Spinal Cord Trauma Flashcards
Key Myotomes
C5 elbow flexors C6 wrist extensors C7 elbow extensors C8 finger flexors T1 finger abductors
L2 Hip flexors L3 Knee extensors L4 Ankle dorsiflexion L5 Long toe extensors S1 Ankle plantar flexors
Spinal cord syndromes
Central cord - forward fall with facial impact
Anterior cord - paraplegia and bilateral loss of pain and temperature sensation - from cord ischaemia
Brown square. Hemisection of cord - usually due to penetrating trauma
Cervical spine injuries
Axial loading, flexion, extension, rotation, lateral bending, distraction
Atlanta-occipital - traumatic flexion and distraction —> brain stem injury
Atlas - Jefferson fracture, usually axial loading, associated with C2
C1 Rotary subluxation - often in children —> Torricelli
C2 - Longest, susceptible to various fractures
- Odontoid - most of these - type 1 is tip, type 2 is base, type 3 base
- Posterior element - extension type injury
C5-6 Greatest flexion and extension area - C5 - C6 subluxation
Thoracic spine
Anterior wedge - axial
Burst - vertical axial compression
Chance - transverse flexion about axis anterior to vertebral column - only lap belt restraint
- Associated retroperitoneal and abdominal injuries
Fracture-dislocations - extreme flexion or blunt trauma
Thoraco lumbar
Be really careful logrolling
Acute hyper flexion and rotation - unstable
Cauda equina
Lumbar fracture
Cauda equina
Canadian C spine
Fall from >1m Axial load Motor vehicle collision - high speed, rollover, ejection Motorised recreational vehicle collision Bicycle collision
NEXUS
Neuro deficit eTOH Extreme distracting injury Unable to provide history Spinal tenderness - midline
C spine x ray
Bone deformity/fracture
Loss of alignment posterior aspect of vertebral bodies
Increased distance between the spinous processes at one level
Narrowing of the vertebral canal
Increased prevertebral soft tissue space
Anything above C6 can cause respiratory depression
