Spinal trauma

Question 1

What is the typical mechanism of injury in a C spine fracture?

Answer 1

High energy - RTA, fall from height etc

Question 2

What are the two different mechanisms of injury in a thoracolumbar spinal fracture?

Answer 2

High energy - motorbike accident

osteoporotic wedge fractures

Question 3

What is spinal shock?

Answer 3

physiologic response to injury - complete loss of sensation, motor function and reflexes below the level of injury, will resolve itself within 24 hrs

Question 4

What is the bulbocavernous reflex and what is it used to test?

Answer 4

reflex contraction of the anal sphincter with either a squeeze of the glans penis, tapping the mons pubis or pulling on a urethral catheter
Will be absent in spinal shock and its return signals the end of spinal shock

Question 5

What is neurogenic shock?

Answer 5

occurs due to temporary shutdown of sympathetic outflow from cords T1-L2 (usually due to injury to the cord)
Hypotension and bradycardia

Question 6

Management of neurogenic shock?

Answer 6

IV fluids

Question 7

What is the difference between dermatomes and myotomes?

Answer 7

Dermatome = area of skin that a single nerve innervates for sensation
Myotome = group of muscles that a single nerve innervates for movement