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KIN 3160 > spinal column injuries > Flashcards

spinal column injuries Flashcards

1
Q

what are 4 prevention methods used to reduce the risk of obtaining a spinal injury

A

1) proper lifting techniques
2) safe posture
3) protective equipment
4) rules and regulations

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2
Q

list 5 different types of posture

A

1) sway back
2) lumbar lordosis
3) thoracic kyphosis
4) forward head
5) good posture

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3
Q

dermatomes

A

sensation areas (where different spinal nerve roots go)

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4
Q

what are two assessment methods used to diagnose a possible spinal

A

1) dermatomes
2) reflexes
- biceps - between C5/6
- brachioradialis - C6
- triceps - C7
- patellar tendon - L4
- achilles tendon - S1

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5
Q

C-spine fracture and dislocation

A
  • relatively uncommon

- but can cause catastrophic impairment to the spinal cord - damage to cone isn’t the main concern

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6
Q

in which cervical vertebrae do most fractures occur?

A

C4, C5, and C6

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7
Q

which sports have the highest incidence of C-spine fractures

A

gymnastics, ice hockey, diving, football, and rugby

-pool diving accidents as well

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8
Q

C-spine fracture - MOI

A
  • axial load
  • flexion
  • hyperextension
  • rotation and flexion
  • rotation and hyperextension
  • lateral flexion

fracture: axial loading with neck flexion; sudden forced hyperextension
dislocation: violent flexion and rotation of head

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9
Q

S&S of C-spine fracture

A
  • point tenderness over spinous process (with or without deformity)
  • restricted ROM
  • muscle spasm
  • pain in neck and or chest
  • numbness in trunk and or extremities
  • weakness or paralysis in trunk and or extremities
  • loss of bladder or bowel control
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10
Q

management of C-spine fracture

A
  • stabilize (collar and spinal board)

- activate EMS

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11
Q

there were approximately ______ spinal cord injuries in Canada in 2010

A

4300

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12
Q

___% of spinal cord injuries in Canada in 2010 were considered traumatic, ___% of all permanent injuries were sport related, and ___% of spinals in sports are related to inappropriate handling after the injury

A

42, 15, 25

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13
Q

lifelong care following a spinal cord injury is over ___$

A

one million

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14
Q

spinal cord injury: complete lesion

A
  • spinal cord totally severed
  • complete loss of all motor and sensory function below the level of injury - recovery below the level of injury is unlikely
  • the higher up it is, the more severe it is considered
  • some nerve root function may return 1-2 levels above the injury
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15
Q

at or above a C3 spinal cord lesion, what is impaired?

A

impaired respiration and death

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16
Q

a spinal cord lesion to C4-5 impairs which functions?

A

deltoid function

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17
Q

a spinal cord lesion at C5-6 impairs what?

A

elbow flexion and wrist extension

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18
Q

a spinal cord lesion at C6-7 impairs what?

A

elbow and finger extension and wrist flexion

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19
Q

a spinal cord lesion at C7-T1 impairs what?

A

grip function

20
Q

what are the five basic mechanisms of a complete C-spinal lesion?

A

1) laceration by bone fragment
2) hemorrhage
3) contusion
4) cervical cord neuropraxia
5) shock

21
Q

mechanism of complete C-spinal cord lesion - laceration by bone fragment

A

-jagged edges of bone from combined dislocation or fracture cut and tear spinal cord

22
Q

mechanism of complete C-spinal cord lesion - hemorrhage

A
  • hemorrhage from injury to surrounding tissues (fractures, dislocations, sprains, and strains) seldom causes harmful effects
  • hemorrhage from the cord itself causes irreparable damage
23
Q

mechanism of complete C-spinal cord lesion - contusion

A
  • any violent force to the neck
  • sudden displacement of vertebrae compresses the cord, then returns to its normal placement
  • various degrees of temporary and or permanent damage
24
Q

mechanism of complete C-spinal cord lesion - cervical cord neuropraxia

A
  • temporary S&S (paralysis and numbness) following severe twist of neck
  • S&S resolve leaving only a sore neck
  • often associated with stenosis (narrowing of spinal canal)
25
Q

mechanism of complete C-spinal cord lesion - shock

A
  • most often with a cord transection
  • immediate loss of function below the level of the lesion
  • initially limbs are flaccid, later become spastic
  • total loss of reflexes, which later become hyperreflexia
26
Q

brown séquard syndrome

A

spinal cord injury

  • below injury level, motor weakness or paralysis on one side of the body (hemiparaplegia)
  • loss of sensation on the opposite side (hemianesthesia)
27
Q

C-spine injury: whiplash MOI

A

sudden acceleration - deceleration

results in:

  • sprain of ligaments
  • anterior/posterior longitudinal ligaments
  • interspinous ligs
  • supraspinous ligs
  • strain of neck musculature
28
Q

S&S of whiplash

A
  • localized pain
  • pont tenderness (spinous process and transverse process)
  • restricted ROM
  • muscle guarding
  • appears the day after trauma due to inflammation or injured tissue and protective muscle spasm
  • ACUTE: last up to 2-3 months
  • CHRONIC: over 3 months
29
Q

management of whiplash

A
  • evaluated by physician to rule out fracture, dislocation, disc injury, concussion
  • cervical soft collar to reduce muscle spasm
  • POLICE: 48-72 hours
  • severe injury: bed rest and medication
  • therapy: cryotherapy, heat, massage, and manual treatments (traction)
30
Q

L-spine fracture/dislocation S&S

A
  • recognize injury potential from MOI
  • point tenderness of TP or SP
  • localized swelling
  • muscle guarding
  • tingling, numbness in lower extremity
31
Q

management of L spine fracture/dislocation

A
  • immobilize and transport via spinal board
  • minimize movement of fractured segment
  • xray required for diagnosis
32
Q

what are common L-spine fracture sites?

A

1) compression of vertebral body
- MOI: hyperflexion or fall from height landing on feet or buttock
2) fracture of TP or SP
- MOI: kick or direct impact to back
- erector spinae protect TP

33
Q

dislocations to L-spine vertebrae are common

true or false?

A

false, they are rare due to facet orientation

34
Q

spondylosis -def

A

fracture in the pars interarticularis (region between superior and inferior articular facets)
-L-spine

35
Q

spondylolithesis - def

A
  • anterior dislocation of the pars interarticularis fracture (step deformity)
  • often L5 on S1
  • biggest change in angle here
  • shifting is more common
36
Q

between spondylosis and spondylolithesis, which is more common in boys and girls?

A

spondylosis is more common in boys and sponsylolithesis is more common in girls

37
Q

what is the cause of spondylosis/spondylolithesis?

A
  • congenital
  • acquired - repetitive hyperextension movements
  • back bends in gymnastics, lifting weights, football block, tennis serve, volleyball spike, butterfly stroke
38
Q

S&S of spondylosis/spondylolithesis

A
  • no symptoms (spondylosis)
  • persisten mild to moderate back ache or stiddness
  • increase pain after, but not during activity
  • low back tired or weak
  • need to change positions frequently
39
Q

management of spondylosis/spondylolithesis

A
  • bracing and bed rest (1-3 days)
  • core and trunk strengthening to stabilize hypermobile segment
  • brace for high level activity
40
Q

herniated disc

A
  • nucleus pulposus protrudes through the annulus fibrosis

- compresses nerve root

41
Q

what is the most common site of a herniated disc?

A

L4-L5

-L5-S1 is second most common

42
Q

MOI of herniated disc

A

forward bending and twisting

43
Q

S&S of herniated disc

A
  • sharp, central pain
  • radiates unilaterally in a dermatomal pattern to the buttock and down the back of the leg
  • pain that spreads across back
  • weakness in lower limb
  • worse in the morning

posture: forward bend with side bending away from side of pain

44
Q

what position worsens the pain of a herniated disc? what makes it better?

A

pain is worse in forward bending and sitting positions

pain is better in backward bending (extension) position

45
Q

how do we assess a herniated disc?

A
  • straight leg raise (SLR): pain at 30 deg is a positive test
  • use this to see hamstring length/tension as well
  • diminished tendon reflexes
  • bilateral muscle weakness
  • valsalva maneuver increases pain - deep breath or movement that increases thoracic pressure
46
Q

management of a herniated disk

A
  • pain reduction (ice or modalities)
  • manual traction
  • back extension progression exercises - helps push everything anteriorly
  • core strengthening

KIN 3160 (10 decks)

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