Traumatic Spinal Cord Injury

Question 1

What is a devastating injury resulting in permanent paralysis and disability?

Answer 1

Traumatic Spinal Cord Injury

Question 2

What is the most common etiology of Spinal Cord Injury?

Answer 2

MVA (38%)
Acts of violence (13.5%)
Sports (9%)

Question 3

What do you call the bruising of the spinal cord that includes bleeding into the cord, causing edema and possible neuronal death due to compression?

Answer 3

Contusion

Question 4

It is an actual tear in the spinal cord that can result in a spinal injury.

Answer 4

Laceration

Question 5

What is the sudden deceleration of the head and neck (head on motet collision/ diving incidents) that usually affects the C5-C6?

Answer 5

Hyperflexion

Question 6

What is the most common type of injury, caused by a fall, rear end MVA, getting hit in the head?

Answer 6

Hyperextension

Question 7

When a person lands on the feet or buttocks after falling or jumping from a height or a direct blow to the head, injury results from vertebral column compression leading to fracture, what mechanism of injury is this?

Answer 7

Axial Loading

Question 8

What should be prioritized when assessing a client with a Spinal Cord Injury?

Answer 8

ABCs with attention to immobilization of the spine to prevent further injuries.

Question 9

What do you call the surgical intervention for the removal of the lamina of the vertebral ring which allows decompression and removal of bony fragments?

Answer 9

Laminectomy

Question 10

What mechanism of injury forces extreme twisting or lateral flexion of the head and neck?

Answer 10

Rotational Injuries

Question 11

What entails the fusion of 2-6 vertebral elements in order to provide stability and prevent motion?

Answer 11

Spinal Fusion

Question 12

What stabilizes and realigns the larger segments of the spinal column (Harrington rods) and is useful in the thoracolumbar area?

Answer 12

Rodding

Question 13

How do you differentiate complete spinal injury from incomplete spinal injury?

Answer 13

Complete SCI: total loss of sensory and motor function below the level of injury due to complete interruption of motor and sensory pathway.

Incomplete SCI: mixes loss of motor and sensory function as some spinal tracts remain intact.

Question 14

What do you call the severing of the spinal cord resulting in the complete loss of function below the level of the injury?

Answer 14

Transection

Question 15

What may occur due to the temporary suppression of reflexes controlled by the segments below the level of the spinal cord injury?

Answer 15

Spinal Shock

Question 16

Where is the frequent point of lower back pain?

Answer 16

Sacral Region

Question 17

What results in mixed loss of motor and sensory function as some spinal tracts remain intact?

Answer 17

Incomplete SCI

Question 18

What usually occurs due to the sudden loss of sympathetic tone, with preserved parasympathetic function, leading to autonomic instability?

Answer 18

Neurogenic Shock

Question 19

What is considered as a life-threatening complication for SCI at or above T6 due to unopposed sympathetic response below the level of injury?

Answer 19

Autonomic Dysreflexia

Question 20

Why is mechanical ventilation required for spinal cord injury at C2 and above?

Answer 20

Due to loss of diaphragmatic innervation

Question 21

What is maintained throughout the trauma evaluation to prevent additional injury?

Answer 21

Immobilization

Question 22

What test is done to identify presence of injury to the vertebral column?

Answer 22

X-Ray

Question 23

What image is taken to reveal injury to the spinal cord itself?

Answer 23

CT Images

Question 24

What test is done to reveal more subtle signs of injury to the ligaments and other supporting structures?

Answer 24

MRI

Question 25

What pharmacologic management is done in order to prevent post-traumatic spinal cord ischemia, improving energy metabolism, restoring extracellular calcium and improving nerve impulse conduction?

Answer 25

Methylprednisolone (bolus then continuous infusion for at least 24-48h)