C spine Lecture Flashcards

1
Q

abt how many pts receive spinal immobilization each year

A

5 million

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2
Q

what percentage of cervical fractures are males?

and what % involve ETOH?

A

80% males

25% involve ETOH

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3
Q

True or False..

Increased risk of cervical fractures are seen in older pts, pts with RA, down syndrome or on chronic steroid therapy

A

True

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4
Q

MC site for vertebral fracture?

A

cervical (55% of spinal injuries)

thoracic, thoracolumbar jxn, lumbar are each 15%

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5
Q

fracture of bony elements, dislocation at one or more joints, tearing of ligaments, disruption of discs—force + flexion, extension, rotation, compression

A

primary fracture

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6
Q

minutes to hours after injury—incompletely understood, ischemia, hypoxia, inflammation, edema

A

Secondary fracture

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7
Q

First steps in management of spinal injury? then what?

A

First…ABCD (airway, breathing, circulation, disability)

Then.. gross motor, senstation and reflexes

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8
Q

*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?

A

ALL criteria must be met to avoid getting c-spine radiography

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9
Q

is pt awake and alert?
any neuro deficits?
any major distracting injuries?
midline neck pain?

if no to all..?
if yes to any..?

A

No to all…can take off collar. no imaging needed

If yes to any..C spine plain films or CT

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10
Q

3 views needed for c-spine films?

A

Long AP
Lateral (must include T1)
Open mouth

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11
Q

Where is the injury…

loss of spontaneous breathing

A

C4

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12
Q

Where is the injury…

loss of shoulder shrug

A

C5

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13
Q

Where is the injury…

loss of flexion at elbow, biceps reflex

A

C6

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14
Q

Where is the injury…

loss of extension at elbow, triceps reflex

A

C7

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15
Q

Where is the injury…

loss of flexon at fingers

A

C8/T1

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16
Q

Where is the injury…

Loss of intercostal muscle and abdominal use

17
Q

70% of detectable c-spine abnormalities will be visible in what view?

A

lateral view

18
Q

image of choice for “low risk” c-spine pts?

image of choice or high risk?

A

low risk…plain films

high risk..CT

19
Q

C1 fracture
VERY UNSTABLE
Caused by axial loading (ie diving)

A

Jefferson fx

20
Q

More than 1/2 of all C2 fractures
VERY unstable

A

Odontoid fxs

21
Q

C2 fracture caused by MVAs, falls, crashes

caused by force hyperextension of neck

Unstable bu opens spinal canal
These pts may walk in

A

Hangman’s fx

22
Q

Fracture of the upper part of the odontoid peg (c2)

*rare, potentially unstable

A

Odontoid Type 1 Fracture

23
Q

Fracture at the base of the odontoid

*unstable
**has high risk of non-union

A

Odontoid type II fracture

24
Q

Through the odontoid and into the lateral masses of C2

**best prognosis for healing

A

Type III Odontoid Fracture

25
Fractures of the spinous process of a lower cervical vertebra (usually C7) \*usually a sress fracture
Clay-shoveler fracture
26
Complete paralysis below lesion Loss of pan and temperture sensation \*No loss in proprioception or vibratory sensation **BAD prognosis!**
Anterior cord syndrome
27
Quadriparesis that is **worse in upper extremities** Some pain and temperature sensation loss (worse in upper than lower) Good prognosis
Central cord syndrome
28
Ipsilateral spastic paresis Loss of vibratory and proprioception Loss of contralateral pain and temperature sensation Good prognosis
Brown Sequard Syndrome