Spine and Nervous System Trauma

Question 1

Spinal cord injury usually seen in flexion injuries. Caused by damage to anterior aspect of spinal cord by
ruptured intervertebral disk or
fragments of vertebral body extruded posteriorly into spinal canal by damage to anterior spinal artery

Answer 1

anterior cord syndrome

Question 2

Overactivity of autonomic NS that causes an abrupt onset of extremely high BP

Answer 2

autonomic hyperreflexia syndrome

Question 3

Vertical compression of spine that results when direct forces are transmitted along length of spinal column

Answer 3

axial loading

Question 4

Functional hemitransection of spinal cord resulting in weakness of upper and lower extremities on same side and loss of pain and temp sensation on opposite side

Answer 4

Brown-Sequard syndrome

Question 5

SCI commonly seen with hyperextension cervical injuries; less commonly seen with flexion injuries
Characterized by greater motor impairment of upper vs lower extremities

Answer 5

Central cord syndrome

Question 6

Skin surface area supplied by a single spinal root

Answer 6

dermatome

Question 7

Spinal injury that occurs if spinal motion is stopped suddenly relative to body motion, causing weight to shift away

Answer 7

distraction

Question 8

Hypotension following spinal injury caused by loss of sympathetic tone in vessels; ie. neurogenic hypotension

Answer 8

Neurogenic shock

Question 9

Damage to spinal cord that may result from direct injury to cord itself or indirectly from damage to surrounding structures and tissue

Answer 9

spinal cord injury

Question 10

Temporary loss or depression of all or most spinal reflex activity below the level of the injury; ,ay or may not include loss of sympathetic tone that causes hypotension

Answer 10

spinal shock

Question 11

Condition of the spine characterized by fixation or stiffness of vertebral joint

Answer 11

spondylosis

Question 12

Partial dislocation

Answer 12

subluzation

Question 13

Weakness or paralysis of all four extremities and trunk

Answer 13

tetraplegia

Question 14

Twisting of neck caused by injuries to the cervical spine that generate muscle spasms. Causes painful fixed head tilt accompanied by shoulder elevation

Answer 14

torticollis

Question 15

Complete or incomplete lesion to spinal cord

Answer 15

transection

Question 16

Location at which spinal cord ends in
adults
infants

Answer 16

L1-L2
L3

Question 17

Nerve root for motor
Nerve root for sensory

Answer 17

Anterior nerve root
Posterior nerve root

Question 18

Nerve tract for sensory impulses
Nerve tract for motor impulses

Answer 18

Ascending nerve tract
Descending nerve tract

Question 19

Type of bending that may result in dislocations and bony fractures to the C and T spine

Answer 19

Lateral bending

Question 20

SCI without radiologic abnormality is common in what age group?

Answer 20

Children

Question 21

Injury to a ligament

Answer 21

Sprain

Question 22

Injury to muscle or tendon

Answer 22

Strain

Question 23

Common in low speed, rear-end car crashes; known as whiplash

Answer 23

hyperextension

Question 24

Most frequent injured spinal regions (3)

Answer 24

C5-C7
C1-C2
T12-L2

Question 25

Fractures resulting from compression to anterior portion of vertebral body; STABLE

Answer 25

Wedge-shaped fracture

Question 26

Fractures resulting from severe hyperflexion and compression force; UNSTABLE

Answer 26

Teardrop fractures

Question 27

Classifications of SCI

Answer 27

Primary Secondary

Question 28

Injury of SCI that occurs at time of impact

Answer 28

Primary SCI

Question 29

Injury of SCI that occurs after initial injury: swelling ischemia bone fragment movement

Answer 29

Secondary SCI

Question 30

Injury of this region causes partial or total loss of movement in upper and lower extremities. May need ventilation assistance

Answer 30

C1-C4

Question 31

Injury of this region will usually leave pts with ability to flex elbow and or extend wrist but with limited hand function

Answer 31

C5-C6

Question 32

Injury to this region will usually leave pt with functional triceps and ability to bend and extend elbow, fingers, wrist function

Answer 32

C7-C8

Question 33

Injury below this region usually spare innervation and function of all upper extremity function

Answer 33

T1

Question 34

Spinal nerve exit locations in spinal column (3)

Answer 34

C1-C7 nerve above C1-C7 vertebra C8 below C7 T1-L1-S1 Nerve below associated vertebra

Question 35

Crucial element in evaluating likelihood for SCI

Answer 35

MOI

Question 36

What is the key role of paramedic supposed to prevent?

Answer 36

Secondary SCI

Question 37

Nerve root that controls voluntary muscle function of fingers and hands

Answer 37

T1

Question 38

Plantar flexors of foot are controlled by which nerve root?

Answer 38

S2

Question 39

Lack or response to stimulation of upper extremities indicates injury to what region?

Answer 39

Cervical

Question 40

Lack or response to stimulation of lower extremities indicates injury to what region

Answer 40

Thoracic and/or Lumbar

Question 41

Reflex movement that indicates spinal cord lesion in older child and adult.

Answer 41

Babinski sign

Question 42

Dermatome that provides sensation around neck and anterior chest below clavicles

Answer 42

C2-C4

Question 43

Dermatome that provides sensation at nipple line

Answer 43

T4

Question 44

Dermatome that provides sensation to umbilicus

Answer 44

T10

Question 45

Dermatome that provides sensation to soles of feet

Answer 45

S1

Question 46

Apply rigid cervical collar in what 5 situations

Answer 46

-Midline neck or spinal pain -Tenderness upon palpation -Unreliable pt (GCS <15, alcohol, distracting injury, communication barrier) -Focal or neuro deficit -Torticollis in children

Question 47

May require padding under torso with application of cervical collar

Answer 47

Children

Question 48

Recommended that spinal precautions are indicated for children less than what age when significant MOI is present?

Answer 48

8 y/o