Spinal Cord Injury Flashcards

1
Q

What is NEXUS?

A

the National Emergency X-Radiography Utilization Study

criteria recommends cervical spine radiography in all patients with traumat unless they meet all of a specific set of criteria

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2
Q

What are the criteria for NEXUS?

A

no posterior midline cervical spine tenderness

no evidence of intoxication

normal level of alertness

no focal neurologic deficits

no painful distracting injuries

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3
Q

99% sensitive but not very specific

will get lots of imaging studies that aren’t needed, but won’t miss many injuries

A

NEXUS

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4
Q

level of spinal cord injury if:

loss of spontaneous breathing

A

C4

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5
Q

level of spinal cord injury if:

loss of shoulder shrug

A

C5

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6
Q

level of spinal cord injury if:

loss of flexion at elbow/biceps reflex

A

C6

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7
Q

level of spinal cord injury if:

loss of extension at elbow/triceps reflex

A

C7

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8
Q

level of spinal cord injury if:

loss of flexion at fingers

A

C8/T1

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9
Q

level of spinal cord injury if:

loss of intercostal muscle & abdominal muscle use

A

T1/T2

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10
Q

What is superior to plain film?

A

CT

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11
Q

When should we used plain films?

A

for “low risk” patients

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12
Q

70% of detectable abnormalities will be visible on which view?

A

lateral view

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13
Q

C1

extremely unstable

axial loading (diving)

A

Jefferson fracture

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14
Q

C2

more than 1/2 of all C2 fractures

extremely unstable

A

odontoid fracture

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15
Q

C2

falls, MVCs

forced hyperextension of the neck

unstable but opens spinal canal

A

Hangman’s fracture

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16
Q

stable fracture of a spinous process

A

Clay shoveler’s fracture

17
Q

compression-type fracture that involves the posterior half of the vertebrae

may result in retropulsed fragments that can impinge on the spinal canal & can cause neurological injury

A

vertebral burst fracture

18
Q

aka Beck’s syndrome

loss of motor function, pain, temperature sensation

A

anterior cord syndrome

19
Q

decreased strength and (to a lesser degree) decreased pain & temperature sensation, more in the upper than the lower extremities

A

central cord syndrome

20
Q

hemisection of the cord-usualy from a penetrating injury

A

brown-sequard syndrome

21
Q

S/S of Brown-sequard syndrome

A

ipsilateral loss of motor function, proprioception, vibratory sensation

contralateral loss of pain & temperature sensation

22
Q

S/S of cauda equina

A

bowel and/or bladder dysfunction

decreased rectal tone

“saddle anesthesia”

decreased lower extremity reflexes

sciatica