Spinal Flashcards
What mechanisms of injury should spinal care be considered in?
- Major trauma
- Multiple injuries
- High speed injuries
- Falls
- Sporing injuries
- Head injuries
- ?All unresponsive patients
What is the Three Column concept?
- Anterior
- Middle
- Posterior
What is transverse Spinal cord damage?
- Complete tearing of the spinal cord, no signals are getting through
Brown Sequard Syndrome
- Most common from penetrating injuries
- Can be caused by tumour and injection
- Contralateral loss of pain and temperature sensation
Anterior Cord syndrome
- Anterior section of the cord, causes occlusion of the artery
- Loss of motor control
- Sensations are maintained
- This is how your body knows where your limbs are, perception of them
Posterior cord syndrome
- Loss of touch and temperature.
Cauda Equina syndrome
- Numb bum
- Weakness of the legs
- Loss of bladder and bowl control
- Excluded from treat and refer guidelines must be transported
6 ps of spinal cord injury
- Paraesthesia
- Pain
- Paralysis
- Poikilothermia
- Priapism
o Uncontrolled erection - Paradoxical respirations
o Opposite respirations. So when they breath out chest looks inflated
What is Spinal shock?
- Temporal loss of sensation, pain, motor control.
Neurogenic shock
- Occurs when the nervous system is no longer functioning properly
- Causes
o Trauma to spinal cord
o Epidural goes wrong - It is the loss of vascular tone and the pooling of peripheral blood
o The loss of sympathetic tone
This sympathetic tone on blood vessels is there to maintain blood pressure and allow flow.
o The loss of tone means that as blood hits the artier of vein walls it will lose its momentum due to the loss of tone like a limp trampoline causing blood to pool and not move around the body as freely and not perfusing tissues and organs as needed. - All of this lack of perfusion will reduce cardiac output. As les return of blood to the heart = reduce SV = reduce C0.
- The sympathetic nervous system also controls HR, this means that a reduce in HR will also cause a further reduction in CO.
- This all leads to a shutdown in oxygen delivery.
- Symptoms would be as follows
o Alt conscious state
o Decrease urine output
o Organ dysfunction
o Bradycardia – key symptom of neurogenic shock
o Warm skin – due to the dilation of all blood vessels, this is diverting blood from vital organs
- Treatment for neurogenic shock
o Pressor that clamp back down the blood vessels
o IV fluids to maintain fluid volume to help push blood through the system
↑ Both help increase BP
o Atropine
Blocking parasympathetic nervous system increase fight or flight response
• This will cause an increase in HR to increase C0 to improve the pumping of blood throughout the cardiovascular system.
What are Cervical spine fractures a result of?
- Hyper flexion
- Hyperextension
- Flexion- rotation
- Vertebral compression
- Lateral flexion
- Distraction- pulled and stretched beyond normal limits.
• Compression fractures
o Most common type of vertebral fracture, partially seen in people with bone disease.
o Loss of height of the anterior part of the vertebral body with posterior cortex intact.
o Commonly results in a wedge fracture which is a subtype of compression.
• Burst fracture.
o Extreme Trauma
o Vertebrae is crushed involving anterior, middle and sometimes posterior column.
o Bony fragments spread out and cause spinal injury
• Distraction (flexion- distraction)
o Seen when the spine is made to flex forward placing excessive stress on the spine (e.g. MVA)
o Involves horizontal fractures of posterior and middle column
o Often includes separation of the posterior elements
High chance of cord injury.
