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Trauma > Neck and Spinal Trauma > Flashcards

Neck and Spinal Trauma Flashcards

1
Q

How long is the spinal column on average?

A

70-72 cm long

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2
Q

What are the 4 curvatures of the spine?

A

2 anteriorly concave- cervical and lumbar

2 convex posteriorly- Thoracic and sacral

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3
Q

what are the different regions of the spine and how many vertebrae are in each?

A 
7 cervical 
12 thoracic 
5 lumbar
5 sacral 
4 coccygeal
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4
Q

What supports the vertebral column?

A
  • Cartilage discs
  • Strong ligaments
  • Other structures such as ribs and sternum
  • Natural cures to prive balance
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5
Q

What is the function of the spinal column?

A 
To support the trunk 
serves as an attachment for muscles 
to articulate with the pelvis
to provide attachment for lower limb muscles
and to protect the spinal chord
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6
Q

How long is the spinal chord?

A

42-45cm approximately

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7
Q

where does the spinal chord fit in the spinal column? where does it start and finish?

A

in the vertebral foramen from the superior boarder of C1 to L 1/2

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8
Q

How many spinal nerves are there and where do they exit the spinal column?

A 
31
8 cervical
12 thoracic
5 lumbar
5 sacral 
1 coccygeal
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9
Q

What is the Cauda equina?

A

The nerves from L2-5, S1-5 and C-1 that arise from the conus medullaris (horses tail)

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10
Q

what protective layers surround the cauda equina?

A

The Pia mater, arachnoid mater and dura mater

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11
Q

where is is most likely to fracture the spinal column?

A

in the cervical region above C4 particularly

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12
Q

What are the major MOI for SCI?

A 
Hyperextension
Hyperflexion
vertical compression
Flexation/rotation
Penetrating trauma
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13
Q

What occurs if the sin undergo hyperextension?

A

tearing of intervertebral disc and stretching of the spinal chord and may result in Central chord syndrome

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14
Q

What is the common MOI and demographic of hyperextension spinal chord injuries?

A

Usually in elderly patients with osteoarthritic or spondylosis changes

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15
Q

What is spinal chord hyeprflexion?

A

Sudden forcible flection usually in the cervical region or lumbar region

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16
Q

What injuries would you expect to see in a spinal chord hyperflexion injury?

A

Accompanying bilateral dislocation and associated ligamentous damage

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17
Q

What is the common MOI for spinal hyeprflexion injuries?

A

MCAs and domestic falls

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18
Q

what injuries would you expect to see in a compression spinal chord injury?

A

Body of vertabre burst and displaces bone particles and disc into spinal canal

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19
Q

Where do compression injuries usually occur in the spine?

A

Cervical and lumbar regions

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20
Q

What is a common MOI for compression spinal chord injuries?

A

Diving, falling objects

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21
Q

What is the neurological damage caused compression SCI?

A

Burst fractures

Jefferson at c1

22
Q

Where are Rotation (flexion) injuries usually seen in the spin?

A

cervical/ lower thoracic and lumbar region

23
Q

What injuries are seen with a rotation injuries?

A

Unilateral fracture- dislocation

Postieiror ligaments and vertebral body fractures- highly unstable

24
Q

MOI common with rotation SCI?

A

Back seats in MCA, lap belts, side impacts

25
Q

What are some types of Direct penetrating trauma SPI?

A

Violent blow to vertebral column or chord

Major assault

26
Q

What are the different types of spinal chord injuires that might occur?

A 
Transient concussion 
Contusion 
Laceration 
Compression of chord substance 
Transection of chord
27
Q

What is a transient concussion of the spinal chord?

A

Due to extreme acceleration/de-ce;eration forces. May cause temporary neurological changes lasting less than 48 hors leaving no structural changes

28
Q

What is a spinal chord contusion?

A

Is a bruise that includes bleeding, subsequent oedema, and possible necrosis from the oedematous compression

29
Q

What are the classification of SCI?

A

Quadriplegia/ tetraplegia- T1 and above
Paraplegia- T2 and below
These can be complete or incomplete

30
Q

What is central chord syndrome?

A

Associated with cervical injury and chord compression leading to ischaemia

31
Q

Who is Central Chord syndrome most likely to affect?

A

the elderly

32
Q

What is the prognosis for central chord syndrome?

A

Can be good for recovery as spinal column may not be injured.

33
Q

What is Brown-Sequard Syndfrom?

A

Motor loss on same side of chord damage

Sensory loss of pain and temp on opposite side

34
Q

Where do the sensory fibres cross over in the spinal column?

A

At the level of entry to the spinal chord

35
Q

Where to the motor fibres cross over in the spinal column?

A

Above the spinal chord in the medulla oblongata

36
Q

What is anterior chord syndrome?

A

Commonly associated with injury to the anterior spinal column and interruption of the anterior spinal artery supply

37
Q

Where is the damage in anterior chord syndrome?

A

In the anterior two thirds with the posterior third unaffected

38
Q

What is preserved and altered with anterior chord syndrome?

A

Preservation of position, vibration and touch with motor function usually more altered

39
Q

What can Spinal chord injury result in?

A

Loss of movement and sensation, decreased circulation, altered respiratory function, inability to control body temperature, altered bladder and bowel control and altered sexual function

40
Q

What is the primary MOI for SCI?

A

Initial crush, shear impingement of chord as result of trauma

41
Q

What are the secondary SCIs?

A

Odeama, ischeamia, electrolyte dysregulation

Contributing to exaggerated stimulation and cell death

42
Q

What are the consequences of a SCI dependent on?

A

Type of primary injury

The degree of secondary injure and the neurological level

43
Q

What is SCIWORA?

A

Spinal chord abnormality without radiological abnormality. Trauma damages spinal chord and the bones reset in the wrong position

44
Q

How do we asses a SCI?

A

MOI

Modified NEXUS Criteria

45
Q

What are the categories for the modified NEXUS criteria?

A

Risk of SCI?
Assess the patient
Actual evidence of structural injury
Neck range of motion

46
Q

What are some signs and symptoms that you may see in a SCI?

A

Hypotension with no associated tachycardia
External signs on internal heamoraage may be absent
Pink, Warm skin with hypotension and bradycardia

47
Q

What is spinal shock?

A

loss of reflect and sensory function below the level of a spinal chord injury. It manifests as flaccid paralysis, including loss of bowl and bladder reflexes.

48
Q

Why does hypotension result from neurogenic shock?

A

The result of sympathetic denervation that causes loss of arteriolar tone and results in venous pooling

49
Q

Why does bradycardia result from neurogenic shock?

A

Because o the interruption of cardiac sympathetics allowing unopposed vagal response

50
Q

Why does hypothermia develop after neurogenic shock?

A

Due to the inability to redirect blood from the peripheral circulation and inability to shiver

51
Q

What may cause partial or complete paralysis of the diaphragm?

A

Injury to C5 or higher

52
Q

What level of lessons may cause breathing compromise?

A

Any session above the level of T12 - intercostal and abdominal muscles are affected from T1 to T12

Trauma (31 decks)

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