18: Spinal Cord Injury - Thompson

Question 1

avg age spinal cord injury

Answer 1

42

80% male

Question 2

*** LMN injuries

Answer 2

• decreased reflexes
• decreased tone
• muscle atropy

Question 3

*** UMN injuries

Answer 3

• spasticity
• increased tone
• increased reflexes

Question 4

how many bones in spinal tract?

Answer 4

33

Question 5

*** brown-sequard syndrome:

Answer 5

ipsilateral paresis

loss of vibrationand proprioception

contralateral loss pain and temp

Question 6

anterior v. central cord

Answer 6

paralysis below lesion with loss of pain/temp

corticospianl tract injury; worse upper extremities than lower; some loss pain temp

Question 7

***describe cauda equina

Answer 7

from peripheral n. injury

motor/sensory loss LE

bowel bladder dysfunction

saddle anesthesia

*this is an emergency

Question 8

“concussion to spine”

Answer 8

spinal shock

flaccid paralysis, areflexia, lss sphincter tone, priapism, incontinence

resolves in 24 hrs

Question 9

neurogenic shock

Answer 9

loss of sympathetic tone

hyptensive and bradycardia (instead of tachycardia)

flushed dry warm

urinary retention

more common in injuries above T6

Question 10

***keep them or get them off the board?

Answer 10

off the board - use it for transport only

Question 11

___ of unconscious MVCs or falls have major cspine injury

Answer 11

10%

assume they have one until you can rule it out

Question 12

*** NEXUS Criteria

clearing a c-spine after trauma

Answer 12

• no bony tenderness
• no neuro deficits
• no intox
• no altered level of consciousness
• no distracting injuries

Question 13

an intubated trauma pt has incidence of ___ likely to miss on xrays

Answer 13

10% chance c spine injry

get the CT scan

Question 14

if prevertebral space is widened …

Answer 14

hematoma secondary to fx

Question 15

*** very common with calcaneal fractures

Answer 15

L spine injury

transverse fractures of L1 associated with renal injury

Question 16

“scotty dog” in oblique view

Answer 16

spondlolysis

genetic

Question 17

*** chance fracture

Answer 17

• horizontal fx through spinous process, lamina, pedicle and vertebral body

50% have organ involvement

usually a seatbelt injury

Question 18

____ of calcaneal fx have associated lumbar

Answer 18

10%

26% other injury

check UA (blood) if suspicious

Question 19

***hypertrophic skin changes and hypertrophic nail changes

Answer 19

higher the lesion/longer injury

risk for pressure ulcers, DVT

Question 20

____ of peds spinal injury have spinal cord injury without radiographic abnormalilty

Answer 20

25-50%

vertebral bodies are displaced, then return inot place so not visible on xray

weak, burning, paresthesia