrae above and below
these 3 spinal cord tracts can be assessed in spinal cord injured patients
- lateral corticospinal tract
- spinothalamic tract
- dorsal columns
This spinal cord tract controls motor power of the same side of the body. Can be tested by voluntary muscle contractions or involuntary response to painful stimuli
This spinal cord tract transmits pain and temperature sensation from the opposite side of the body. Can be tested by pinprick and light touch
This spinal cord tract carries position sense (proprioception), vibration sense, and some light-touch sensation from the same side of the body. Can be tested by position sense in the toes and fingers or vibration sense using a tuning fork.
why can't complete spinal cord injury be diagnosed in the first week after the injury?
possibility of spinal shock
Impairment of the descending sympathetic pathways in the cervical or upper thoracic spinal cord → loss of vasomotor tone and sympathetic innervation to the heart
neurogenic shock → loss of vasomotor tone → ?
vasodilation of the visceral and lower extremity blood vessels → pooling of blood and subsequent hypotension
neurogenic shock → loss of sympathetic innervation → ?
- blood pressure not restored by fluid infusion
note: rapid fluid resuscitation might result in fluid overload and pulmonary edema
- blood pressure can be restored by vasopressors (Epi, NE, vasopressin) after moderate volume replacement
- atropine for hemodynamically significant bradycardia
neurogenic shock is rare with neurologic injuries below what spinal level?
Refers to flaccidity or loss of muscle tone and loss of reflexes after a spinal cord injury
Disproportionately greater loss of motor strength in the upper extremities than the lower extremities. Thought to be due to vascular compromise of the cord in the distribution of the anterior spinal artery.
central cord syndrome
Paraplegia and a dissociated sensory loss with a loss of pain and temperature sensation. Dorsal column function is preserved.
anterior cord syndrome
(due to infarction of the cord in the territory supplied by the anterior spinal artery)
Ipsilateral motor loss and loss of position sense. Contralateral loss of pain and temperature sensation beginning 1-2 levels below the injury. Results from hemi-section of the cord, usually from penetrating trauma.
Can result from severe traumatic flexion and distraction. Most patients die from apnea associated with brain stem destruction or have profound neurologic dysfunction
what spinal cord syndrome has the poorest prognosis?
anterior cord syndrome
MC C1 fracture
burst fracture (Jefferson fracture)
Patient presents with neck pain after a heavy load landed on their head. The neck is placed in a cervical collar. What type of x-ray should be ordered?
open mouth view of C1 and C2
how are odontoid fractures identified?
open mouth odontoid or lateral cervical spine x-ray
How are odontoid fractures classified?
Based on the location of the fracture:
- type I: tip of the odontoid; uncommon
- type II: through the base; most common
- type III: base of the dens and extend obliquely into the body of the axis
fracture of the posterior element of C2
MC level of vertebral fracture
MC level of vertebral subluxation
this type of thoracic spine fracture is due to axial loading and flexion; most are stable due to the rib cage
anterior wedge compression fracture
this type of thoracic spine fracture is a transverse fracture through the vertebral body; frequently seen following MVC where the patient was restrained by only a lap belt
this type of thoracic spine fracture is uncommon; most always due to extreme flexion or severe blunt trauma to the spine
preferred modality for evaluating cervical spine
(if not available → x-rays consisting of lateral, AP, open mouth odontoid view; all 7 cervical vertebra and T1 must be visualized on lateral view)
what x-ray view should be employed if you cannot fully see C7-T1?
indications for screening for carotid and vertebral artery injuries
- C1-C3 fracture
- cervical spine fracture with subluxation
- fractures involving the foramen transversarium
study of choice to evaluate for carotid and vertebral artery injuries
what MOI is usually the cause for central cord syndrome?
hyperextension injury in a patient with cervical stenosis
common cause of death in shaken baby syndrome
anterior compression wedge fractures are common in what area of the spine?
Sets found in the same folder
Emergency Medicine - Unit 5 - Thoracic and Abdomin…
Emergency Medicine - Unit 4 - Lower Extremity MSK…
Emergency Medicine - Unit 4 - Trauma and Shock
Emergency Medicine - Unit 5 - Environmental Emerge…
Sets with similar terms
Spinal Cord Injury
Spinal Cord Injury
N459 Lecture 3 - Spinal Cord Injury
ATLS Written Review
Other sets by this creator
Women's Health - Abnormalities and Complications o…
Pharmacology IV - Unit 3
Emergency Medicine - Unit 4 - Traumatic Brain Inju…
Emergency Medicine - Unit 4 - Anaphylaxis
Other Quizlet sets
Psychology Homework Chapter 5
Molec Chapter 17: cytoskeleton
CR TBL 8: ischaemic heart disease