Spinal Trauma Flashcards

1
Q

Who? Cause?

A
  • DUDES!!! Males (life of adventure…)
  • MC auto-accident
  • blunt trauma
  • often PREVENTABLE
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2
Q

Long-term spinal injury effects

A
  • less employment
  • divorce
  • shorter life expectancy
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3
Q

how many vertebrae?

A

33

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4
Q

Fracture through cervical vertebral foramen?

Order

A

CT w/ contrast = spinal cord injury

*blunt force

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5
Q

Thoracic vertebral fracture?

Investigate

A

Spleen/liver lac, etc.

*HUGE force needed

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6
Q

Lumbar vertebral fracture

MC?

A

Compression

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7
Q

Spinal Injury

Initial Management

A

*ABCs
*Immobilization (C-spine collar, etc.)
*High cervical Injury = Early Intubation
Jaw thrust - NO HEAD tilt/chil lift
*Transport

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8
Q

Spinal immobilization

A

*Rigid cervical collar
*supportive blocks
*backboard w/ straps
(Exam b/f and after)

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9
Q

Focused Neuro / Spine exam

A
  • Palpate spine (tenderness, stepoffs)
  • Motor level assess
  • Neurosurgery rectal (Tone, Sensation, Contraction, Blood)
  • sensory : light touch + pinprick
  • reflexes = MC initially absent
  • ASIA score
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10
Q

ASIA score

A
A = nothing
B= Sensory , NO MOTOR
C= Sensory/Motor, WEAKNESS +1/2 
D= Sensory/Motor, WEAKNESS -1/2
E = normal

REVIEW OTHERS

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11
Q

Spinal Imaging

NEXUS Criteria

A

NO IMAGE if:

NO

  • midline cervical tenderness
  • focal neuro s/s
  • abnormal alertness
  • intoxication
  • painful distracting injury
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12
Q

Minimum Required Imaging

A

1st = thin cut axial C from OCCIPITAL –> T1 + sag/coronal reconstructions

  • w/ pan-scan of body w/ reformatting =all 3 planes
  • also MRI, CT Myelogram, Flexion/Extension
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13
Q

Types of Injury

A
  • Blunt Injury
  • Falls
  • Sports Injury
  • Penetrating Trauma
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14
Q

ANY Cervical Spine fracture =

  • Compression Fracture
  • Burst fracture
  • Flexion-distraction (seatbelt)
  • Fracture dislocation

Surgery?

A

SURGERY REQUIRED

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15
Q

Minor injuries

A

Transverse,spinal, articulating processes

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16
Q

4 point burst fracture of ring of C1

A

Jefferson Fracture

17
Q
  • Bilateral Pars fractures = C2
  • Traumatic sublixation of C2 on C3

?

A

Hangman’s Fracture

18
Q

Odontoid fracture

where in spine?

A

Cervical fracture

19
Q

Injuries w/ foramen transversarium

Consider…

A

Vascular injury

20
Q

Assess Injury Morphology, Neuro status, PLC Integrity

A

TLICS score

<3 = Non-OP
4 = Grey Zone
5< = Surgical
21
Q

Compression fracture

possible surgery?

A

Fusion

W/ corpectomy

22
Q

Don Juan fracture

A

Double calcaneal fracture

Check back!

23
Q

Car crash

Spine flexes, damaging facet/ligs/ etc.

A

Flexion-distraction

24
Q

Spinal Injury

Long-term care = must refer to

A

Spinal Rehab PT/OT

25
Q
PT
OT
Speech language
Case manager
Psyc/Social Worker
Therapeutic recreation 
Transportation specialist
Pastoral care
Peer mentor
A

Spinal injury ancillary report

26
Q

Spinal Injury RED ALERTS

Send to SCAN

A
  • Ankylosing Spondylitis (DISH) - bamboo CT/fusing
  • Osteoporosis
  • Steroid use
27
Q

Initial Hospital Assessment

A
  • ABCs
  • Trauma team activation
  • Focused Neuro assess
  • Other injuries = ATLS