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


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






3. Tibialis Anterior (Ankle dorsiflexion)






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






5. 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






6. Hamstrings (Knee flexion)






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






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






9. Quadriceps (Knee extension)






10. 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






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






12. NEXUS C-Spine Criteria (5)






13. Bladder






14. Extensor Carpi Radialis (Wrist extension)






15. Triceps (Elbow extension)






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






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






18. 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






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






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


21. Gastrocnemius (Ankle plantar flexion)






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






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






24. 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






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






26. 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






27. Chest Muscles






28. Canadian C-Spine Criteria (3)






29. 45% of Spinal Cord Injuries due to this






30. 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 ->






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






32. Abdominal Muscles






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






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






35. 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






36. 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


37. Illiopsoas (Hip Flexion)






38. Extensor hallucis longus (Big toe extension)






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






40. 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






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






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






43. Persistent irrection - Implies a complete spinal cord injury






44. 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