Neuro Spine and Bone Trauma

Question 1

spine fractures that require operative intervention:

Answer 1

fx with disruption of the posterior column and intrusion into the spinal canal
compression fx with >35% loss of vertebral body height
perched facets
type II odontoid fx
fx associated with decline in neuro exam

Question 2

most common cervical spine fx in geriatric pts:

Answer 2

odontoid fx (C2)

Question 3

most common cervical spine fx in young adults:

Answer 3

C4-C7 b/c it is the most mobile

Question 4

injury associated with complete disruption of the shoulder girdle

Answer 4

scapulothoracic dissociation; associated with massive bleeding; tx first with reduction and immobilization

Question 5

what nerve innervates the intrinsic muscles of the hand?

Answer 5

ulnar

Question 6

flexor digitorum profundus injury:

Answer 6

aka jersey finger; inserts on distal phalanx and controls flexion of the DIP

Question 7

what muscle controls PIP flexion

Answer 7

flexor digitorum superficialis

Question 8

chronic neuropathic pain after brachial plexus injury is most often associated with ?

Answer 8

nerve root (preganglionic) avulsion

Question 9

what nerve is prone to injury with LE fasciotomy? Where is it? What does it supply?

Answer 9

superficial peroneal nerve; lies in intermuscular septum between anterior and lateral compartments; supplies sensation to the dorsum of the foot

Question 10

what nerve is vulnerable to injury with anterior shoulder dislocation and what is the deficit?

Answer 10

axillary nerve; inability to abduct (loss of deltoid fxn) and decreased sensation over lateral shoulder

Question 11

first compartment usually affected in compartment syndrome

Answer 11

anterior

Question 12

type 1 odontoid fracture

Answer 12

oblique fracture through upper portion of dens; usually stable and nonoperative

Question 13

type 2 odontoid fracture

Answer 13

extends into the base of the dens; unstable; treat with rigid collar or halo; may require surgery; may cause airway compromise due to upper airway swelling

Question 14

type 3 odontoid fracture

Answer 14

extends to C2 vertebral body; usually stable and nonoperative

Question 15

regeneration rate of a typical axon

Answer 15

1-2 mm/day

Question 16

what is Brown sequard syndrome

Answer 16

ipsilateral loss of motor control with contralateral loss of pain and temperature sensation; can occur from injury to 1/2 of the spinal cord

Question 17

associated nerve injury for midshaft humeral fracture

Answer 17

radial nerve

Question 18

associated nerve injury for anterior shoulder dislocation

Answer 18

axillary nerve

Question 19

associated injury for posterior shoulder dislocation

Answer 19

axilllary artery

Question 20

elbow dislocation and supracondylar fractures are associated with what injuries

Answer 20

median nerve and brachial artery

Question 21

associated nerve injury for posterior hip dislocation

Answer 21

sciatic nerve

Question 22

associated nerve injury with distal radial fracture

Answer 22

median nerve

Question 23

associated injury for posterior knee dislocation

Answer 23

popliteal artery

Question 24

What is anterior cord syndrome:

Answer 24

loss of motor function as well as pain and temperature below level of injury; proprioception and vibration preserved

Question 25

What is central cord syndrome:

Answer 25

loss of sensation and weakness of the upper extremities; usually caused by hyperextension of cervical spine in patient with cervical spondylosis

Question 26

Brown Sequard syndrome:

Answer 26

hemitransection of the spinal cord; ipsilateral loss of proprioception, motor function, and light touch with contralateral loss of pain and temperature

Question 27

posterior cord syndrome:

Answer 27

loss of proprioception and vibration; motor function preserved

Question 28

Conus medullaris syndrome:

Answer 28

injury to T12 and L1-L2 regions; loss of sensation in saddle region with bowel and bladder dysfunction; no lower extremity weakness