C-Spine injuries Flashcards
Fracture of bony elements, dislocations at one or more joints, tearing of ligaments, disruption of discs - force + flexion, extension, rotation, compression
Primary injury
Minutes to hours after injury - incompletely understood, ischemia, hypoxia, inflammation, edema
Secondary injury
What do you need to avoid with secondary spine injuries?
Hypotension
What do you need to take care of first with C-Spine injuries?
ABCD - airway, breathing, circulation, disability
No posterior midline cervical spine tenderness, no evidence of intoxication, normal level of alertness, no focal neurological deficits, no painful distracting injuries
NEXUS low-risk criteria – NO need for spine radiography!
Age 65 years old, dangerous mechanism of injury, paresthesias in extremeties
Canadian C-Spine rule – Perform radiography on these patients!
Will result in loss of spontaneous breathing
C4
Will result in loss of shoulder shrug
C5
Will result in loss of flexion at elbow/biceps reflex
C6
Will result in loss of extension at elbow/triceps reflex
C7
Will result in loss of flexion at fingers
C8/T1
Will result in loss of intercostal muscle and abdominal muscle use
T1/T2
70% of detectable spine abnormalities will be visible on the _____ X-ray view
Lateral
Do normal radiographs rule out significant cervical cord injury?
NO!
When should you use CT vs x-ray?
X-ray is good for “low risk” patients, CT is for “high risk” patients
Fracture at C1, extremely unstable, axial loading
Jefferson fracture
Fracture at C2, extremely unstable, more than 1/2 of all C2 fractures
Odontoid fractures
Fracture at C2, results from falls and motor vehicle crashes, forced hyperextension of the neck, unstable but opens spinal canal… These patients may be able to walk in to the ER!
Hangman’s fracture
Stable fracture of a spinous process, named after these people who were shoveling clay or some shit
Clay shoveler’s fracture
