Spine + Critical Inquiry Flashcards
Local core mm’s vs global core mms’
local = transverse abdominus, multifidi, diaphragm, pelvic floor; global = rectus, psoas, EXToblique, erector spinae
Exam feature that indiciate spondylolisthesis?
heart shaped buttocks
What is transient quadriparesis?
temporary burning paresthesia + B extremity weakness. Motor and sensory disturbance affecting 2-4 limbs. MOI: cervical extension. Sx’s last 15min - 36 hours.
What is a stinger?
transient, unilateral sx’s with motor weakness. Usually caused by stretch/traction to brachial plexus.
When can pt go back after transient quadriparesis? Stinger?
TQ = not in the same game. Stinger = full resolution of symptoms
Pt reports lump in throat after axial load?
suspect cervical spine instability
Function of internal oblique?
ipsilateral rotation, flexion, lateral flexion
On x-ray for lumbar ROM, how many mm is indicative of instability?
4-5mm
Sharp Purser Test
Tests for upper C spine instability
Can a player diagnosed with concussion RTP on the same day? How about adolescent?
No, NO! Kid should be able to go through school first, asymptomatically, before going back to sport
What is a concussion?
rapid onset of short term impairment of neurological function that resolves spontaneously. This is a functional, rather than structural disturbance. Imaging is normal, but CT would be the best method to rule out other pathology.
Best on field assessment tool for concussion?
SCAT3, Child SCAT3
Cornerstone of concussion management?
Physical and cognitive rest
Factors that influence/modify concussion management? Red herrings?
LOC>1 minute; tonic posturing and motor posturing
Findings that would lead you to believe that there is a catastrophic c-spine injury? (4)
LOC or altered LOC; bilateral neuro signs/symptoms; significant midline pain; obvious spinal deformity
First thing to do when responding to potential c-spine injury? Something that responder should NOT do?
provide manual stabilization; do NOT apply traction
For c-spine injury, which is recommended? Jaw-thrust or head-tilt? Lift & slide or log roll?
jaw-thrust, lift & slide
Where does the liver radiate pain?
Right shoulder
Where does the appendix live? (quadrant) Name of specific point?
RLQ, McBurney’s point
Where does the spleen radiate?
L shoulder (Kehr’s sign)
What is the ratio of abd thrusts to breaths for adults, children, and infants?
30 abdominal thrusts to 2 breaths
Where do you give abd thrusts in adults? infants?
adult: center of chest; infant = 2-3 finger width below nipple line
SAMPLE acronym
Symptom, Allergies, Medication, Past med history, Last oral intake, Events leading up to the injury
Difference b/w epidural and subdural hematomas?
Epidural (Extra-dural) affects the meningeal arteries. Pt will have a GRADUAL progression of s/s, possible dilation of one pupil (CNIII injury).. Pt will usu have a brief LOC and then gradually begin to feel worse in the next few hours. Usu younger patient. Subdural = venous injury (usu older patient).
