lecture 5+6: spinal injuries and evaluation Flashcards
true or false: rule out spinal before conussion
false
rule out concussion first
what are some functions of the spine
protects spinal cord maintains posture allows movemnt shock absorption (disks) attachment for muscles
whoch cervicals are more liekly to be injured
c1 and c2
if athelte is unconcious…
always assume spinal
c4 injury
complete paralysis below neck
c6 injury
partial paralysis of hands and arms as well as lower body
t6 injury
paralassis below chest
paralpgia
l1 injuries
results in paralysis below waist
what sports are more likely to have thorasic/lumbar spinal injiries
snowboarding and skiing
what are the 4 types of injuries that can happen to the spine
1) compression fracures (wednege compression/total flattening)
2) fracures (small frags of bones)
3) subluxation (partial disslocation)
4) overstressitng.tearing ligs and msucles
what are some MOi for spinal inkiryes
axial loading hyperflexion hyperexntision hyperrotation lateral bending overelongation of spine
explain flexion with axial compession
most common
veretbral body fractures burn psoterior to the spinal cord
ex: hockey, football , diving
what the problem with flexion and axial load
in flexion
force is not distributed normally, can cmpress a nerve and cause injury
explain extrension with compression
causes compression fracure to arch and spinal
rupture anterior long. lig
where is the force distributed in extension w compression
not on the body, on the vertebra
explain rotation and hyperxntion
facemask iinjury can cause fracutres and dislocation
where is rotation and hyperextension common
common in helmet sports
what does sudden lateral bending cause
injury to brachial plexus
what is a burner or stinger caused by
stretch or compression injury to the bracial plexius
what is the brachial plexus from and responsible for
c5-t1
responsible for cutaneous and muscular innervation of upper lumb
what are the sumptoms of the stinger
severe burnign pain
prickly that radiates to beck and arms and fingers
what are the red dlag symptoms of stingers
shoulder weakness and muscle and tenderness of neck
experiences hours/days past injury
what sports is stingers common in
football
wrestling
HOCKER
what are the 2 mechanisms for stringers
stretch and compression
what is the stretcnh mechanism for stringers
lateral flexion of head and depression of the shoulder
what is the compression mechanism of stinger
head is lateral compression but shoulder of the same side is compressed (elevating shoulder)
what is typical posture for burner
depressed shoulder
what are the 3 degrees of brachial plexus injuries
1) 1st degress (neuraplaxia)
2) 2nd degress (axonotmesis)
3) 3rd degress (neurotmesis
what is neuroplaxia and prognosis
=cervical nerve pinch/stretch syndrome
temporary loss of sensation/motor function
without structural changes
recoverey without a few days to weeks
what are the signs and prognosis for axonotmesis
significant motor and mild sensoty decificts
causes axonal damage
defecit lasts 2 weeks (slow regrowth but normal function is usually resotred)
what are the signs and prognosis for neurotmesis
motor and sensoty deficits persist for up to 1 year
nerve lacerated/avulsed
poor prognosis (surgical intervention)
what is the most common brachial blexus injury
neuropraxia
what are the signs and symtoms of neuroplaxia
burning, tingling, numbess shoulder to hand loss of function and sensation transcient (should go away) change in grip strength
low long does mild neuroplaxia
lasts seconds to minutes
how long does moderate neuroplaxia last
minutes/hours
how long does severe neuropraxia last
unresolved at 12 h
if you have mild or moderate neuroprxia, you cannot return to tplay
false, you can
how can you help RTP for neuropraxia
ice
what is grade 2/2nd degress 9axonotmesis
degeneration of the axon (cut away from the stretch)
but nerve sheat is still intact
true or false: recovery is possible with grade 2
true
what are the signs and symptomms of axonotmesis
numbness, tingling, affected function
long nerves have great healing time than shorts
true or false: 2nd degress/axonotmesis is rare within athletics
true
how long does it take for full strength and senstation for axonotmesis to be re gained
6 weeks-6 months
are you sent to the hos[ital for grade 2
yes
true or false: permament nerve damage occurs in 1st degree
false
in grade 3
what is grade 3/ neurotmesis
complete cut of nerve fiber and steath
immediate loss of snestation
what is the TX for neurotmesis
ice and neurosurgery
what are the 2 subsets of spinal cord innjuries
primary
secondary
when does primary spinal cord injuries occur
at the time of impact or focre applciation
when does secondary injury of spinal offuce
after initial injury
what are some examples of spinal injury sports
diving football gymnastics skiing etc
what are the 4 conditions of the c spine
fractures
dislocations
sprains
spinal stenosis
where are cervical fractures most common
c4 c5 c6
what is the MOi for cervical fracrues
axial loading
flexion of vertebral body
what happens imore in sports, cervical fractures or fisplcations
disclocations
what is MOI for disloacted
violent flexion and rotations (facets move before normal ROM)
what are the signs and symtpms of cervical fracure and dislocation
CONSIDERABLE PAIN • NUMBNESS • WEAKNESS • PARALYSIS • TILTED NECK (DISLOCATION) • MUSCLES ON SHORT SIDE (SPASM) 52
what is the cause of cervical sprain
sudden extension or flexion
whiplash
what is the treatment for fracture, discloation and sprains
BOARD
what is transcient quadriplegia
complete loss of senstation and motor fucntion of all 4 extremeleties from neck trauma
what causes transcient quad.
cervical stenosis
can be congenital narrowing or devolp it
what can cause trans. quad if not born with it
repeated hyperflexion/extension with axial loading
what are the signs and symtpoms of transcient. quad
burning numb or tingling without any pain
full ROM
when is full recovery from transcient quad/
10-15 min
true or false: spinal stenosis always have signs ans symptoms
false
true ro false: you need medical clerance to go back to pay
true
what is a myotme for
motor eval (dont let me move u)
what does the c5 reflex test
biceps brachhi
what does the c6 reflex test
brachioradialis
what does the c7 reflex test
triceps brachi
what does the l4 reflex test
quads fem 9knee jerk)
what does the l5 reflex test
extensor digi brev
what does the s1 reflex test
achilles
what do reflexes test
integrity of tehe nervous system, sensory and motor pathways
expkain head stabilixation
come from facing do not cover ears
prone: side of face and head on top w forearm on spine
sitting: vice grip
explain head reallignment
side bending and roation
what are the 6 contraindications
bony block spasm increase pain increase neurological symtpmos patient doesnt want compromised airway
know how to measure collar and take off equo[
.
study the rolls.
/.
when you are boading, the short end should alway be at the hips>
true
what is the main steps for unconcious spinak
1
1) ERP
2) scene survey and sagety
3) head stabile
4) abcs
5) opa and maintain airway
6) prevent shock
7) assisngment takes over head
8) head to toe palp (secondary assess)
9) baseline vitals
10) DEFG
11) immobolize
12) board
true or false: absense of spinal spigns means spinal ruled out
not ncessarily
true or false: walking is a determining factor on whether they need to be boarded
false
what is the general rule for boarding
THE ATHLETE WITH WEAKNESS, PERSISTENT PARESTHESIA, OR LESS THAN A FULL, PAINFREE
RANGE OF CERVICAL MOTION SHOULD BE PROTECTED”
what are signs and symptoms of cervical fracures and dislocation
pain numb weakness paraylsis dislocation msucle spasm
what is the rule for cervical collar
COLLAR HAS TO BE IN-LINE WITH THE
STERNUM AND PROPERLY FITTED (open mouth)
what is the ked
THE K.E.D.
KENDRICK EXTRICATION DEVICE
what is another name for long board and what is it used ofr
spinal board
extracation
