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Muscluloskeletal Systems > Spinal Injury > Flashcards

Spinal Injury Flashcards

1
Q

Give 4 functions of the spine

A

Support the axial skeleton

Movement of the trunk

Protect the spinal cord

Haematopoeisis

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2
Q

What spinal fractures are most common and why?

A

Thoracolumbar fractures most common

Majority L1 and T12

  • Transition between fixed thoracic spine and free lumbar spine
  • Fewer further from junction
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3
Q

When assessing a spinal fracture where else should you check?

A

THE WHOLE SPINE

10% of spinal fractures will have another spinal injury
-Remember distracting injuries

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4
Q

Give signs and symptoms of spinal injury

A

Pain

Flaccidity, paralysis, numbness

Paraesthesia, paresis, weakness

Priapism, incontinence etc

Need to rule out abdominal trauma

Spinal shock versus neurogenic shock

Hypotension, bradycardia, vasodilation

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5
Q

What is the difference between spinal and neurogenic shock?

A

Spinal shock is transient
-Flacid areflexic paralysis

Neurogenic shock effects autonomic NS
-Vascularities dilate

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6
Q

What are the 5 ASIA assessment groups for spinal injury

A 
A
B
C
D
E
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7
Q

What is ASIA A

A

A = “complete” spinal cord injury

-No motor or sensory function

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8
Q

What is AISA B

A

B = “incomplete” spinal cord injury

-Sensory but not motor function preserved bewlow neurological level
iIncludes the sacral segments S4-S5

-Transient phase and if recovers motor incomplete i.e. ASIA C or D

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9
Q

What is ASIA C

A

C = “incomplete” spinal cord injury

  • Motor function preserved below the neurological level
  • More than half of key muscles below the neurological level have a muscle grade of less than 3
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10
Q

What is ASIA D

A

D = “incomplete” spinal cord injury

-Motor function is preserved below the neurological level and at least half of key muscles below the neurological level have a muscle grade of 3 or more

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11
Q

What is ASIA E

A

E = “normal” where motor and sensory scores are normal.

Can have spinal cord injury and neurological deficits with completely normal motor and sensory scores

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12
Q

What segmental spinal cord levels control neck flexors and extensors?

A

C1-C6 = Neck flexors

C1-T1 = neck extensors

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13
Q

What segmental spinal cord levels control diaphragm?

A

C3,C4 and C5

mostly C4

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14
Q

What segmental spinal cord levels control shoulder movement and flexion of elbow joint?

A

C5 and C6

Shoulder movement, raise arm (deltoid); flexion of elbow (biceps)

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15
Q

What segmental spinal cord levels externally rotate the arm (supinate)?

A

C6

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16
Q

What segmental spinal cord levels extend elbow and wrist (triceps and wrist extensors); pronates wrist

A

C6 and C7

17
Q

What segmental spinal cord levels flex wrist and supply the small muscles of the hand?

A

C7 and T1

18
Q

What segmental spinal cord levels supply intercostals and trunk above the waist?

A

T1-T6

19
Q

What segmental spinal cord levels supply abdominal muscles?

A

T7-L1

20
Q

What segmental spinal cord levels control thigh flexion?

A

L1-L4

21
Q

What segmental spinal cord levels control thigh abduction and adduction?

A

Abduction = L4, L5 and S1

Adduction = L2, L3 and L4

22
Q

What segmental spinal cord levels control extension of the leg at the hip (Gluteus maximus)?

A

L5, S1, S2

23
Q

What segmental spinal cord levels control extension of the leg at the knee (quadriceps femoris)?

A

L2, L3 and L4

24
Q

What segmental spinal cord levels control flexion of the leg at the knee (hamstrings)?

A

L4, L5, S1 and S2

25
Q

What segmental spinal cord levels control dorsiflextion of the foot (tibialis anterior)?

What about plantar flexion of foot?

A

L4, L5, S1

Plantarflexion = L5, S1 and S2

26
Q

What segmental spinal cord level controls extension of the toes?

What about flexion of the toes

A

L4, L5 and S1

Flexion = L5, S1 and S2

27
Q

What are the features of anterior cord syndrome?

A

Both motor and sensory pathways

Crude sensation, movement and fine sensation lost

28
Q

What are the features of central cord syndrome?

A

Weakness and paralysis of both arms and some sensory loss

Legs less effected

29
Q

What are the features of Brown-Sequard syndrome?

A

Injury to half of cord

Movement and some sensory loss below injury
Pain and temperature on opposite side

30
Q

How do you initially manage someone who may have attained a spinal injury?

A

Mechanism of injury

Other associated injuries

Prevent secondary injury

Immobilise the spine

Spinal injury only part of the picture

Immediate life threatening injuries

Haemorrhage

31
Q

What is a chance fracture?

A

It consists of a compression injury to the anterior portion of the vertebral body and a transverse fracture through the posterior elements of the vertebra and the posterior portion of the vertebral body. It is caused by violent forward flexion, causing distraction injury to the posterior elements.

32
Q

What are burst fractures?

A

A vertebra breaks from a high-energy axial load (e.g., traffic collisions or falls from a great height or high speed, and some kinds of seizures), with sharps of vertebra penetrating surrounding tissues and sometimes the spinal canal.

Burst fractures are considered more severe than compression fractures because long-term neurological damage can follow. The neurologic deficits can reach their full extent immediately, or can progress for a prolonged time.

33
Q

What is a wedge compression fracture?

A

A compression fracture is a common fracture of the spine. It implies that the vertebral body has suffered a crush or wedging injury.

This may cause the front part of the vertebral body to crush forming a wedge shape. This is known as a compression fracture. If the entire vertebral body breaks, this is considered a burst fracture.

34
Q

What does SCIWORA stand for?

A

Spinal Cord Injury Without Radiographic Abnormality

35
Q

What is a Clay Shoveler’s fracture?

A

Clay-shoveler’s fracture is a stable fracture through the spinous process of a vertebra occurring at any of the lower cervical or upper thoracic vertebrae, classically at C6 or C7

36
Q

What is a Jefferson fracture?

A

A Jefferson fracture is a bone fracture of the anterior and posterior arches of the C1 vertebra, though it may also appear as a three- or two-part fracture. The fracture may result from an axial load on the back of the head or hyperextension of the neck (e.g. caused by diving), causing a posterior break, and may be accompanied by a break in other parts of the cervical spine.

37
Q

What is a hangman’s fracture?

A

A hangman’s fracture is the colloquial name given to a fracture of both pedicles or pars interarticularis of the axis vertebra (C2) (or epistropheus).

Muscluloskeletal Systems (29 decks)

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