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Emergency Medicine: Spinal Trauma

Instructions:
  • Answer 44 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Caused by axial loading and flexion - with subsequent failure of the anterior column - Middle column remains intact - Stable unless > 50% decrease in vertebral height - unlikely to be directly responsible for neuro damage






2. NEXUS C-Spine Criteria (5)






3. Tibialis Anterior (Ankle dorsiflexion)






4. Transverse hemisection of the spinal cord - unilateral cord compression - Ipsilateral spastic paresis - loss of prorioception / vibratory senation - Contralateral loss of pain / temp sensations - Good prognosis






5. Hand intrinsics (Finger Abduction) Flexor Digitorum Profundus (Hand Grasp)






6. Caused by a direct axial blow - Vertebral fragments displaced in all directions






7. High speed MVC (>35 mph)- Fatal MVC- Ped vs Auto- Fall from >10 ft- Significant or serious closed head injury - Neuro signs/symptoms referable to C-Spine - Pelvic of multiple extremity injuries - ICH seen on CT






8. Triceps (Elbow extension)






9. Complete neurologic lesion as the absence of sensory and motor function below the level of injury - Minimal chance of recovery






10. Most susceptable spinal region in MVA and falls from a height injuries






11. Caused by intense flexion against a contracted posterior erector spinal muscle - Avulsion fx of the lower cervical spinous processes (C7 especially)

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12. Canadian C-Spine Criteria (3)






13. Deltoid (Arm Abduction) Biceps (Elbow Flexion)






14. Most damaging of all injuries - Compression - flexion - distraction - rotation - shearing forces -> failure of ALL 3 columns - Causes subluxation or dislocation - Grossly unstable spine T11 -> L2






15. Direct _____ compression - flexion of the cervical spine - Thrombosis of anterior spinal artery. - Complete paralysis below the lesion - loss of pain / temp sensation - Preservation of proprioception and vibratory function - Poor prognosis






16. Controversial - ______ infusion with acute blunt SCI can improve both motor/sensory function if started right away






17. Peripheral nerve injury - Variable motor and sensory loss in the lower extremites - sciatica - bowel/bladder dysfunction - 'saddle anesthesia' - Good prognosis






18. Gastrocnemius (Ankle plantar flexion)






19. Functional disturbance and/or pathological change in the spinal cord - Due to a spinal cord lesion - stenosis - or compression






20. Any injury above C5 -> Intubation - Hypotension due to neurogenic/spinal shock - blood loss - cardiac injury - Blood loss should be presumed to be the caUse of hypotension until proven otherwise

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21. Serious spinal cord damage and disruption of tracts w/o a fx - Most common in children - Flexion - hyperextension - longitudinal distraction - and ischemia causing complete - severe - or partial cord lesions






22. Bladder






23. 45% of Spinal Cord Injuries due to this






24. Extensor hallucis longus (Big toe extension)






25. Abdominal Muscles






26. Pain seeming to radiate from the spine to extend outward - Due to a single spinal nerve root irritation






27. Hamstrings (Knee flexion)






28. Caused by significant external forces - frequently involve other C-spine injuries - Dens projection






29. Injury to C/T spinal cord -> Peripheral sympathetic denervation - Patients are warm - peripherally vasodilated - hypotensive - relative bradycardia






30. Extensor Carpi Radialis (Wrist extension)






31. Caused by direct blow to top of head - Outward displacement of lateral masses of ___






32. roots of phrenic nerve (supplying diaphragm) emerges at C3-C5 - Intubate any injury above C5






33. Illiopsoas (Hip Flexion)






34. Caused by seat belt-type injuries (particularly lap belt only) - Middle and Posterior column failure - Increased height and/or fx of posterior vertebral body - posterior opening of disc space - Chance fx - Unstable






35. Indicates spinal cord injury or nerve severing - No Bueno






36. Caused by failure of the vertebral body under axial load - Both the anterior and middle columns fail - Retropulsion of bone/disc into canal -> Neuro damage - Unstable






37. The temporary loss or depression of spinal reflex activity that occurs below a complete or incomplete spinal cord injury - Loss of neuro function w/ this can cause an incomplete spinal cord injury to mimic a complete cord injury - Duration of days ->






38. Persistent irrection - Implies a complete spinal cord injury






39. Quadriceps (Knee extension)






40. Test anogenital reflexes -> ______ with preservation o fthe reflexes denotes an incomplete spinal cord level - even if patient has complete sensory/motor loss






41. Chest Muscles






42. Men:Women = 4:1 - Mean age 40 years - Occurs on weekends / holidays






43. Fx of both pedicles of C2 - Body of C2 displaces anteriorly on C3

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44. Hyperextension injuries - disruption of blood flow to the spinal cord - cervical spinal stenosis - Quadriparesis (Upper > Lower) - Some loss of pain / temp - Good prognosis