20 Spinal trauma Flashcards
Where is the conus medullaris?
T12 to L1
Which spinal tract transmits pain and temperature?
spinothalamic
Where would you experience referred liver and gallbladder pain?
right shoulder
Where would you experience referred heart pain?
inner left arm
Where would you experience referred lung and diaphragm pain?
neck and left shoulder
Where might you experience urinary bladder referred pain?
coccyx and superior posterior thighs
Where might you experience stomach referred pain?
interscapular region
What are the hip flexors innervated by?
What are the hip extensors innervated by?
L2, L3 (swing the tree)
L4,L5
What are the knee extensors innervated by?
What are the knee flexors innervated by?
L3, L4 (kick the door)
L5, S1
What would happen in neural compression about C4?
loss of ventilation
What would happen in neural compression at C5?
quadriplegia
What would happen in neural compression from C5-T1
decreasing arm function
think brachial plexus
What would happen in neural compression from T1-L1?
paraplegia (legs)
What would happen in neural compression from L2-L5?
decreasing leg function
think Lumbar plexus
What would happen in neural compression from L5 and below?
impaired sphincter and sexual function
foot and ankle weakness
What would an initial assessment of a spinal injury look like?
ATLS protocol
Airway and C-spine control
Breathing
Circulation
How to approach spinal radiographs…?
A - alignment
B - bony abnormality
C - contours and cartilage
D - disc spaces
What is the policy with ankylosing spondylitis trauma patients?
A patient with ankylosing spondylitis with a history of trauma and spinal pain has a fracture until proven otherwise
What does Denis’ 3 column principle of stability dictate?
if 2 of the 3 column’s are disrupted then the spine is unstable
When might a wedge compression fracture be unstable?
faling of anterior column
50% loss of height
30 degree kyphosis
When might a flexion distraction fracture be caused?
chance or seatbelt fracture
What is a flexion distraction fracture and how is it treated?
facet joint dislocation
reduction and surgical fusion
What is a burst fracture?
high power fracture, shards of vertebrae
What might a fractue dislocation be accompanied by?
rotation
shear
What are some secondary causes of SCI?
hypotension
hypoxia
oedema
ischaemia
What should be taken into consideration with spinal surgery?
deteriorating neurology
stable neuroogy
mechanical stability
