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. 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 ->






2. NEXUS C-Spine Criteria (5)






3. Bladder






4. Abdominal Muscles






5. Hamstrings (Knee flexion)






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






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






8. 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






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






10. Gastrocnemius (Ankle plantar flexion)






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






12. 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






13. 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






14. Canadian C-Spine Criteria (3)






15. 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






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






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






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


19. Tibialis Anterior (Ankle dorsiflexion)






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






21. 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






22. Persistent irrection - Implies a complete spinal cord injury






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






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






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






26. 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






27. Illiopsoas (Hip Flexion)






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






29. Extensor hallucis longus (Big toe extension)






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






31. Triceps (Elbow extension)






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


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






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






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






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






37. 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






38. 45% of Spinal Cord Injuries due to this






39. Extensor Carpi Radialis (Wrist extension)






40. Chest Muscles






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. 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


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






44. Quadriceps (Knee extension)