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MSK > Spinal Fractures > Flashcards

Spinal Fractures Flashcards

1
Q

What type of curve is in the cervical spine?

A

Lordosis

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2
Q

What type of curve is in the thoracic spine?

A

Kyphosis

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3
Q

What type of curve is in the lumbar spine?

A

Lordosis

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4
Q

Define a dermatome

A

Area of skin that is mainly supplied by a single spinal nerve

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5
Q

Define a myotome

A

Group of muscles that a single spinal nerve innervates

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6
Q

Shoulder abduction is what myotome?

A

C5

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7
Q

Elbow flexion/ wris exxtension is what myotome

A

C6

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8
Q

Elbow extension is via what myotome?

A

C7

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9
Q

Long finger flexion is via which myotome

A

C8

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10
Q

Finger abduction is via which myotome

A

T1

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11
Q

Hip flexion is via which myotome

A

L2

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12
Q

Knee extension is via which myotome?

A

L3, L4

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13
Q

Ankle dorsiflexion is via which myotome?

A

L4

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14
Q

Big toe extension is via which myotome?

A

L5

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15
Q

Ankle plantar flexion is via which myotome?

A

S1

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16
Q

Tenderness on spine common causes

A

Spinal fracture,
Infection of spine,
Malignancy of spine

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17
Q

Common lumbar abnormality gaits

A

Antalgic gait,

Foot drop gait

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18
Q

When someone is walking on their tip toes what myotome are they using?

A

S1

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19
Q

What myotome(s) are being used if someone is walking on their heels?

A

L4, L5

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20
Q

what is a characteristic cervical spine gait?

A

No proprioception so will look at feet, shuffle, take broad base, short steps

21
Q

What is a +ve straight leg raise

A

Shooting pain in L5, S1

22
Q

What is a +ve femoral stretch test?

A

Pain in L3, L4

23
Q

What percentage of people with a fracture/ dislocation will have a spinal cord injury?

A

15%

24
Q

Common causes of spinal cord injury?

A 
Fall, 
RTC,
Sport,
Trauma, 
Knocked over, 
Sharp trauma
25
Q

Complete spinal cord injury

A 
No motor or sensory function distal to lesion, 
No anal squeeze, 
No sacral sensation,
ASIA Grade A,
No chance of recovery
26
Q

Incomplete spinal cord injury?

A

Some function is present below site of injury,

More favourable prognosis

27
Q

Can you determine if a spinal cord injury is complete or incomplete initially?

A

No as patient may be in spinal shock

28
Q

ASIA classification A?

A

Complete,

No sensory or motor function preserved in sacral segments S4-S5

29
Q

ASIA classification B?

A

Incomplete,
Sensory preserved below the neurological level and extending through sacral segments S4-S5,
No motor

30
Q

ASIA classification C?

A

Incomplete,
Motor function below neurological level,
Key muscles have a grade <3

31
Q

ASIA classification D

A

Incomplete,
Motor below neurological level,
Key muscle have a grade >3

32
Q

ASIA classification E?

A

Normal motor and sensory function

33
Q

Types of patterns of injury?

A 
Tetraplegia,
Paraplegia, 
Central cord syndrome, 
Anterior cord syndrome, 
Brown-Sequard Syndrome
34
Q

Define tetraplegia

A

Partial/total loss of use of four limbs and trunk,

Loss of motor/sensory function in cervical segments of the spinal cord

35
Q

Define paraplegia?

A

Partial/total loss of use of lower-limbs,

Impairment/ loss of motor/ sensory function in thoracic, lumbar or sacral segments of the spinal cord

36
Q

When is central cord syndrome commonly seen?

A

In older patients with arthritic neck,

In an hyperextension injury

37
Q

Presentation of central cord syndrome?

A

Weakness of arms > legs,

Perianal sensation and lower extremity power preserved

38
Q

Partial cord syndrome caused by hyperextension?

A

Central cord syndrome

39
Q

Partial cord syndrome caused by hyper flexion?

A

Anterior cord syndrome

40
Q

Common cause of anterior cord syndrome

A

Anterior compression fracture,

Damaged anterior spinal artery

41
Q

Presentation of anterior cord syndrome?

A

Profound weakness,

Fine touch and proprioception preserved

42
Q

What partial cord syndrome is caused by hemi-section of the cord?

A

Brown-sequard Syndrome

43
Q

Common cause of Brown-Sequard syndrome?

A

Penetrating injuries

44
Q

Presentation of Brown-Sequard syndrome

A

Paralysis of affected side,
Loss of proprioception and discrimination,
Pain and temperature loss on opposite side below lesion

45
Q

Management of spinal cord injury?

A

ABCD,

ATLS (advanced trauma life support)

46
Q

Signs of neurogenic shock?

A 
Low BP and HR, 
Loss of sympathetic tone, 
Vasopressors,
Hypothermia, 
Injury above T6
47
Q

Signs of spinal shock

A

Transient depression of cord function below level of injury,
Flaccid paralysis,
Areflexia,
Lasts several hours to days

48
Q

Surgical fixation of spinal cord injury

A

Majority fixed posteriorly via pedicle screws

49
Q

Long-term management of spinal cord injury?

A 
Spinal cord injury unit, 
Physiotherapy, 
OT, 
Psychological support, 
Urological/ sexual counselling

MSK (40 decks)

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