Serious Spinal Pathology Flashcards
Why does priapism indicate a spinal cord injury in the unconscious patient?
loss of sympathetic input to pelvic vasculature
leads to increased parasympathetic input and uncontrolled blood flow into the penile sinusoidal spaces
any lesions at any level from T2 to the conus could be associated with priapism
How long does spinal shock take to resolve?
24 hours
What is the first reflex to return after spinal shock?
bulbocaverosus reflex is the lowest reflex that can be tested clinically
What is neurogenic shock?
State of inadequate tissue perfusion and oxygenation due to:
• Reduced sympathetic outflow (T1-L2) with resultant unopposed vagal tone
What are the clinical signs of neurogenic shock?
bradycardia - due to no sympathetic stimulation (reduced cardiac stimulation)
hypotension due to loss of vessel tone, leads to venous pooling
What is the major cause of secondary injury following initial spinal cord trauma?
lipid peroxidation oxidative stress (production of oxygen free radicals) reacts with endogenous proteins, lipids and nucleic acids causing structural changes
What is the most common cord syndrome?
central cord syndrome
What 4 things make up the posterior ligamentous complex?
supraspinous ligament, interspinous ligament, facet joint capsule, ligamentum flavum
What is the normal atlas dens interval?
3mm (
What does an atlas dens interval of more than 5mm indicate?
transverse and accessory ligament rupture
How is static instability diagnosed?
imaging techniques
MRI - disrupted posterior ligamentous complex
CT - facet complex disruption
X-ray - widened spinous processess
What is occult compartment syndrome in relation to SCI?
bleeding or swelling within an enclosed bundle of muscle fibres
could occur in erector spine muscles
What is the main cause of caudal equina syndrome?
canal filling disc compressing the entire caudal equina system
