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Flashcards in Spinal Cord Injuries Deck (28):
1

What are the mechanisms of spinal injury

Hyperflexion
Hyper extension
Lateral stress
Rotation
Compression
Distraction

2

What are common causes of spinal injuries

Trauma: car accidents, contact sports, falls, alcohol
Head injuries: 20% have c spine injury

3

Where are common sites of spinal injury

C6/7 (50%)
C2 (30%)

C1/2 in children (heavy head + lax ligaments)

4

What are the types of spinal cord injuries

Complete transection
Hemisection
Anterior cord injury
Central cord injury
Posterior cord injury

5

What are the causes of complete transection

Trauma
Infarction
Transverse myelitis
Abscess
Tumour (metastasis)

6

What are the clinical features of complete transection

Spinal shock
Neurological shock
Bilateral paralysis below level of injury
Bilateral sensory loss of all modalities below level of injury
Priapism

7

What is spinal shock

Paralysis of bladder and rectum

8

What is neurological shock

Hypotension and bradycardia due to loss of sympathetics in cervical spine lesions

9

What is priapism

Prolonged sustained erection due to unopposed parasympathetic activity

10

What are the causes of spinal cord hemisection

Penetrating trauma
Fractured vertebrae
Tumour
Abscess
Multiple sclerosis

11

What are the features in Brown Sequard Syndrome

Ipsilateral loss of proprioception at+below level of lesion
Ipsilateral loss of motor function at+below level of lesion
Contralateral loss of pain sensation below level of lesion

12

What are the causes of anterior cord injury

Flexion injury: fracture, dislocation, herniation
Anterior spinal artery injury: atherosclerosis, iatrogenic (clamping, dissection)

13

What are the clinical features of anterior cord injury

Complete paralysis at+below lesion
Complete loss of pain sensation below lesion
Sparing of proprioception, fine touch, vibration
Autonomic dysfunction: bladder, bowel, sexual

14

What are the causes of central cord injuries

Trauma: hyperextension (elderly), hyperflexion (young)
Disruption to spinal blood flow
Cervical spinal stenosis
Degenerative spinal disease
Syringomyelia
Central canal ependymoma

15

What are the clinical features of central cord injury

Initial Loss of pain + temp in cape like distribution
Followed by paralysis in cape like distribution
Motor>sensory
Upper extremity > Lower extremity
Distal>proximal

Bladder dysfunction
Sparing of proprioception, fine touch, vibration

16

What are the causes of posterior cord injury

Chronic pathological processes:
Spondylosis
Spinal stenosis
Infection
Vitamin B12 deficiency

Posterior spinal arteries occlusion

17

What are the clinical features of posterior cord injury

Loss of proprioception, fine touch, vibration
Sparing of motor function
Sparing of pain + temp sensation

18

What are the principles of management of spinal injuries

Intubation + icu admission
Early c spine immobilisation
C spine restriction for 6 weeks
PT/OT long term
Surgery - progressive neurological deficit, unstable fractures

19

What is the initial management of spinal cord injuries

ABCDE assessment
Intubation
Log-roll and Backboard
Rigid C collar
Manual stabilisation
Treat: hypoxia, shock, hypothermia
Catheterise

20

Why is intubation important

Spinal injuries above C5 loss of diaphragm innervation, intercostal muscle’s will tire out

21

When do you assume spinal injury

Head injury present
Focal neurological deficit
Altered level of consciousness/GCS
Spinal tenderness

22

What is log roll

Manoeuvre to transfer patient onto backboard as a team

23

What is a backboard

Board to transport patients in pre-hospital trauma setting in supine position

24

What is manual stabilisation

Technique used to minimise movement of head and neck

25

What are the methods of manual stabilisation

Place hands on patients mastoid processes from above the patient

Place hands on sides of head from patients side with elbows on their chest

26

In what position do you place patients head in manual stabilisation

ANY position comfortable for patient
You must not apply traction

27

Why is catheterisation important

Possible bladder dysfunction and retention

28

How do you “clear” spinal injuries

Communication:
Alert and oriented
No language barrier
Not intoxicated

Examination:
No focal neurological deficits
No posterior midline tenderness
No painful distracting injuries