Chapter 32 - Spinal Column and Spinal Cord Trauma

Question 1

the nervous system has two major functions:

Answer 1

communication and control

Question 2

consists of the brain and the spinal cord

Answer 2

CNS

Question 3

consists of nerves located outside of the brain and spinal cord

Answer 3

peripheral nervous system

Question 4

the bulky portion of a vertebra that faces anteriorly in the spinal column

Answer 4

body

Question 5

the posterior aspect of a vertebra

Answer 5

spinous process

Question 6

there are three main types of tracts within the spinal cord that are tested in the assessment to determine if spinal cord injuries exist.

Answer 6

motor tracts
pain tracts
light touch tracts

Question 7

the spine is particularly susceptible to injury from the following mechanisms:
1
2
3
4
5
6
7

Answer 7

compression
flexion
extension
rotation
lateral bending
distraction
penetration

Question 8

spinal injury when the weight of the body is driven against the head. this is common in falls, diving accidents, motor vehicle crashes, or other accidents where a person impacts an object face first.

Answer 8

compression

Question 9

spinal injury when there is severe forward movement of the head in which the chin meets the chest, or when the torso is excessively curled forward

Answer 9

flexion

Question 10

spinal injury when there is severe backward movement of the head in which the neck is stretched, or when the torso is severely arched backward.

Answer 10

extension

Question 11

spinal injury when there is lateral movement of the head or spine beyond its normal rotation

Answer 11

rotation

Question 12

spinal injury when the body or neck is bent severely from the side

Answer 12

lateral bending

Question 13

spinal injury when the vertebrae and spinal cord are stretched and pulled apart. this is common in hangings

Answer 13

distraction

Question 14

spinal injury when there is injury from gunshots, stabbings, or other types of penetrating trauma that involve the cranium or spinal column.

Answer 14

penetration

Question 15

results when an area of the spinal cord has been completely transected (cut crossways) either physically or physiologically

Answer 15

complete spinal cord injury

Question 16

a temporary concussion like insult to the spinal cord that causes effect below the level of injury. such an injury usually occurs high in the cervical region.

Answer 16

spinal cord shock

Question 17

condition associated with injury to the spinal cord that results in vasodilation and relative hypovolemia

Answer 17

neurogenic hypotension

Question 18

injury to the spinal cord that does not affect all spinal cord tracts: motor, light, touch, and pain. may produce conflicting and confusing assessment findings as some motor and sensory functions remain intact while others do not.

Answer 18

incomplete spinal cord injury

Question 19

the three most common types of incomplete spinal cord injury:

Answer 19

central cord syndrome
anterior cord syndrome
brown sequard syndrome

Question 20

loss of function in upper extremities caused by injury to the middle portion of the spinal cord

Answer 20

central cord syndrome

Question 21

loss of most function below the site of injury to the anterior portion of the spinal cord

Answer 21

anterior cord syndrome

Question 22

loss of different functions on opposite sides of the body from injury to one side of the spinal cord

Answer 22

brown sequard syndrome

Question 23

the medial (inner) aspects of the motor and pain tracts control the ________ extremities

Answer 23

upper

Question 24

the lateral (outer) portions of the tracts control the ________ extremities

Answer 24

lower

Question 25

motor function assessment - upper extremities:
1
2
3
4

Answer 25

flex your arms (bend arms at the elbow) across chest
(tests function at C6)

extend your arms (straighten arms to the side of the body)
(tests function at C7)

spread your fingers out on both hands and don’t let me squeeze them together
(tests function at T1)

hold out both arms and dont let me push your hand down (done while you support the hand under the wrist)
(tests function at C7)

Question 26

motor function assessment - lower extremities:
1
2

Answer 26

push down against my hands with your feet (place hands under feet)
(tests motor function at S1 and S2)

pull up against my hands with your feet (place your hands on the tops of the feet)
(tests motor function at the level of L5)

Question 27

three situations in which you will have to move a patient with a suspected spine injury before immobilizing him to a long board or short spinal device:

Answer 27

scene is not safe

pt condition is so unstable that you need to move and transport immediately

pt blocks access to a second or more seriously injured pt

Question 28

when the time saved by immediate extrication between life and death- a _______ is performed.

Answer 28

rapid extrication

Question 29

there are only two circumstances in which a melmet should be premoved:

Answer 29

if it does not adequately secure the head because it is too large for the pt

if you cannot gain access to the airway