Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine Lecture - Professor Kramer > Spinal Cord trauma > Flashcards

Spinal Cord trauma Flashcards

1
Q

Arm abduction ?

A

C5, C6, deltoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Elbow flexion ?

A

C5, C6, biceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wrist extension ?

A

C6, C7, extensor carpi radialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elbow extension ?

A

C7, C8, triceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Finger abduction and Hand grasp ?

A

C8, T1,

hand intrinsics,

flexor digitorum profundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chest muscles ?

A

T2-T7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abdominal muscles ?

A

T9-T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hip flexion ?

A

L1, L2, L3,

Iliopsoas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Knee extension ?

A

L2, L3, L4

Quads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Knee flexion ?

A

L4, L5,S1, S2

hamstrings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ankle dorsiflexion ?

A

L4, L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Great toe extension ?

A

L5, S1

extensor hallicus longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ankle Plantar flexion ?

A

S1, S2

gastrocnemius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Voluntary rectal tone ?

A

S2, S3, S4

bladder /anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SC Anatomy and physiology own notes ?

A

C - it is above the bone

T - it is below the bone

know where the injury is and what it can cause here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Two main phases of spinal cord injury ?

A

Direct mechanical injury

Tissue degeneration phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Direct mechanical injury facts ?

A

hemorrhage into the cord

formation of edema at the injured site

vasospasm and thrombosis of the small arterioles
–Local spinal cord blood flow is decreased.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tissue degeneration phase

facts ?

A

begins within hours of injury

release of membrane-destabilizing enzymes and mediators of inflammation

disruption of calcium channel pathways

Lipid peroxidation and hydrolysis

inflammatory phase causes more injury so steroid!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

lesion types ?

A

Spinal shock

Complete

incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Spinal shock definition ?

A

initial loss of all reflex activities below the area of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Complete definition ?

A

absence of sensory and motor function below the level of injury

lesions cannot be deemed complete until spinal shock has resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Incomplete definition ?

A

sensory, motor, or both functions are partially present below the neurologic level of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spinal cord trauma patho own notes ?

A

warm shock cause massive vasodilation, warm and the BP drops and they have a bradycardia

no sympathetic innervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Determination of acute unstable injuries ?

A

Any C1-C2 injury (atlas and axis - connection site to the skull)

Disruption of at least two columns

Degree of vertebral body compression

neuro deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Degree of vertebral body compression to be considers unstable ?

A

> 25% for the third to seventh cervical

> 50% in the thoracic or lumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Anterior cord etiology ?

A

Direct anterior cord compression

flexion of C-spine

Thrombosis of anterior spinal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Anterior cord sxs. ?

A

Complete paralysis below the lesion w/ loss of pain and temp sensation

Preservation of proprioception and vibration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Central cord etiology ?

A

Hyperextension injuries

Disruption of blood flow in the spinal cord

C-spine stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Central cord sxs. ?

A

Quadriparesis

greater in the UE than the LE

some loss of pain and temp sensation, also greater in the UE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Brown-Sequard etiology ?

A

Transverse hemisection of the SC

Unilateral cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Brown-Sequard sxs. ?

A

Ipsilateral Spastic paresis

loss of proprioception and vibratory sensation and

contralateral loss of pain and temp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Cauda Equina etiology ?

A

Peripheral nerve injury

33
Q

cauda equina sxs. ?

A

Variable motor and sensory loss in the LE

sciatica, bowel, bladder dysfunction

saddle anesthesia

34
Q

Spinal cord trauma prevalence ?

A

40 cases per million

more frequently on weekends, holidays, and during summer months

35
Q

Spinal cord trauma demographic ?

A

mean age of 40 years old

male-to-female ratio 4 to 1

36
Q

Spinal cord trauma etiology ?

A

MVA 42%

Falls 27%

Violence 15% (primarily gunshot wounds)
Sports 8%
Other 8%

37
Q

Spinal cord trauma: Prehospital immobilization type ?

A

Cervical spine (hard collar and/or bilateral blocks)

Backboard

38
Q

Spinal cord trauma: Prehospital immobilization indications ?

A

Tenderness

Neurologic complaints

High risk mechanism

39
Q

Spinal cord trauma Hx. ?

A

Mechanism

Pain

Weakness

  • Focal
  • Paralysis

Paresthesias

Incontinence

40
Q

Spinal cord trauma PE ?

A

Neurogenic shock

Vertebral tenderness

Motor loss

Reflex loss

Sensory loss

41
Q

Neurogenic shock

sxs. ?

A

warm, peripherally
vasodilated

hypotensive

relative bradycardia

Caution
**hypotension in the trauma patient can never be presumed to be caused by neurogenic shock until other possible sources of hypotension have been excluded

42
Q

SC trauma: Reflex loss - anogenital indicates complete SC damage ?

A

Bulbocavernosus

Cremasteric

Anal wink

43
Q

Reflex: Biceps ?

A

C5, C6

44
Q

Reflex: Brachioradialis ?

A

C6

45
Q

Reflex: Triceps ?

A

C7

46
Q

Reflex: Patellar ?

A

L4

47
Q

Reflex: Achilles tendon ?

A

S1

48
Q

SC trauma: C-spine - low risk ?

A

X-ray cervical spine

49
Q

SC trauma: C-spine - high risk ?

A

CT cervical spine

50
Q

You dont need to get a C-spine XR if they meet what criteria ?

A

NEXUS

51
Q

NEXUS criteria ?

A

National Emergency X-Radiography Utilization Study Criteria

52
Q

C-spine XR Unnecessary if meet each criteria ?

A

Absence of midline cervical tenderness

Normal level of alertness and consciousness

No evidence of intoxication

Absence of focal neurologic deficit

Absence of painful distracting injury

**what you can use to clear someone of cervical spine ijurt **

53
Q

Canadian cervical spine rule also used ?

A

Goal is “clinically important” injuries

54
Q

SC trauma: if you get a C-spine XR what views ?

A

lateral, anteroposterior, and odontoid performed

single lateral cervical spine film will identify approximately 90% of injuries to bone and ligaments

55
Q

Cervical spine xray

you can find what ?

A

Poor for identifying C1-C2 injuries

Column disruption

Compressions

56
Q

What imaging is better for SC trauma ?

A

Cervical spine CT

Better imaging than plain films

More sensitive and specific

57
Q

Thoracic or lumbar spine

initial imaging ?

A

XR

58
Q

Thoracic or lumbar spine

if abd. or major trauma ?

A

CT

59
Q

Thoracic or lumbar spine

ID nerve damage?

A

MRI

60
Q

Thoracic or lumbar spine x-ray ?

A

initial imaging of these spinal levels

Anterior and lateral films are generally obtained

61
Q

Thoracic or lumbar CT

indications ?

A

Proven bony spinal injury

neurologic deficits (with normal plain films)

severe neck or back pain (with normal plain films)

62
Q

Thoracic or lumbar CT

for multisystem trauma ?

A

Thoracic and abdominal CT scans reformatted

reconstruct images of the thoracic and lumbar spine

63
Q

Thoracic or lumbar CT

purpose and findings ?

A

Anatomy of an osseous injury

Grade canal impingement

Assess stability

64
Q

Thoracic or lumbar MRI

indications ?

A

Test of choice for anatomy of nerve injury

Helpful for identifying herniated disks or spinal cord contusions

65
Q

Thoracic or lumbar MRI

limitations ?

A

Not as sensitive as CT for detecting bone injuries

66
Q

SC trauma complications ?

A

Neurogenic shock

67
Q

SC trauma goals of tx. ?

A

prevent secondary injury

alleviate cord compression

establish spinal stability

68
Q

SC trauma: all spine trauma tx. ?

A
  • Airway considerations
  • Make sure cervical spine stabilized

Remove from backboard

Order appropriate imaging

69
Q

SC trauma: If neurologic deficit or unstable tx. ?

A

Consult spinal surgery immediately

70
Q

SC trauma: If blunt trauma

tx. ?

A

High dose corticosteroids (methylprednisolone)

71
Q

SC trauma: Neurogenic shock tx. ?

A

Stabilization cervical spine

IV crystalloid
-mean arterial blood pressure at 85 to 90 mm Hg

If insufficient
-inotropic pressor (atropine, dobutamine)

Identify possible other causes

72
Q

SC trauma: airway considerations ?

A

any patient with an injury at C5 or above should have his or her airway secured via endotracheal intubation

**above C5 careful of phrenic nerve injury - it innervates the diaphragm

73
Q

SC trauma: Operative management ?

A

Determined by spinal surgeon

74
Q

SC trauma: Nonoperative stabilization choices ?

A

Philadelphia collar

Miami J collar
-May have thoracic extension

Halo vest

  • Gold standard
  • Very invasive
75
Q

Operative management

common indications ?

A

Neurologic deterioration– URGENT SURGERY

Instability

76
Q

SC trauma: Thoracic and lumbar spine injury

- Nonoperative patients ?

A

Usually not immobilized, very difficult

Educate to restrict movements

77
Q

LeFort I description ?

A

maxilla only

78
Q

LeFort II description ?

A

maxilla and zygomatic

79
Q

LeFort III description ?

A

zygomatic and orbits

Clinical Medicine Lecture - Professor Kramer (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions