Spinal Fractures

Question 1

What type of curve is in the cervical spine?

Answer 1

Lordosis

Question 2

What type of curve is in the thoracic spine?

Answer 2

Kyphosis

Question 3

What type of curve is in the lumbar spine?

Answer 3

Lordosis

Question 4

Define a dermatome

Answer 4

Area of skin that is mainly supplied by a single spinal nerve

Question 5

Define a myotome

Answer 5

Group of muscles that a single spinal nerve innervates

Question 6

Shoulder abduction is what myotome?

Answer 6

C5

Question 7

Elbow flexion/ wris exxtension is what myotome

Answer 7

C6

Question 8

Elbow extension is via what myotome?

Answer 8

C7

Question 9

Long finger flexion is via which myotome

Answer 9

C8

Question 10

Finger abduction is via which myotome

Answer 10

T1

Question 11

Hip flexion is via which myotome

Answer 11

L2

Question 12

Knee extension is via which myotome?

Answer 12

L3, L4

Question 13

Ankle dorsiflexion is via which myotome?

Answer 13

L4

Question 14

Big toe extension is via which myotome?

Answer 14

L5

Question 15

Ankle plantar flexion is via which myotome?

Answer 15

S1

Question 16

Tenderness on spine common causes

Answer 16

Spinal fracture,
Infection of spine,
Malignancy of spine

Question 17

Common lumbar abnormality gaits

Answer 17

Antalgic gait,

Foot drop gait

Question 18

When someone is walking on their tip toes what myotome are they using?

Answer 18

S1

Question 19

What myotome(s) are being used if someone is walking on their heels?

Answer 19

L4, L5

Question 20

what is a characteristic cervical spine gait?

Answer 20

No proprioception so will look at feet, shuffle, take broad base, short steps

Question 21

What is a +ve straight leg raise

Answer 21

Shooting pain in L5, S1

Question 22

What is a +ve femoral stretch test?

Answer 22

Pain in L3, L4

Question 23

What percentage of people with a fracture/ dislocation will have a spinal cord injury?

Answer 23

15%

Question 24

Common causes of spinal cord injury?

Answer 24

Fall, 
RTC,
Sport,
Trauma, 
Knocked over, 
Sharp trauma

Question 25

Complete spinal cord injury

Answer 25

``` No motor or sensory function distal to lesion, No anal squeeze, No sacral sensation, ASIA Grade A, No chance of recovery ```

Question 26

Incomplete spinal cord injury?

Answer 26

Some function is present below site of injury, | More favourable prognosis

Question 27

Can you determine if a spinal cord injury is complete or incomplete initially?

Answer 27

No as patient may be in spinal shock

Question 28

ASIA classification A?

Answer 28

Complete, | No sensory or motor function preserved in sacral segments S4-S5

Question 29

ASIA classification B?

Answer 29

Incomplete, Sensory preserved below the neurological level and extending through sacral segments S4-S5, No motor

Question 30

ASIA classification C?

Answer 30

Incomplete, Motor function below neurological level, Key muscles have a grade <3

Question 31

ASIA classification D

Answer 31

Incomplete, Motor below neurological level, Key muscle have a grade >3

Question 32

ASIA classification E?

Answer 32

Normal motor and sensory function

Question 33

Types of patterns of injury?

Answer 33

``` Tetraplegia, Paraplegia, Central cord syndrome, Anterior cord syndrome, Brown-Sequard Syndrome ```

Question 34

Define tetraplegia

Answer 34

Partial/total loss of use of four limbs and trunk, | Loss of motor/sensory function in cervical segments of the spinal cord

Question 35

Define paraplegia?

Answer 35

Partial/total loss of use of lower-limbs, | Impairment/ loss of motor/ sensory function in thoracic, lumbar or sacral segments of the spinal cord

Question 36

When is central cord syndrome commonly seen?

Answer 36

In older patients with arthritic neck, | In an hyperextension injury

Question 37

Presentation of central cord syndrome?

Answer 37

Weakness of arms > legs, | Perianal sensation and lower extremity power preserved

Question 38

Partial cord syndrome caused by hyperextension?

Answer 38

Central cord syndrome

Question 39

Partial cord syndrome caused by hyper flexion?

Answer 39

Anterior cord syndrome

Question 40

Common cause of anterior cord syndrome

Answer 40

Anterior compression fracture, | Damaged anterior spinal artery

Question 41

Presentation of anterior cord syndrome?

Answer 41

Profound weakness, | Fine touch and proprioception preserved

Question 42

What partial cord syndrome is caused by hemi-section of the cord?

Answer 42

Brown-sequard Syndrome

Question 43

Common cause of Brown-Sequard syndrome?

Answer 43

Penetrating injuries

Question 44

Presentation of Brown-Sequard syndrome

Answer 44

Paralysis of affected side, Loss of proprioception and discrimination, Pain and temperature loss on opposite side below lesion

Question 45

Management of spinal cord injury?

Answer 45

ABCD, | ATLS (advanced trauma life support)

Question 46

Signs of neurogenic shock?

Answer 46

``` Low BP and HR, Loss of sympathetic tone, Vasopressors, Hypothermia, Injury above T6 ```

Question 47

Signs of spinal shock

Answer 47

Transient depression of cord function below level of injury, Flaccid paralysis, Areflexia, Lasts several hours to days

Question 48

Surgical fixation of spinal cord injury

Answer 48

Majority fixed posteriorly via pedicle screws

Question 49

Long-term management of spinal cord injury?

Answer 49

``` Spinal cord injury unit, Physiotherapy, OT, Psychological support, Urological/ sexual counselling ```