Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Medicine Lecture - Professor Kramer > Spinal Cord trauma > Flashcards

Spinal Cord trauma Flashcards

(79 cards)

Start Studying
1
Q

Arm abduction ?

A

C5, C6, deltoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Elbow flexion ?

A

C5, C6, biceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wrist extension ?

A

C6, C7, extensor carpi radialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Elbow extension ?

A

C7, C8, triceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Finger abduction and Hand grasp ?

A

C8, T1,

hand intrinsics,

flexor digitorum profundus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chest muscles ?

A

T2-T7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abdominal muscles ?

A

T9-T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hip flexion ?

A

L1, L2, L3,

Iliopsoas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Knee extension ?

A

L2, L3, L4

Quads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Knee flexion ?

A

L4, L5,S1, S2

hamstrings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ankle dorsiflexion ?

A

L4, L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Great toe extension ?

A

L5, S1

extensor hallicus longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ankle Plantar flexion ?

A

S1, S2

gastrocnemius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Voluntary rectal tone ?

A

S2, S3, S4

bladder /anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SC Anatomy and physiology own notes ?

A

C - it is above the bone

T - it is below the bone

know where the injury is and what it can cause here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Two main phases of spinal cord injury ?

A

Direct mechanical injury

Tissue degeneration phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Direct mechanical injury facts ?

A

hemorrhage into the cord

formation of edema at the injured site

vasospasm and thrombosis of the small arterioles
–Local spinal cord blood flow is decreased.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tissue degeneration phase

facts ?

A

begins within hours of injury

release of membrane-destabilizing enzymes and mediators of inflammation

disruption of calcium channel pathways

Lipid peroxidation and hydrolysis

inflammatory phase causes more injury so steroid!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

lesion types ?

A

Spinal shock

Complete

incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Spinal shock definition ?

A

initial loss of all reflex activities below the area of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Complete definition ?

A

absence of sensory and motor function below the level of injury

lesions cannot be deemed complete until spinal shock has resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Incomplete definition ?

A

sensory, motor, or both functions are partially present below the neurologic level of injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spinal cord trauma patho own notes ?

A

warm shock cause massive vasodilation, warm and the BP drops and they have a bradycardia

no sympathetic innervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Determination of acute unstable injuries ?

A

Any C1-C2 injury (atlas and axis - connection site to the skull)

Disruption of at least two columns

Degree of vertebral body compression

neuro deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Degree of vertebral body compression to be considers unstable ?
>25% for the third to seventh cervical >50% in the thoracic or lumbar
26
Anterior cord etiology ?
Direct anterior cord compression flexion of C-spine Thrombosis of anterior spinal artery
27
Anterior cord sxs. ?
Complete paralysis below the lesion w/ loss of pain and temp sensation Preservation of proprioception and vibration
28
Central cord etiology ?
Hyperextension injuries Disruption of blood flow in the spinal cord C-spine stenosis
29
Central cord sxs. ?
Quadriparesis greater in the UE than the LE some loss of pain and temp sensation, also greater in the UE
30
Brown-Sequard etiology ?
Transverse hemisection of the SC Unilateral cord compression
31
Brown-Sequard sxs. ?
Ipsilateral Spastic paresis loss of proprioception and vibratory sensation and contralateral loss of pain and temp.
32
Cauda Equina etiology ?
Peripheral nerve injury
33
cauda equina sxs. ?
Variable motor and sensory loss in the LE sciatica, bowel, bladder dysfunction saddle anesthesia
34
Spinal cord trauma prevalence ?
40 cases per million more frequently on weekends, holidays, and during summer months
35
Spinal cord trauma demographic ?
mean age of 40 years old male-to-female ratio 4 to 1
36
Spinal cord trauma etiology ?
MVA 42% Falls 27% Violence 15% (primarily gunshot wounds) Sports 8% Other 8%
37
Spinal cord trauma: Prehospital immobilization type ?
Cervical spine (hard collar and/or bilateral blocks) Backboard
38
Spinal cord trauma: Prehospital immobilization indications ?
Tenderness Neurologic complaints High risk mechanism
39
Spinal cord trauma Hx. ?
Mechanism Pain Weakness - Focal - Paralysis Paresthesias Incontinence
40
Spinal cord trauma PE ?
Neurogenic shock Vertebral tenderness Motor loss Reflex loss Sensory loss
41
Neurogenic shock | sxs. ?
warm, peripherally vasodilated hypotensive relative bradycardia Caution ****hypotension in the trauma patient can never be presumed to be caused by neurogenic shock until other possible sources of hypotension have been excluded
42
SC trauma: Reflex loss - anogenital indicates complete SC damage ?
Bulbocavernosus Cremasteric Anal wink
43
Reflex: Biceps ?
C5, C6
44
Reflex: Brachioradialis ?
C6
45
Reflex: Triceps ?
C7
46
Reflex: Patellar ?
L4
47
Reflex: Achilles tendon ?
S1
48
SC trauma: C-spine - low risk ?
X-ray cervical spine
49
SC trauma: C-spine - high risk ?
CT cervical spine
50
You dont need to get a C-spine XR if they meet what criteria ?
NEXUS
51
NEXUS criteria ?
National Emergency X-Radiography Utilization Study Criteria
52
C-spine XR Unnecessary if meet each criteria ?
Absence of midline cervical tenderness Normal level of alertness and consciousness No evidence of intoxication Absence of focal neurologic deficit Absence of painful distracting injury **what you can use to clear someone of cervical spine ijurt **
53
Canadian cervical spine rule also used ?
Goal is “clinically important” injuries
54
SC trauma: if you get a C-spine XR what views ?
lateral, anteroposterior, and odontoid performed single lateral cervical spine film will identify approximately 90% of injuries to bone and ligaments
55
Cervical spine xray | you can find what ?
Poor for identifying C1-C2 injuries Column disruption Compressions
56
What imaging is better for SC trauma ?
Cervical spine CT Better imaging than plain films More sensitive and specific
57
Thoracic or lumbar spine | initial imaging ?
XR
58
Thoracic or lumbar spine | if abd. or major trauma ?
CT
59
Thoracic or lumbar spine | ID nerve damage?
MRI
60
Thoracic or lumbar spine x-ray ?
initial imaging of these spinal levels Anterior and lateral films are generally obtained
61
Thoracic or lumbar CT | indications ?
Proven bony spinal injury neurologic deficits (with normal plain films) severe neck or back pain (with normal plain films)
62
Thoracic or lumbar CT | for multisystem trauma ?
Thoracic and abdominal CT scans reformatted reconstruct images of the thoracic and lumbar spine
63
Thoracic or lumbar CT | purpose and findings ?
Anatomy of an osseous injury Grade canal impingement Assess stability
64
Thoracic or lumbar MRI | indications ?
Test of choice for anatomy of nerve injury Helpful for identifying herniated disks or spinal cord contusions
65
Thoracic or lumbar MRI | limitations ?
Not as sensitive as CT for detecting bone injuries
66
SC trauma complications ?
Neurogenic shock
67
SC trauma goals of tx. ?
prevent secondary injury alleviate cord compression establish spinal stability
68
SC trauma: all spine trauma tx. ?
- Airway considerations - Make sure cervical spine stabilized Remove from backboard Order appropriate imaging
69
SC trauma: If neurologic deficit or unstable tx. ?
Consult spinal surgery immediately
70
SC trauma: If blunt trauma | tx. ?
High dose corticosteroids (methylprednisolone)
71
SC trauma: Neurogenic shock tx. ?
Stabilization cervical spine IV crystalloid -mean arterial blood pressure at 85 to 90 mm Hg If insufficient -inotropic pressor (atropine, dobutamine) Identify possible other causes
72
SC trauma: airway considerations ?
any patient with an injury at C5 or above should have his or her airway secured via endotracheal intubation **above C5 careful of phrenic nerve injury - it innervates the diaphragm
73
SC trauma: Operative management ?
Determined by spinal surgeon
74
SC trauma: Nonoperative stabilization choices ?
Philadelphia collar Miami J collar -May have thoracic extension Halo vest - Gold standard - Very invasive
75
Operative management | common indications ?
Neurologic deterioration– URGENT SURGERY Instability
76
SC trauma: Thoracic and lumbar spine injury | - Nonoperative patients ?
Usually not immobilized, very difficult Educate to restrict movements
77
LeFort I description ?
maxilla only
78
LeFort II description ?
maxilla and zygomatic
79
LeFort III description ?
zygomatic and orbits

Clinical Medicine Lecture - Professor Kramer (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions