Cervical spines trauma

Question 1

what signs of clinically significant ligamentous instability can be seen on lateral x ray of patient with suspected cervical spine fractures

Answer 1

1- Disruption  of vertebral lines 
2-3 column injury 
3-  Bilateral facet joint dislocations 
4- type 2 dens fracture 
5- Atlanto-occipital dislocation

Question 2

state 4 examination findings of spinal shock

Answer 2

1- flaccid paralysis
2- areflexia
3- priapism
4- urinary retention

Question 3

If plain x ray shows a ( bilateral facet joint dislocation ) of C4/C5 , LIST 3 POSSIBLE COMPLICATIONS OF THIS PRESENTATION ?

Answer 3

1- diaphragmatic nerve injury = mx by intubation and mechanical ventilation
2- hypotension and bradycardia( neurogenic shock ) - mx with adrenaline infusion
3-urine retention-mx by IDC insertion.

Question 4

List the NEXUS low risk criteria for the clinical exclusion of cervical spine fracture

Answer 4

1- lack of neurological deficit 
2-Lack of midline cervical spine tenderness 
3- alert
4-lack of intoxication
5-Lack of distracting injuries

Question 5

List the nerve root supply for the following upper limb actions :
elbow flexion
elbow extension
wrist extension
fingers abduction

Answer 5

elbow flexion : C5/C6
elbow extension : C7/C8
wrist extension :C7/C8
fingers abduction : T1