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Prevention and Care Exam 2 > Chapter 9- Spine Injuries > Flashcards

Chapter 9- Spine Injuries Flashcards

0
Q

C3, c4, c5

A

Keeps body alive

Nerves that inner set diaphragm and help with breathing

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1
Q

Intervertebral disc (cervical spine)

A

Helps with spacing and movement

– fibrocartilage

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2
Q

PLL

A

Posteriors longitudinal ligament (most important )

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3
Q

Ligaments flavem

A

Dense connective tissue

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4
Q

Inter spinal and supra spinal

A

Inside and Outside

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5
Q

Segmented motion

A

Each vertebrae contributes to portion of movement of neck overall

Ex: forward flex ion = 70 degrees so each vertebrae may do 10 degree

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6
Q

Flexion, extensions, and rotation of spine

A

Not like other joints in body

- limitations: impairments at what point each vertebrae can move

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7
Q

Cervical spine injuries dates

A

1977- less than10 players per year suffer from percent cord injuries

1976- NCAA enacted rule to bare spearing

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8
Q

Predisposing risk factors of spinal injuries

A
  • cervical or spinal stenosis (narrowing of spinal canal)
  • weak musculature
  • long thin neck
  • previous spinal injury
  • poor tackling technique
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9
Q

Mechanisms of neck injury

A
  • hyperflexion, hyper extension, rotation, late Flexion, AXIAL LOADING
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10
Q

Axial loading

A

Places neck in a slightly flexed position – segmented column
***major risk for catastrophic injury

  • nothing can prevent axial loading except for not doing it so proper technique will help
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11
Q

Reasons why 1976 no spearing rule did not always work

A
  • refs not calling
  • coaches poor technique or no enforcement
  • players do. to use the technique
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12
Q

Problem when neck is slightly flexed (axial loading)

A
  • with head lowered neck cannot absorb and dissipate force upon impact
  • spine (vertebrae) absorbs (over)load and as a result will fracture and displace (dislocated)
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13
Q

3 ways to prevent neck injuries

A
  1. Pepper coaching techniques concerning butt-blocking and tackling (spearing)
  2. Strength and conditioning programs aimed at the cervical spin
  3. Proper protection during contact (helmet, shoulder pads, matting)
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14
Q

Strain/sprain neck

A
  • neck strains RARELY involve nerve damage

- strains generally Miele painful than serious

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15
Q

Fracture/dislocation of neck

A

Severe injuries involve fractures that are displaced

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16
Q

Brachial plexus dysfunction

A

Spinal nerve

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17
Q

Best way to break cycle of pain spasm

A

Ice because it numbs area and lowers nerve conduction velocity

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18
Q

Mechanisms of sprain and strain neck

A

Hyperflexion, ext (jammed), rotations

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19
Q

Abnormal posturing can cause

A

Spasmodic torticollis or wry neck

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20
Q

Spasmodic torticollis

A

Spasms (naturally how neck protects self)

Contorted collar

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21
Q

Whiplash injury **exam

A
  • sternocleidomastoid
  • comes off sternum
  • clavicle and inserts at mastoid
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22
Q

Anterior cervical spine fracture

A

Body- stable PLL

* second most worry some

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23
Q

Canal cervical spine fractures

A

Laminar or pedicle fractures

  • ligamenta flava
  • *most worry some
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24
Q

Posterior cervical spine fracture

A

Spinous process

  • interspinal
  • supra spinal
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25
Q

What does upper cervical spine consist of

A

C1 and C2

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26
Q

C1 Jefferson or burst fracture

A
  • atlas
  • axial bonding communited
  • displacement into spinal cord
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27
Q

C2 hangman’s fracture

A
  • axis
  • bilateral axis – pedicle
  • forced extension “whiplash” with compression
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28
Q

Location and mechanism fracture of cervical spine

A
  • close proximity to brain stem and common carotid artery

- fractured segment can displace and put pressure on spinal cored (paralysis)

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29
Q

What vertebrae in lower cervical spine

A

C3-C7 (C6-C7 is 50%)

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30
Q

Mechanism of injury for lower cervical spine injury

A
  • axial loading
  • spinal cord injury SCI
  • May result in paralysis
    • -> transient or permanent
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31
Q

SCI (spinal cord injury) upper spine

A
  • quadriplegia or tertraplegia (full or partial)
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32
Q

SCI of lower spine

A

Paraplegia

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33
Q

What is the difference between complete and incomplete SCI

A

Complete: function below neurological level is lost

Incomplete: some sensation and movement below the level is retained (MORE common)

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34
Q

Full paralysis

A

Usually can recover to partial use of limbs

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35
Q

Injuries to brachial plexus

A

Aka burner or stinger
- produce significant but transient symptoms

S&S: feels like pins and needles or in fire

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36
Q

MOI if brachial plexus

A

Stretch or compression of nerve at the level of divisions or cords
* most common with tackle

37
Q

Difference between Traction injury brachial plexus and compression

A
  • Traction: head forced into lateral Flexion and tensile load causes injury
  • compression: head forced down and rotated
38
Q

S&S of brachial plexus injury

A

Tingling and numbness in to the hand
- temporary paralysis of limb or weakness of grip, posturing of shoulder, tenderness over brachial plexus

  • higher rate of reoccurrence
39
Q

Initial treatment guidelines for neck injury

A
  • always assume head injury with neck injury

- primary survey

40
Q

Primary survey of neck injury

A
  • immobilize head and neck immediately
  • check vital signs
  • in unconscious attempt to arouse
  • in unconscious, immobilize and place on spine board
41
Q

Immediate care guidelines for neck injury

A
  • suspected catastrophic cervical injuries
  • immobilize head and neck
  • primary and secondary survey
42
Q

Initial treatment guidelines DO NOTS

A
  • remove hemmed and shoulder pads bc keeps spine in neutral position
  • move the athlete
  • use ammonia capsule to awaken
  • rush thru secondary survey
43
Q

Secondary survey of neck injury

A

On the field

  • conscious athletes is less complicated than unconscious
  • conscious: ask few questions and if confused or disoriented assume concussion and plan to active EMS
  • -> use quick neurological test like grip strength and skin sensation
  • palate neck for deformity pain or spasm
  • any sign if pain stabilize and EMS
44
Q

Quick neurological tests for secondary survey neck injury

A

Grip test
Skin sensation
(On field)

45
Q

Where do most problems occur in lumbar spine

A

L4-L5 and L5-S1 because of dramatic Curve

46
Q

Lumbar spine anatomy

A

Lordosis

  • L1-L5
  • erector spinae
  • segmented motion
47
Q

Major ligaments of lumbar spine

A

Anterior and posterior longitudinal

  • interspinal
  • supraspinal
  • **PLL most important
48
Q

Facet joints anatomy

A
  • bilateral
  • 2 superior and 2 inferior
  • guide motion
    • -> work with disc to help segment
  • block hyperextension
49
Q

Sciatic nerve anatomy

A

L4-L5

  • inner ares thigh and lower leg
  • large never femoral nerve in front
50
Q

Difference between nucleus pulposus and annulus fibrosis

A

Np: gelatinous (water)

  • distribute hydraulic pressure under compressive loads
  • collagen fibrils
  • proteoglycans

Af: fibrous (more collagen)

  • contains nucleus
  • lamellae (15-25 concentric sheets)
  • surrounds np
51
Q

Fibrocartilage in disc anatomy

A

Collagen
Proteoglycans
Water

52
Q

What are vertebral end plates

A

Cartilage

  • attach disc to vertebrae
  • supply nutrients
  • hyaline cartilage
53
Q

What receives blood supply from bone where nutrients are taken up into bone ??? Check with slides

A

End plates

54
Q

Bone has greater blood supply than…

A

Discs

55
Q

Four functions of lumbar spine

A
  1. Protect spinal cord
  2. Provide core stabilization
  3. Assist in movement
  4. Absorb axial load
56
Q

Four motions of lumbar spine

A
  • segmented motion
  • Flexion (lateral and forwards)
  • extension
  • rotation.
57
Q

Most common region for strains

A

Erector spinae

58
Q

MOI of lumbar strains

A
  • weak core
  • forceful contractions (bad positions)
  • poor lifting technique
  • over stretch
59
Q

Natural way of body protecting self from pain of strain

A

Spasm but too much is not good

60
Q

S&S of lumbar strain

A
  • local muscle spasm
  • pain
  • acute postural abnormalities associated with recent trauma
  • stretching program
61
Q

First aid for lumbar strain

A

Ice and compression to reduce spasm

- supine position with parallel legs

62
Q

Common skeletal lumbar injuries

A

They are spondylogenic

  • spondylolysis
  • spondylolisthesis
    • usually I. Sports with hyperextension (cheerleading)
63
Q

Spondylolysis ?

A
  • unilateral
  • stable
  • defect in the neural arch
  • such deficits compromise the articulation between vertebrae
64
Q

Defect in natural arch of in lumbar region

A

Para interartcularis

65
Q

Spondylolothesis

A

More severe

  • defect in vertebrae is bilateral
  • slip forward
66
Q

Spondylogenic injuries occur commonly at

A

L5 and S1

67
Q

Spondylogenic symptoms

A
  • low back pain
  • worsen during hyperextension
  • radiating pain in butt and lower extremities (sciatica)
      • boney defect
68
Q

Spondylogenic treatment

A

PRICE. And drug therapy

  • lumbar bracing
  • core strengthening program
69
Q

Management and acute care spondolysis

A

PRICE and NSAIDS

70
Q

Lumbar bracing

A
  • helps maintain proper posture

- not much stability

71
Q

Conservative management of spondolysis

A
  • core strengthening program
  • para spinal and abdominal muscle tone supports spine and stabilizes fracture
  • effective if consistent
72
Q

Last resort to lumbar repair

A

Surgical repair - limits mobility and loss segmented motion

73
Q

Most common area of lumbar disk injuries

A

L4/L5 or L5/S1

74
Q

What is weak annulus fibrosis

A

Bulging and herniation

75
Q

Annulus of disk

A

Outer ring (deteriorate)

76
Q

Nucleus pulposus of disk

A

Inner ring

77
Q

Protrusion pressure on spinal nerve may cause

A

Local or radiating pain

78
Q

Degenerating disc

A

Multiple tears and bulging of nucleus pulposus

79
Q

Concentric tears or fissures

A

Layers separate

80
Q

What does dehydration do to degenerating discs

A

Loss of disc height and joint space

81
Q

Can incomplete herniation recover?

A

Yes!

82
Q

4 stages of disc herniation

A

Bulge (radial tears)
Protrusion
Extrusion
Sequestration

83
Q

Bulge and protrusion is …

A

Incomplete herniation

84
Q

Extrusion and sequestration

A

Complete herniation

85
Q

Pressure on nerve root with PLL intact

A

Protrusion

86
Q

Extrusion with PLL disrupted

A

Pressure on roots

87
Q

Special tests for disc herniation

A

Straight leg raise with dorsiflexion
Early radiating or radically pain
Sciatica

88
Q

Positive test of disc herniation

A

Pain reproduced about DF after hip flexed at hip

89
Q

Wallet in. Back pocket syndrome

A

Pisiform is syndrome (pressure on sciatic nerve)

90
Q

Cause of sciatica

A

Skeletal (spondylogenic)
Discogenic- herniation
Muscular (myogenic)- piriformis syndrome

Prevention and Care Exam 2 (4 decks)

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