SPINAL INJURIES

Question 1

What vital structures are at risk in neck trauma?

Answer 1

Airway, jugular vein, arteries, thyroid gland, parathyroid gland, and nerves.

Question 2

What is the most common cause of death in penetrating neck trauma?

Answer 2

Haemorrhage.

Question 3

What is a major concern in blunt neck trauma?

Answer 3

Airway damage, especially to the larynx.

Question 4

What is a common spinal consequence of hanging?

Answer 4

Cervical spine disruption.

Question 5

What are signs of laryngeal or tracheal injury?

Answer 5

Voice alterations, stridor, drooling, dyspnoea, and haemoptysis.

Question 6

What effect can airway burns have?

Answer 6

Swelling that closes off the airway.

Question 7

How many vertebrae are in each spinal section?

Answer 7

7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, and 3–4 fused coccygeal.

Question 8

What is lordosis and kyphosis?

Answer 8

Lordosis is an inward curvature; kyphosis is an outward curvature.

Question 9

What does the atlanto-occipital joint allow?

Answer 9

Nodding movement of the skull.

Question 10

Where is the spinal canal narrowest and most vulnerable?

Answer 10

Sub-axial cervical spine (C3–C7).

Question 11

Why is the thoracic spine less commonly injured?

Answer 11

Limited range of motion and protected by the rib cage.

Question 12

Why is the thoracolumbar junction vulnerable?

Answer 12

Due to spinal curvature and load transfer.

Question 13

What are the three main spinal ligaments?

Answer 13

Anterior longitudinal, posterior longitudinal, and ligamentum flavum.

Question 14

What is the function of facet capsules?

Answer 14

Prevent facet joints from separating.

Question 15

What is the butterfly-shaped region in spinal cord cross-section?

Answer 15

Grey matter (cell bodies).

Question 16

What is the function of dorsal and ventral roots?

Answer 16

Dorsal root: afferent (sensory); ventral root: efferent (motor).

Question 17

What are the common mechanisms of spinal column injury?

Answer 17

Falls, collisions, transport accidents, water-related incidents.

Question 18

What can spinal column injury involve?

Answer 18

Fracture, subluxation, or dislocation with or without damage to discs, ligaments, or facet joints.

Question 19

What distinguishes spinal cord injury from spinal column injury?

Answer 19

SCI causes neurological damage; spinal column injury may not.

Question 20

What defines a complete SCI?

Answer 20

Complete disruption of spinal tracts, causing tetraplegia or paraplegia.

Question 21

What characterizes an incomplete SCI?

Answer 21

Partial motor or sensory function remains; may improve or worsen.

Question 22

What are mechanisms of spinal injury?

Answer 22

Axial compression, flexion-compression, extension, distraction, rotation.

Question 23

What is a Jefferson’s fracture?

Answer 23

C1 ring fracture due to axial compression; stable unless ligaments rupture.

Question 24

What region is most vulnerable to flexion-compression injuries?

Answer 24

C4–C6.

Question 25

What is a teardrop fracture and how is it caused?

Answer 25

Extension injury causing anterior ligament tension and vertebral fracture.

Question 26

What is a hangman’s fracture?

Answer 26

Traumatic spondylolisthesis of C2; unstable with low SCI risk.

Question 27

What is atlanto-occipital dislocation?

Answer 27

Detachment of the skull from the spine; high mortality.

Question 28

What is SCIWORA?

Answer 28

Spinal Cord Injury Without Radiological Abnormality; common in children.

Question 29

Why are children more prone to SCIWORA?

Answer 29

Softer vertebrae, flatter facet joints, larger head-to-body ratio.

Question 30

What spine issues are more common in elderly patients?

Answer 30

Disk degeneration, osteoporosis, instability, face-first falls.

Question 31

What signs suggest spinal cord injury?

Answer 31

Paralysis, paraesthesia, low HR/BP, flushed skin, paradoxical breathing.

Question 32

What is priapism and what does it indicate in spinal injury?

Answer 32

Prolonged erection without stimulation; can indicate SCI.

Question 33

How do you clear a patient from spinal immobilisation in the field?

Answer 33

GCS 15, no altered behaviour, no neck/head/shoulder pain, no neurological symptoms, no distracting injuries.

Question 34

What devices are used for spinal immobilisation?

Answer 34

C-collar, vacuum mattress, spinal board (for transport), manual in-line immobilisation, spinal extrication splint.

Question 35

When should spinal immobilisation be used?

Answer 35

With trauma history, unconscious patients, or signs of neurological injury.

Question 36

What is the purpose of a cervical collar?

Answer 36

Physically limits neck movement in trauma patients.

Question 37

What is the purpose of a log roll?

Answer 37

To assess the back with synchronised movements.

Question 38

When is a spinal extrication splint appropriate?

Answer 38

In non-time-critical patients with suspected spinal column injury.

Question 39

What are benefits of a vacuum mattress?

Answer 39

Comfortable, reduces pressure sore risk, good spinal support.

Question 40

When is manual in-line immobilisation used?

Answer 40

In time-critical patients to stabilise the neck.

Question 41

How is a helmet removed safely in spinal injury?

Answer 41

Two-person technique with manual stabilisation and gentle removal.

Question 42

What factors may contraindicate spinal immobilisation?

Answer 42

Significant kyphosis, time criticality, lack of neurological symptoms, and clear conscious state.

Question 43

What must be reported in spinal injury cases?

Answer 43

Mechanism of injury, force vector, extraction and immobilisation methods, neurological deficits.

Question 44

What is the controversy around spinal boards and clearance?

Answer 44

USA uses time-consuming tie-down methods; Europe prefers vacuum mattress and questions spinal boards' benefits.

Question 45

Describe the functional anatomy of the spinal cord and the significance of dorsal and ventral roots.

Answer 45

The spinal cord contains grey matter (central, H-shaped) for cell bodies and white matter for nerve tracts. ## Footnote Dorsal root: Afferent (sensory) input. Ventral root: Efferent (motor) output. Damage to these roots impairs sensory or motor function, depending on location and severity.