Spine and Head Flashcards
What are the 6 sections/lobes of the brain?
Parietal lobe - language and touch
Occipital lobe - sight
Temporal lobe - hearing, learning, feeling
Frontal lobe - thinking, memory, behaviour, movement
Brain stem - breathing, HR, temperature
Cerebellum - balance, coordination
What are the sections of the spine and how many vertebrae are in each?
Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 5 fused
Coccyx - 4 fused
Where does the spinal cord exit the skull from?
Foramen magnum at the base of the skull
What are some bony landmarks that correlate to specific vertebrae?
Spine of scapula - T1/2
Inferior angle of scapula - T7/8
Iliac crest - L1/L2
List some examples of dangerous MOIs for spinal injuries
Fall from a height greater than 1m
Axial load to the head
MVA
Impact that cracks helmet
Penetrating trauma to head or neck
Severe blunt force to head or neck
Unresponsive with unknown MOI
What are the typical motions involved with spinal injuries?
Hyper flexion
Hyper rotation
Hyper extension
Whiplash
Axial load
What is whiplash?
Hyper flexion or extension which is rapidly followed by the other
Extension -> flexion
Flexion -> extension
Why is the vertebral artery an issue with spinal injuries?
Passes through the spinous processes of the cervical vertebrae, where it can be compresses with rotation and extension. Supplies 20% of the blood for the brain
What are some S/S of a head/spinal injury?
Blood/CSF from nose/ears
Periorbital ecchymosis
Periauriclear ecchymosis
Unequal pupils
Persistent headaches
Seizure
Paralysis/Numbness/tingling in limbs
Abnormal strength in limbs
Deformity of skull
Balance/coordination issues
Changes in LOR
Increased BP
Bradycardia
Increased Hr
Irregular respirations
Def: Rhinorrhea + Otorrhea
Rhinorrhea - CSF out of nose
Otorrhea - CSF from ear
What are the conditions to be able to apply the CCR?
Patient is alert (GCS of 15)
Patient is above 16
No history of spinal surgery
Stable vital signs
What is the step by step process for CCR?
Do GCS. Must be a 15
Ask if any N/T in hands or feet, + normal sensation
Check for normal strength in limbs
If they have c spine pain, ask if it was immediate onset or delayed. If delayed, can move forward.
Palpate c spine for bony pain
If all before cleared, ask them to move neck 45 degrees each direction under their own power.
What are contraindications to realigning the head and neck?
Patient has pain, pressure, spasms, crepitus when you begin to realign the head and neck
You feel crepitus, spasms or resistance when you attempt to realign
What is spinal shock
A temporary loss of feeling/function/autonomic function below the site spinal injury
What order do you strap someones body onto a spinal board?
Torso
Pelvis/proximal legs
Distal legs
Head
Def: Epidural Hematoma
Arterial bleed
From low velocity blows to the head
Between skull and dura mater - does not leak into the actual brain matter. Creates bubble of blood that presses on brain matter
S/S appear rapidly - brief loss of LOR followed by regained consciousness
Pupil differences
Subdural hematoma
Bleeding located within the subdural space - but still outside of actual brain
Venous bleed
From violent blow to the head
S/S can appear much slower - immediately all the way up to days later - than epidural hematoma
S/S include headaches, personality changes, speaking and motor function impairment
Def: Intracerebral hematoma
Caused by blunt force or penetrating trauma that damages the blood vessels of the brain itself
What is Cushings Triad? What does it represent?
- Increased BP
- Bradycardia
- Irregular respirations
Physiological nervous system response to acute elevations of intracranial pressure
Def: Direct (Coup)/Indirect (Contrecoup) brain MOI
Direct/coup - brain strikes the skull on the side of the impact
Indirect /contrecoup - secondary impact of the brain on the skull on the other side from primary due to brain recoiling
What is second impact syndrome (SIS)?
A second head trauma before the first head trauma is involved. Compounds the risk of the second trauma and can be fatal
