Spinal Trauma Flashcards
What is the function of the spine?
To allow spinal motion while protecting the enclosed neural elements from injury. The spinal column forms the foundation of the axil skeleton of the body from the base of the skull to the pelvis
What is the spinal column composed of?
7 cervical, 12 thoracic, 5 lumber, 5 sacral and 4-5 coccygeal vertebral segments
What is the basic anatomy for the vertebra?
Has an opening (spinal central canal) and multiple processes that serve as level arms for the ligament and muscular attachments
Why is the cervical spine the most vulnerable part of the spine to injury?
Because of its mobility and exposure
What provides additional support to the thoracic spine?
The rib cage
What is different about the atlas compared to other vertebra?
It doesn’t have a body
What is different about the axis compared to other vertebra?
It has the dens which goes into the atlas
Where does the spinal cord originate and end in an adult?
Originates at the caudal end of the medulla oblongata at the foramen magnum and ends near the L1 bony level at the conus medullaris
What are the 3 tracts of the spinal cord that can be assessed clinically?
The lateral corticospinal tract
The spinothalamic tract
The dorsal columns
What is a dermatomes?
The area of the skin innervated by the sensory axons within a particular segmental nerve root
What is a sensory level?
The lowest dermatome with normal sensory function and can often differ on 2 sides of the body
What are the different mechanisms that can result in a c-spine injury?
Atlanto-occipital dislocation
Atlas (C1) fracture
C1 rotary subluxation
Axis fracture
What is the mechanism that results on a atlanto-occipital dislocation?
Severe traumatic flexion and dislocation
What happens to most patients that have a Atlanto-occipital dislocation?
They die of brain stem destruction and apnoea or have profound neurological impairments.
What is a common causes of death in shaken baby syndrome?
Atlanto-occipital dislocation
What are fractures of the atlas commonly associated with?
Fractures of the axis (C2)
What is the most common fracture of the C1?
Burst / Jefferson fracture
What is the typical mechanism that causes a Jefferson/burst fracture?
Axial loading: a large load falls on the head or the patient lands on top of their head in a relatively neutral position
Are Jefferson/burst fractures commonly associated with spinal cord injuries and are the stable or unstable?
Not associated with spinal cord injuries but they are unstable
Why is the axis susceptible to a multitude of fractures of note: the pronto is and posterior element fractures?
It is the largest cervical vertebra and is the most unusual shape
What do a large volume of C2 fractures involve?
The odontoid process (a peg shaped protuberance that projects upwards and is normally positioned in contact with the anterior arch of C1)
What is a type 1 odontoid fracture?
Involves the tip of the odontoid and is relatively uncommon
What is a type 2 odontoid fracture?
Occurs through the base of the dens and is the most common fracture
What is a type 3 odontoid fracture?
Occurs at the base of the dens and extends obliquely into the body of the axis
