Spinal Symposium Flashcards
Which myotomes supply which upper arm muscles?
Shoulder Abduction - Deltoid - C5
Elbow flexion & Wrist extension = C6
Elbow extension = C7
Finger flexion (FDS/P) = C8
Finger Abduction (interossei) = T1
Which myotomes supply the lower limbs?
Hip flexion - Iliopsoas - L2
Knee Extension - Quads - L3/4
Ankle Dorsiflexion - Tib Ant - L4
Hallucis Extension - EHL - L5
Ankle Plantar Flexion - Gastroc - S1
Peak demographic for a spinal cord injury?
Males 20-29yrs
Majority caused by falls or RTAs
How do we grade spinal injuries?
ASIA grading A–>E
A = complate (no sensory/motor function preserved)
B-D = Incomplete
E = Normal function
Define Quadraplegia and how it happens?
Partial/total loss of use of all 4 limbs & trunk
Due to damage in cervical cord (Phrenic keeps you alive)
Define Paraplegia?
Partial/total loss of use of lower limbs +/- bladder/bowel
Thoracic/lumbar/sacral injury
What type of injury is likely to occur in an elderly patient who falls and hyperextends their neck?
A central Cord Syndrome
Damage to the central cervical tracts in older people with arthritic necks who hyperextend, typically when falling
How does a central cord syndrome look?
Weakness greater in arm than legs
Perianal sensation & lower limb power largely preserved
What happens in anterior cord syndrome?
You daage everything but the dorsal columns –> Profound weakness but retaining fine touch and proprioception
How could an anterior cord syndrome be caused?
- Hyperflexion
- Ant Compression fracture
- Ant Spinal art damage
What is brown-sequard syndrome?
Hemi-section of the cord due to a penetrating injury
How does brown-sequard syndrome present?
Ipsilateral Paralysis (CST damage) Ipsilateral loss of proprioception & fine touch (dorsal columns) Contralateral loss of pain & temp (STT)
When are you likely to see brown-sequard syndrome?
Let’s just say if you do ever see it make sure to check the sky for flying pigs
How do you manage an acute Spinal cord injury?
ABCD incl:
- C-spine control
- Ventilation & O2
- Fluids
- Vasopressors for neurogenic shock
- Log rolling
- Assess neuro function incl. PR & perinanal sensation
How can you spot neurogenic shock in a SCI?
Injury above T6 with hypothermia, bradycardia and hypotension (due to symp outflow damage)