C spine Lecture Flashcards
abt how many pts receive spinal immobilization each year
5 million
what percentage of cervical fractures are males?
and what % involve ETOH?
80% males
25% involve ETOH
True or False..
Increased risk of cervical fractures are seen in older pts, pts with RA, down syndrome or on chronic steroid therapy
True
MC site for vertebral fracture?
cervical (55% of spinal injuries)
thoracic, thoracolumbar jxn, lumbar are each 15%
fracture of bony elements, dislocation at one or more joints, tearing of ligaments, disruption of discs—force + flexion, extension, rotation, compression
primary fracture
minutes to hours after injury—incompletely understood, ischemia, hypoxia, inflammation, edema
Secondary fracture
First steps in management of spinal injury? then what?
First…ABCD (airway, breathing, circulation, disability)
Then.. gross motor, senstation and reflexes
*no posterior midline c-spine tenderness
*no evidence of intoxication
*normal level of alertness
*no focal neuro deficits
*no painful distracting injuries
all patients with trauma should get c-spine radiography unless they meet how many of the above criteria?
ALL criteria must be met to avoid getting c-spine radiography
is pt awake and alert?
any neuro deficits?
any major distracting injuries?
midline neck pain?
if no to all..?
if yes to any..?
No to all…can take off collar. no imaging needed
If yes to any..C spine plain films or CT
3 views needed for c-spine films?
Long AP
Lateral (must include T1)
Open mouth
Where is the injury…
loss of spontaneous breathing
C4
Where is the injury…
loss of shoulder shrug
C5
Where is the injury…
loss of flexion at elbow, biceps reflex
C6
Where is the injury…
loss of extension at elbow, triceps reflex
C7
Where is the injury…
loss of flexon at fingers
C8/T1
