Spine + Critical Inquiry

Question 1

Local core mm’s vs global core mms’

Answer 1

local = transverse abdominus, multifidi, diaphragm, pelvic floor; global = rectus, psoas, EXToblique, erector spinae

Question 2

Exam feature that indiciate spondylolisthesis?

Answer 2

heart shaped buttocks

Question 3

What is transient quadriparesis?

Answer 3

temporary burning paresthesia + B extremity weakness. Motor and sensory disturbance affecting 2-4 limbs. MOI: cervical extension. Sx’s last 15min - 36 hours.

Question 4

What is a stinger?

Answer 4

transient, unilateral sx’s with motor weakness. Usually caused by stretch/traction to brachial plexus.

Question 5

When can pt go back after transient quadriparesis? Stinger?

Answer 5

TQ = not in the same game. Stinger = full resolution of symptoms

Question 6

Pt reports lump in throat after axial load?

Answer 6

suspect cervical spine instability

Question 7

Function of internal oblique?

Answer 7

ipsilateral rotation, flexion, lateral flexion

Question 8

On x-ray for lumbar ROM, how many mm is indicative of instability?

Answer 8

4-5mm

Question 9

Sharp Purser Test

Answer 9

Tests for upper C spine instability

Question 10

Can a player diagnosed with concussion RTP on the same day? How about adolescent?

Answer 10

No, NO! Kid should be able to go through school first, asymptomatically, before going back to sport

Question 11

What is a concussion?

Answer 11

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.

Question 12

Best on field assessment tool for concussion?

Answer 12

SCAT3, Child SCAT3

Question 13

Cornerstone of concussion management?

Answer 13

Physical and cognitive rest

Question 14

Factors that influence/modify concussion management? Red herrings?

Answer 14

LOC>1 minute; tonic posturing and motor posturing

Question 15

Findings that would lead you to believe that there is a catastrophic c-spine injury? (4)

Answer 15

LOC or altered LOC; bilateral neuro signs/symptoms; significant midline pain; obvious spinal deformity

Question 16

First thing to do when responding to potential c-spine injury? Something that responder should NOT do?

Answer 16

provide manual stabilization; do NOT apply traction

Question 17

For c-spine injury, which is recommended? Jaw-thrust or head-tilt? Lift & slide or log roll?

Answer 17

jaw-thrust, lift & slide

Question 18

Where does the liver radiate pain?

Answer 18

Right shoulder

Question 19

Where does the appendix live? (quadrant) Name of specific point?

Answer 19

RLQ, McBurney’s point

Question 20

Where does the spleen radiate?

Answer 20

L shoulder (Kehr’s sign)

Question 21

What is the ratio of abd thrusts to breaths for adults, children, and infants?

Answer 21

30 abdominal thrusts to 2 breaths

Question 22

Where do you give abd thrusts in adults? infants?

Answer 22

adult: center of chest; infant = 2-3 finger width below nipple line

Question 23

SAMPLE acronym

Answer 23

Symptom, Allergies, Medication, Past med history, Last oral intake, Events leading up to the injury

Question 24

Difference b/w epidural and subdural hematomas?

Answer 24

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).

Question 25

If a tooth gets knocked out? Do’s (4)

Answer 25

1) attempt re-implantation w/in 20 minutes 2) save the tooth 3) utilize store bought product “save-a-tooth”, milk, or saliva 4) immediate referral to dentist

Question 26

If a tooth gets knocked out? DON’T (3)

Answer 26

wash tooth, hold by the root, wait > 20 minutes to get to dentist

Question 27

Hallmark signs (2) of mandibular fx?

Answer 27

loss of symmetry, loss of occlusion

Question 28

Hallmark sign of zygomatic fx?

Answer 28

sunken in face

Question 29

Hallmark sign of maxillary fx?

Answer 29

elongated face

Question 30

What does a downward displaced eye mean after a trauma (e.g. baseball to eye)?

Answer 30

orbital blowout fx

Question 31

Hyphema

Answer 31

blood collects in anterior eye

Question 32

Detached retina

Answer 32

pt reports curtain falling over field of vision

Question 33

What is an eye hordeolum?

Answer 33

sty

Question 34

When to immediately refer to ophthalmology? (7)

Answer 34

globe rupture, periorbital fx, hyphema, iritis, detached retina, corneal laceration, persistent visual disturbance

Question 35

Battle’s sign

Answer 35

bruising, swelling, bleeding behind the ear

Question 36

What are the eye protection requirements for moderate to high risk sport?

Answer 36

3mm lense made of polycarbonate, impact resistant sport frame

Question 37

What is commotio cordis?

Answer 37

blunt, non-penetrating trauma that causes sudden cardiac death. Chest protectors don’t help.

Question 38

NATA guidelines to immediately refer with C-spine injury?

Answer 38

severly painful and limited cervical ROM (rotation

Question 39

Description of abdominal injuries in sports?

Answer 39

can be from blunt trauma or from deceleration. May be slow to develop after initial trauma

Question 40

Axillary nerve muscle actions. Injury commonly involved with what?

Answer 40

ABD (deltoid), ER (t-minor); shoulder dislocation

Question 41

DCAP-BTLS

Answer 41

Deformity, Contusion, Abrasion, Puncture, Burn, Tenderness, Laceration, Swelling

Question 42

DOTS

Answer 42

Deformity, Open Injury, Tenderness, Swelling