Spinal Trauma Flashcards
Spinal Trauma Mechanisms of injury
Describe Hyperextension and give two examples
the head is forced back and the cervical vertebrae are placed in an overextended position
Examples whiplash and hangings
Spinal Trauma Mechanisms of injury
Describe Hyperflexion and give one example
the head is forced forward, and the cervical vertebrae are placed in an over flexed position
Examples driver hitting the windshield
Spinal Trauma Mechanisms of injury
Describe Axial loading and give two examples
a severe blow to the top of the head causes a blunt force on the vertebrae and spinal column.
- Falling from a height and landing on the heels transmits forces up the axial skeleton to the lumbar
- Examples of axial loading mechanisms of injury include diving head first and striking the head on the bottom surface
Spinal Trauma Mechanisms of injury
Describe compression and give two examples
forces from above and below compress the vertebrae
Examples of compression mechanisms of injury include falling down and landing on the buttocks
Spinal Trauma Mechanisms of injury
Describe Overrotation and distraction and give one example
the head turns to one side and the cervical vertebrae are forced beyond normal limits
Examples of overrotation include wrestling moves.
Spinal Trauma
Mechanisms of injury
name 5 types
Hyperextension Hyperflexion Axial loading Compression Overrotation and distraction
Spinal Trauma assessment should include evaluating the movement of what
all 4 extremities
Spinal Trauma assessment
Describe the Assessment of sensory status by testing dermatomes
beginning at the level of no reported sensation and proceeding up to the level in which feeling is intact
What is Sacral Sparing
Incomplete injury by definition includes a phenomenon known as sacral sparing: some degree of sensation is preserved in the sacral dermatomes, even though sensation may be more impaired in other, higher dermatomes below the level of the lesion.
What is a dermatome?
The area of skin innervated by a specific spinal nerve is called a dermatome
What is a myotome?
the group of muscles innervated by a single spinal nerve is called a myotome.
describe the grading system for ASIA Impairment Scale for classifying spinal cord injury
A B C D E
describe ASIA Impairment Scale Grade A
Complete injury. No motor or sensory function is preserved in the sacral segments S4 or S5.
describe ASIA Impairment Scale Grade B
Sensory incomplete. Sensory but not motor function is preserved below the level of injury, including the sacral segments.
describe ASIA Impairment Scale Grade C
Motor incomplete. Motor function is preserved below the level of injury, and more than half of muscles tested below the level of injury have a muscle grade less than 3 (see muscle strength scores, left).
describe ASIA Impairment Scale Grade D
Motor incomplete. Motor function is preserved below the level of injury and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.
describe ASIA Impairment Scale Grade E
Normal. No motor or sensory deficits, but deficits existed in the past.
How should you assess for sacral sparing?
Assess for sacral or perineal sensation. If sacral sensation is present in a patient with focal deficits, the patient has sacral sparing, which should lead you to suspect an incomplete spinal cord injury.
Gently palpate the patients entire vertebral column to detect what? (4)
pain, tenderness, crepitus, and step off deformity.
NEXUS clearence without radiology for low risk patients if they meet all 5 criteria. Low probability for injury include;
No Midline cervical tenderness No focal neurologic deficit Normal alertness No intoxication No painful or distracting injury
A patient with a spinal injury at or above T6 may experience what?
hypotension, and bradycardia (neurogenic shock) because of loss of sympathetic vasomotor tone.
