Spine and spinal cord trauma

Question 1

Most common region for spinal injuries

Answer 1

Cervical

Question 2

Signs of neurogenic shock

Answer 2

Bradycardia with low BP
Neurological deficit
Warm extremities

Question 3

Neurogenic shock is associated with spinal cord injuries above what level

Answer 3

T6

Question 4

Mechanism of neurogenic shock

Answer 4

Injury to sympathetic fibres that maintain tone of vasculature and heart rate

Distributive shock from dilation of peripheral vessels

Question 5

Most common thoracic spine fracture

Answer 5

Wedge compression fractures
- not associated with spinal cord injury

Question 6

Three spinal cord tracts you can assess clinically

Answer 6

Lateral corticospinal tract
Spinothalamic tract
Dorsal columns

Question 7

Cervical nerve roots C5-8 and T1 clinical testing

Answer 7

C5/6 - elbow flexion(biceps)
C6 - wrist extension
C7 - elbow extension (triceps)
C8 - finger flexion
T1 - finger abductors

Question 8

Lumbar -sacral nerve roots clinical testing

Answer 8

L2 - hip flexion
L3 - knee extension
L4- ankle dorsiflexion
L5 - long toe extension or knee flexion
S1 - ankle plantar flexion

Question 9

Spinal shock is

Answer 9

the loss of muscle tone and reflexes immediately after spinal cord injury

(not neurogenic shock, which refers to to the heart and vasomotor tone)

Question 10

Brown sequard syndrome

Answer 10

Penetrating injury, partial spinal cord

Ipsilateral motor loss
Loss of positional sesnse
Loss of pain contralaterally, two levels below injury site

Question 11

Neuro level of spinal cord injury

Answer 11

Most caudal segment of the spinal cord with normal sensory and motor function on both sides of the body

Question 12

Sensory level of spinal cord injury

Answer 12

Most caudal segment of the spinal cord with normal sensory function

Question 13

Motor level of spinal cord injury

Answer 13

Lowest key muscle that has a muscle strength grade of at least 3

Question 14

Paraplegia is injury at which spinal cord region

Answer 14

Thoracic

Question 15

Quadriplegia / tetraplegia is injury at which spinal cord region

Answer 15

Cervical

Question 16

Central cord syndrom

Answer 16

Disproportionately greater loss of motor strength in upper limbs than lower limbs

Question 17

Anterior cord syndrome

Answer 17

Paraplegia and a loss of pain and temperature sensation

Question 18

Which vertebrae in cervical spine have the greatest flexion and extension?

Answer 18

C5-6

C5 most common spinal fracture
C5 on C6 most common subluxation

Question 19

Thoracic spine fracture caused by axial loading with flexion

Answer 19

Anterior wedge compression

Question 20

Thoracic spine fracture caused by vertical-axial compression

Answer 20

Burst injuries

Question 21

Chance fractures in thoracic spine caused by

Answer 21

Flexion about an axis anterior to the vertebral column
- often with improperly placed lap belts
- can have retroperitoneal and abdo visceral injuries

Question 22

Fracture dislocations of thoracic spine caused by

Answer 22

extreme flexion or severe blunt trauma to the spine

Question 23

Thoracolumbar junction fractures (T11 through L1)

Answer 23

Typically combo of acute and hyperflexion and rotation
- usually unstable
- bladder and bowel dysfunction, dec sensation and strength in lower extremities
- vulnerable to rotational movement

Question 24

C spine injuries concerning for associated vascular neck injury

Answer 24

C1-3 fractures
C spine fracture with subluxation
Fractures involving foramen transversarium