Test your basic knowledge |

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. Extensor hallucis longus (Big toe extension)






2. 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






3. Abdominal Muscles






4. Quadriceps (Knee extension)






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






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






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






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






9. Illiopsoas (Hip Flexion)






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






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


12. 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






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






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






15. Bladder






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






17. Canadian C-Spine Criteria (3)






18. Persistent irrection - Implies a complete spinal cord injury






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






20. 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






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






22. Gastrocnemius (Ankle plantar flexion)






23. Tibialis Anterior (Ankle dorsiflexion)






24. Hamstrings (Knee flexion)






25. Triceps (Elbow extension)






26. Extensor Carpi Radialis (Wrist extension)






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






28. 45% of Spinal Cord Injuries due to this






29. 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


30. Chest Muscles






31. 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 ->






32. NEXUS C-Spine Criteria (5)






33. 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






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






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






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






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






38. 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






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






40. 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






41. 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






42. 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






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


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