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MSK > Spinal Injury > Flashcards

Spinal Injury Flashcards

1
Q

What do C5 + C6 myotomes innervates

A
  • C5 = Should abduction (deltoid)

- C6 = Elbow flexion/Wrist extensors (biceps)

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2
Q

What do C7 + C8 myotomes innervate

A
  • C7 = Elbow extensors (triceps)

- C8 = Long finger flexors (FDS/FDP)

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3
Q

What does T1 myotome innervate

A

Finger abduction (interossei)

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4
Q

What do L2 + L3,4 myotomes innervate

A
  • L2 = Hip flexion (iliopsoas)

- L3 + L4 = Knee extension (quadriceps)

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5
Q

What do L4 + L5 myotomes innervate

A
  • L4 = Ankle dorsiflexion (tib ant.)

- L5 = Big toe extension (EHL)

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6
Q

What does S1 myotome innervate

A

Ankle plantar flexion (gastroc)

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7
Q

2 peaks of spinal injury by age

A
  • 20-29 yrs

- 65+ yrs

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8
Q

3 most common causes of spinal injuries

A
  • Fall (41.7%)
  • RTA (36.8%)
  • Sport (11.6%)
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9
Q

Describe a complete spinal injury

A
  • No motor or sensory function distal to lesion
  • No anal squeeze
  • No sacral sensation
  • ASIA grade A
  • No chance of recovery
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10
Q

Describe an incomplete spinal injury

A
  • Some function is present below site of injury

- More favourable prognosis overall

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11
Q

What scoring system is used assess spinal injury severity

A

-ASIA Classification

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12
Q

5 patterns of spinal injury

A
  • Tetraplegia/Quadriplegia
  • Paraplegia
  • Central cord syndrome
  • Anterior cord syndrome
  • Brown-sequard syndrome
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13
Q

Symptoms of quadriplegia/tetraplegia

A
  • Partial or total loss of use of all four limbs + trunk
  • Loss of motor/sensory function cervical segments of the spinal cord
  • Spasticity
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14
Q

Cause of quadriplegia/tetraplegia

A
  • Results from cervical fracture
  • Resp. failure due damage to phrenic nerve (C3-5)
  • “C5 keeps you alive”
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15
Q

Describe paraplegia

A
  • Partial or total loss of use of lower-limbs
  • Impairment or loss of motor/sensory function in thoracic, lumbar or sacral segments of the spinal cord
  • Arm function spared
  • Possible impairment of function in trunk
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16
Q

3 partial cord syndromes

A
  • Central cord syndrome
  • Anterior cord syndrome
  • Brown-sequard syndrome
17
Q

Cause of central cord syndrome

A
  • Older patients (arthritic neck)
  • Hyperextension injury
  • Centrally cervical tracts more involved
18
Q

Symptoms of central cord syndrome

A
  • Weakness of arms>legs

- Perianal sensation & lower extremity power preserved

19
Q

Cause of anterior cord syndrome

A
  • Hyperflexion injury
  • Anterior compression fracture
  • Damaged anterior spinal artery
20
Q

Symptoms of anterior cord syndrome

A
  • Fine touch + proprioception preserved

- Profound weakness

21
Q

Cause of brown-sequard syndrome

A
  • Hemi-section of the cord

- Penetrating injuries

22
Q

Symptoms of brown-sequard syndrome

A
  • Paralysis on affected side (corticospinal)
  • Loss of proprioception + fine discrimination (dorsal columns)
  • Pain + temperature loss on the opposite side below lesion (spinothalamic)
23
Q

Management of SCIs

A
  • Prevent a secondary insult

- Particularly in patients with incomplete injuries

24
Q

Describe spinal shock

A
  • Transient depression of cord function below level of injury
  • Flaccid paralysis
  • Areflexia
  • Last several hours to days after injury
25
Q

Describe neurogenic shock

A
  • Hypotension
  • Bradycardia
  • Hypothermia
  • Injuries above T6
  • Secondary to disruption of sympathetic outflow
26
Q

How to assess disability

A
  • Assess neurological function

- Including PR + perianal sensation

27
Q

Investigations for SCI

A
  • X-rays
  • CT (bony anatomy)
  • MRI (if neuro deficit or children)
28
Q

When to use surgical fixation on SCIs

A

Unstable fractures

29
Q

Long term management of SCI

A
  • SCI Unit (intermediate term)
  • Physio + occ. therapy
  • Psychological support
  • Urological/sexual counselling
30
Q

Are SCIs common or rare

A

Spinal fractures are common but SCIs are rare

31
Q

How to prevent secondary injury

A

ABCD

32
Q

How to assess injury severity

A

Testing myotomes + dermatomes

MSK (28 decks)

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