Chapter 7 - Spine and Spinal Cord Trauma Flashcards
Why can patients have a worsening of spinal injury symptoms after arriving in hospital?
1/ Ischemia
2/ Worsening of spinal cord oedema.
3/ Inadequate immobilization
When can you exlude the presence of a significant spinal injury?
The patient is neurologically intact and there is no pain on palpation of the spine.
How many vertebrae are there in the C-spine, T-spine and the L-spine?
C-spine=7
T Spine=12
L spine=5
Is the cervical canal wide or narrow in the cervical spine?
Wide
What fraction of patients with cervical spine injuries die at the scene from apnea? Why do they die of apnea?
1/3.
This is because of loss of central innervation of the phrenic nerve and spinal cord injury above C3-C5 where the phrenic nerve arises.
How is the cervical spine different form children and adults?
The C-spine of children is:
1/ More flexible, (joint capsules and interspinous ligaments)
2/ Flat facet joints
3/ Vertebral bodies are wedged anteriorly and slide forward with flexion. These changes stop at about 12 years old.
What type of fracture are most thoracic spine fractures?
Wedge compression fractures. (not associated with spinal cord injury)
A fracture dislocation of the thoracic spine almost always results in (blank)?
Complete spinal cord injury.
What is the thoracolumbar junction and why is it more susceptible to injury?
The fulcrum between the inflexible thoracic region and the stronger lumbar levels. It is thus more prone to injuries 15% of all spinal injuries occur here.
Where does the spinal cord originate?
At the caudal end of the medulla oblongata at the foramen magnum.
Where does the spinal cord end?
Usually at the L1 boney level.
This is called the conus medullaris.
Below this is the cauda equina.
Name the 3 tracts of the spinal cord?
Descending (Motor)
- Corticospinal tract
Ascending (Sensory)
- Spinothalamic tract
- Dorsal Column
