Spine Trauma

Question 1

Common causes of spinal injury

Answer 1

blunt trauma, auto accidents, preventable violence- suicide, shootings, etc.

Question 2

who is typically affected by spinal injuries

Answer 2

young men

Question 3

which portion of the spine is most vulnerable to blunt force injury

Answer 3

cervical spine

Question 4

what should be a concern when you see someone with a thoracic injury?

Answer 4

organ injuries

Question 5

what is the most common injury to the lumbar spine

Answer 5

compression fracture

Question 6

what level does the spinal cord end

Answer 6

L1-2

Question 7

4 steps in management of spinal injuries

Answer 7

CABs (formerly ABCs)
Immobilization
Early intubation
Transport to appropriate facility

Question 8

what should you avoid when intubating someone with a spinal injury

Answer 8

head tilt chin lift

Question 9

what 3 things are used to immobilize a potential cervical injury

Answer 9

rigid collar
support blocks
backboard with strap

Question 10

what exam should you do when splinting someone with a spinal injury?
when should you do it?

Answer 10

test for motor and sensory deficits in all extremities

test before and after splinting

Question 11

What are you palpating for during a spine exam

Answer 11

step-offs and tenderness

Question 12

what portion of the exam must you not skip!!!

Answer 12

rectal exam- tone, sensation, contraction

Question 13

what normal finding is typically absent with spinal cord injury?

Answer 13

reflexes

Question 14

what are the levels in ASIA scoring

Answer 14

A - E with A being complete loss of motor and sensory function to E being normal motor and sensory function

Question 15

what is the NEXUS criteria

Answer 15

National Emergency X-Radiography Utilization Study

clinical criteria for when CTs or X-rays are indicated

Question 16

when should a cervical CT be ordered per NEXUS?

5 criteria

Answer 16

midline cervical tenderness
focal neuro deficit
if patient is not alert
intoxication
painful, distracting injury

Question 17

what kinds of cervical spine fractures require a surgical consult

Answer 17

ALL of them!

Question 18

when does a thoracic or lumbar spine fracture require a surgical consult

Answer 18

surgery not always necessary- depends on the stability of the fracture and the neurologic status of the patient

Question 19

what is the most common fracture seen in patients with osteoporosis or chronic steroid use?

Answer 19

compression fracture (wedge fracture)

Question 20

where should you refer all patients with a spine injury, regardless of whether it’s surgical?

Answer 20

rehab- early as possible

PT and OT

Question 21

For which patients should you be on high alert if they present with spine pain?

Answer 21

Ankylosing Spondylitis
osteoporosis
chronic steroid use