week 6

Question 1

Outline the pathogenesis of spinal cord injury

Question 2

identify the common classifications of spinal cord injury

Answer 2

complete: total loss of sensation beneath site of injury
incomplete: partial sensation beneath site of injury
autonormic dysreflexia: stimulus below lvl of t6 - no signal passes level of injury (hypertension, bradycardia), flush above the level, white below
corta equina: saddle (incontence, lower back pain, pain down the legs, saddle parasthecia)
central cord: cervical hyperextension/flexion (e.g. coup-contracoup)
anterior cord: caused by fractures and dislocation causing ischaemia, loss of motor, pain, loss of temperature sense, below lesions but not touch
brown-seqard: Rare, - ipsilateral loss of motor, touch, propriception. Contrlateral loss of pain and temp

Question 3

differentiate between complete and incomplete spinal cord injuiry

Answer 3

complete: total loss of sensation below the site of injuiry
incomplete: partial loss of sensation below

Question 4

discuss the characteristics of common spinal cord syndromes

Question 5

explore the diagnosis and management of spinal cord injury

Answer 5

Diagnosis:
MOI?
canadian c-spine rule
palpatate
Dermatones?
Priaspm
weakness
decrease GCS
neurological deficits
tenderness

sympomatic - airway management - oxygenation
Fluid - MAP 80 or SBP 100
c-spine precautions - immobolisation
transport to major hospital - notification

Question 6

examine the common complications associated with spinal cord injury

Answer 6

parasthesia
height on injuiry - apnoeic (c3-5)
bradycardia, bradyponieac
lack of organ and motor function below site of injuiry
increased risk of heart and lung issues
extreme pain

Question 7

understand the physiological impact of a trauma at the various levels of the spinal cord (respiratory, cardiovascular, and other autonomic system function)

Answer 7

respiratory
c3,4,5 keeps the diaphram alive
T2-7 is accessory muscles
T1-11 internal and external intercostals
T6-12 is abdominal muslces

haemodynamic:
T2 upperwards - no sympathetic innervation of the heart
T6 upperwards - severe hypotension (lack of sympathetic innervation)

Question 8

outline the prehospital diagnosis of a potential spinal cord injury

Answer 8

abnormalities on palpation
parasthesia
lack of sensory input
lack of motor function
pain
deterioration

Question 9

describe the nexus criteria and the canadian C-spine rule in the prehospital management

Answer 9

canadian c-spine
high risk:
age above 65
dangerous mechanism
parasthesia in extremities

None -> low risk (if no to these)
simple rear-end
ambulatory
delayed onset of neck pain
abscence of midline c-spine tenderness

if one ->
Able to rotate neck 45 degrees left and right

Question 10

outline the prehsopital management of spinal cord injury, with special attention to the treatment of the shocked patient

Answer 10

c spine precautions
inline stabilisation
vacmat
analgesia
fluid managment (map80 or SBP 100)

shock = lack of perfusion
fluids
oxygen
posturing