CH 12: Spinal & Head Injuries Flashcards
General functions of the different lobes of the brain.
Frontal: Executive functions (intentions and how to accomplish them) cognition, memory/recall, abstract ideas, reasoning.
Temporal: Primary auditory cortex, memory storage, speech comprehension (Wernicke’s area)
Parietal: Tactile sensations, proprioception, kinesthesia, understanding of objects + their relationship to you
Occipital: Primary high-order visual cortex, deals with vision and seen things relationship to you, EXCEPT the ability to see.
How many PAIRS of nerve roots exit each vertebra?
1 pair on each side
What landmark does the spine enter the skull?
Foramen magnum
When the spinal cord is severely damaged or severed altogether, where does loss of function occur?
Function is impaired or lost entirely BELOW the site of injury.
What vertebrae control the phrenic nerve and why is that important for FR’s?
C3,C4 & C5 control the phrenic nerve which controls the diaphragm which controls the ability to breathe.
How can you tell the difference between a sprain/strain & a spinal cord injury?
Muscle sprains and ligament strains are usually localized and tender on palpation.
Spinal cord damage would yield crepitus of vertebrae and referred pain/numbness in places in the body inferior to site of damage.
What are 3 bony landmarks useful for locating specific vertebrae?
Scapular spine: T2/T3
Inf. angle of scapula: T7/T8
Iliac crest: L1/L2
What are the most common dangerous MOI’s? (8)
1) Fall from height >1m
2) Axial load to head
3) Anyone involved in a Motor vehicle accident
4) Unresponsive w/ unknown cause
5) Severe blunt force to head
6) Penetrating trauma to head, neck, or torso
7) Cracked helmet
8) Lighting strike/electrocution
What are the 5 types of motion involved in head/spine injuries?
- Hyper-extension
- Hyper-flexion
- Hyper-rotation
- Axial load
- Whiplash motion
When stabilizing the head during manual SMR, what is the motion that is most important to limit?
Extension of the neck
Describe axial load, and the movements commonly associated with it.
A force that is directed through the top of the head and through the spine.
Because it is rare to just land directly on top of one’s head, axial load is usually in combination with hyper extension and/or hyper flexion
What blood vessel weaves through the vertebral facet joints to provide 20% of blood flow to the brain?
The vertebral artery. As little as 20% rotation/extension can decrease blood flow through this vessel.
What are the terms used to describe bruising around the eyes and ears?
Periorbital ecchymosis: bruising under/around eyes (racoon eye’s)
Periauricular ecchymosis: Bruising under/around ears (Battle’s sign)
What are the terms used to describe CSF leaking from facial orifices?
Rhinorrhea: CSF leakage out of nose
Otorrhea: CSF leakage out of ear.
What is the halo effect?
When blood is mixed with leaking CSF. Looks like a fried egg.
What does periorbital ecchymosis usually a sign of? (More specific than just head trauma)
Facial bone fractures. The articulations of the facial bones compared the larger skull bones are much weaker and susceptible to fractures.
Why was the Canadian C-spine rule created?
The CCR was developed to simplify and standardize the assessment of patients with suspected spinal injuries.
What are the 5 steps to rule out a spinal injury using the CCR?
1) Do you have numbness/tingling in fingers? (Grip test)
2) Do you have pain in your neck?
3) Was your neck pain immediate or delayed? (Immediate = bad)
If ALL previous questions were answered “no” then proceed to step 4:
4) Palpate C-spine. Bones not soft tissue.
5) Ask patient to slowly rotate head 45 degrees left & right.
If all steps are passed, SMR can be ruled out and can be brought to their feet and removed from field to proceed with Secondary assessment.
