Spinal injuries and spine motion restriction Flashcards
Cervial spine
How many vertebrae are in that?
- 7
Thoracic spine
How many vertebrae?
12
Lumbar spine
How many vertebrae?
- 5
Sacral
How many vertebrae?
- 5
Coccyx
How many vertebrae?
- 4
Meninges
Whats that?
- The protective membranes that surround the spinal cord
Motor tract
define
- Carries impulses down the spinal cord and out to the muscles
Pain tracts
Define
- Carry impulses from pain receptors up the spinal cord to the brain
If you wanted to test the right sided pain tract what side of the body would you apply pain?
Why?
- Left side of the body since the pain tract crossess over and carries impulses up the opposite side of the cord
Light touch tract
Define
- tested by applying light touch to the patient
- The light touch sensation is carried up the same side where the touch was applied
SCIWORA
Whats that abbreviation mean?
Whats it mean?
- Spinal cord injury without radiological abnormalities
- The pt has a spinal column injury and hasnt progressed into a spinal cord injury? Pt could be up and walking around with this
Using the spinal cord tracts how would you know if the spine is partially but not completly injured?
- Pt might not feel light touch but can feel pain
7 mechanisms of spinal injury
- Compression
- Flexion
- Extension
- Rotation
- Lateral bending
- Distraction
- Penetration
Compression
Define with examples
- When the weight of the body is driven against the head
- Ex. any accident in which a person imacts and object head first
Flexion
Define
- When there is severe forward movement of the head in which the chin meets the chest, or when the torso is excessively curled forward
Extension
Define
- When there is severe backward movement o the head in which the neck is stretched, or when the torso is severely arched backward
Rotation
Define
- When there is lateral movement of the head or spine beyond its normal rotation
Lateral bending
Define
- When the body or neck is bent severely from the side
Distraction
Define
Whats this common in
- When the vertebrae and spinal cord are stretched and pulled apart
- Hangings
SMR
Define
Spine motion restriction
Spinal column injury
Super Basic definition
- Injury to one of more vertebrae
Complete spinal cord injury
Define
- Results when an area of the spinal cord has been completely cut crossways either physically of physiologically
When the spinal cord is completly severed what do you loss?
- total loss of motor and sensory function below the level of injury
- Loss of bowel and bladder control
Anesthetic effect
Define
Indicitive of?
- Cannot feel sensations of light touch or a pinch
How long does it take for spinal shock to resolve
Typically resolves within 24 hours after incident but can last for several days
Neurogenic hypotension
Define
- Results from injury to the spinal cord that interrupts nerve impulses to the arteries
Incomplete spinal cord injury
How do you know
Some of the spinal cord is not injured so the pt retaines some function
Central cord syndrome
Define
- The middle portion of the spine is injured, causing disfunction in the inner tracts that control upper extremity motor and sensory function
Anterior cord syndrome
*The pt loses the ability to feel pain and crude touch below the site of the injury
Brown sequard
the patient loses motor function and light touch sensation on one side of the body while retaining pain sensation on that same side. On the opposite side of the body, the patient retains motor function and light touch sensation while losing pain sensation.
With penetrating head wounds and suspected spine injuries what equipment would you use?
what wouldnt you use because it increases mortality?
- c collar only
- no backboard
if you have an unresponsive patient lying next to a tree assume what?
They fell out of the tree
What nerve impulses can be damaged by c spine injuries?
- from the brain to the diaphram and intercostal muscles
- can cause absent breathing
whats the criteria for a high priority pt when spine injuries are suspected?
- Unresponsive
- Responsive but cant follow commands
- abnormal respiratory pattern
- Numbness
- Paralysis
Quadriplegia
Define
- paralysis of all 4 extremities
Paraplegia
Define
- Paralysis of only the lower half of the body
Hemiplegia
Define
Loss of function confined to the right or left side of the body
Diaphragmatic breathing indicates what?
spine injury
* good job
Brain break
whos a badass?
YOU IS!
Indications for spine motion restriction
(8)
- glasgow coma scale of <15
- Any suspected traumatic brain injury
- AMS for any reason
- Pain or tenderness along the vertrbral column
- Any paralysis (patial or complete)
- Deformity along the vertebral column
- Any patient with a significant MOI and is under the influence, cant communicate effectively or understand
- Any pt with a distracting injury
3 major complications for spinal injuries
- inadequate breathing effort
- Paralysis
- inadequate circulation
when in doubt whacha gonna do?
Hint: we are talking about spine injuries here
Spine motion restriction
how many rescuers should be involved in applying a c collar?
Atleast 2
- 1 for manual motion restriction
- other to apply the collar
3 times you would rapidly extricate a pt
- The scene is not safe
- The pts condition is so unstable that you need to move and transport immediatly
- the pt blocks your access to a second more seriously injured pt
First things to assess when pt has a hemet on
(4)
- Mental status and ability to follow commands
- Assess ABCs
- Fit of the helmet and the likelihood of movement of the pts head within the helmet
- Determine ability to gain access to the pts airway in needed
When would you remove the helmet?
(5)
- interferes with ability to assess and reassess airway and breathing
- Helmoet interferes with ability to manage airway and breathing
- the helmet doesn’t fit well and allows movement
- helmet messes with proper spine immobilization
- pt is in cardiac arrest
