Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EM 2 > TSCI > Flashcards

TSCI Flashcards

1
Q

4 stable spine fractures

A

Mild anterior subluxation
Simple burst (1 column fx)
Simple wedge
Clay shoveler’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

5 unstable spine fractures

A

Flexion teardrop
Jefferson fx
Hangman fx
Dens (type III, II)
Complex burst fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

leading cause of TSCI for under 65 w/ significant trauma

A

MVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

leading cause of TSCI for people over 65 w/ minor trauma

A

falls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • immediate transient loss of all neurological function below injury level that lasts several hrs to several days/wks d/t K+ loss from damaged cells
  • flaccid paralysis followed by spasic paresis
  • loss of reflexes below SCI but later recover
  • bowel & bladder involved; priapism
A

spinal shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

high cervical and thoracic (above T6) injury can cause what kind of shock

A

neurogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  • disruption of sympathetic outflow from T1-L2 typically 4-6hrs after injury with cord lesions above T6
  • can last 48hrs-several days
  • loss of vasomotor tone (peripheral blood pooling & less preload)
A

neurogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 classic signs of neurogenic shock & how its treated

A
  • hypotension, bradycardia, hypothermia
  • tx– fluid & pressors; atropine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is autonomic dysreflexia (4)

A
  • life threatening
  • usually later complication of lesions above T6 where SBP rises over 250, tachycardia, urticaria, flushing, diaphoresis, reflex brady, throbbing HA
  • can lead to stroke or seizure
  • bladder distention, UTI, fecal impaction, skin lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 signs of poor prognosis for recovery of SCI

A
  • arrived in shock
  • cannot breath
  • complete injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is complete impairment according to ASIA scale

A

no motor or sensory function is preserved in S4-S5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

difference between incomplete B, C, & D impairments in ASIA scale

A
  • B= sacral sensory sparing
  • C= motor preserved below & majority have muscle grade less than 3
  • D= motor preserved below & at least half have muscle grade above 3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of SCI

  • paralysis
  • persistence beyond 24 hrs– no distal function recovery
A

complete SCI
* complete and irreversible loss of motor/sensory function below level of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how long does it take to see the extent of injury with incomplete SCIs

A

6-8 wks (after shock, swelling, and fluid subsides)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • mixed loss
  • can be extremeley variable in each person
A

incomplete SCI– damage that is not absolute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

with complete SCI

injuries above what level causes tetraplagia?

A

above C5

17
Q

with complete SCI

injuries at and below what level causes paraplegia

A

at or below T1

18
Q

what is anterior cord syndrome (2)

A
  • direct trauma to anterior spinal cord (hyperflexion or flexion/rotation injury) or anterior spinal artery infarct causing ischemia
  • retropulsed disc or bone; compression fracture
19
Q

3 expected impairments from anterior cord syndrome

A
  • impairment with pain & temp below level (spinothalamaic tracts)
  • variable loss of motor function (corticospinal tracts
  • can be para or tetraplegic with only few recovering motor function
20
Q

what is central cord syndrome & expected population(3)

A
  • usually at cervical region; hyperextension with osteophytic spurs
  • often in elderly ppl w/ cervical spondylosis and spinal stenosis; surgical decompression
  • in young d/t sporting events
21
Q

3 expected impairments from central cord syndrome

A
  • weakness w/ hand dexterity; neuropathic pain in hands
  • loss of function in arms
  • myelopathic symptoms
22
Q

define posterior cord syndome

A

hyperextension injuries or posterior spinal artery infarct that involves dorsal column pathways

23
Q

expected impairment with posterior cord syndrome (2)

A
  • difficulty in coordinated limb movement (ataxic gait), proprioception & vibration
  • overall strength & sense of pain perserved!!
24
Q

findings with brown-sequard syndrome (3)

A
  • ipisilateral hemiplegia, loss of fine tough, proprioception, vibrations (dorsal columns)
  • contralateral absent pain & temp (lateral spinothalamic tract)
  • most regain bowel & bladder function and ambulatory capacity
25
Q
  • d/t bony compression or disc protrusions in lumbar or sacral region
  • bowel/bladder sphincter disturbance
  • back pain; saddle anesthesia
  • bilateral LE motor weakness and sensory loss
  • no achilles reflex
A

cauda equina syndrome

better prognosis than Conus medullaris

26
Q

3 leading causes of SCI mortality

A
  1. pneumonia
  2. septiciemia
  3. heart dz
27
Q

when should you start steroids?

A

high dose w/in 8 hrs of injury if there is any sign of motor or sensory neuro deficit (solumedrol)

helps recover function and decrease edema/K+ depletion

28
Q

Lesions above what level will cause partial or complete diaphragmatic paralysis

A

C5
C1-C3 will always need respiratory support

29
Q

3 indications for spinal surgery

A
  • significant cord compression w/ neuro deficits
  • unstable fracture or dislocatin
  • instable spine
30
Q

3 groups that should be treated as having an SCI till proven otherwise

A
  • significant trauma victims
  • loss of consciousness
  • spine symptoms (neck pain/tenderness, extremity tingling, numbness or weakness)
31
Q

if there is evidence of compression, what should be done & how fast?

A

urgent decompression w/in 2 hrs for best chance of return to function

32
Q

what other imaging should be done on patients with documented traumatic cervical fractures

A

thoracic & lumbar xrays

33
Q

diagnostic imaging for unstable ligamentous injuries

A

MRI, flexion/exension films

34
Q

4 indications that cervical collar is NEEDED

A
  • altered mental status or intoxicated
  • neuro deficit
  • suspected extremity fracture
  • spine pain/tenderness

if they meet this criteria they should also be getting imaging

35
Q

what group needs radiographica clearance of the ENTIRE spine (not just cervical)?

A

unconscious people who can’t be assessed clinically

36
Q

if awake & asymp (see below), what should you do?

asymp– no neck pain, normal neuro exam, no injury distractinf from eval

also cooperative & NOT drunk; can do ROM

A
  • No radiographic evaluation & stop immobilization
37
Q

if awake & symptomatic, what imaging is indicated?

A

high quality CT or 3-view C-spine series (supplement CT later)

38
Q

what should you do if..

awake with neck pain/tenderness + CT or 3-view series are normal? (3)

A
  • continue immobilization until asymptomatic
  • stop immobilization if normal flexion/extension radiograph OR normal MRI w/in 48 hrs of injury
  • stop immobilization at physician discretion
39
Q

in an obtunded/unevaluable patient with high clinical suspicion but normal CT, what do you do?

A

consult physician

EM 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions