Spine

Question 1

injuries of the vertebral column tend to cluster at the

Answer 1

junctional areas

Question 2

neurologic level

Answer 2

most caudal segment w/ nl sensory and motor function on both sides

Question 3

complete injury

Answer 3

absence of sensory and motor function in the lowest sacral segment

Question 4

zone of preservation

Answer 4

1. dermatomes and myotomes caudal to the neurologic level that remain partially innervated;
2. only used in complete injuries

Question 5

neurologic rectal examination

Answer 5

spinal cord dysfunction based on physiologic rather than structural disruption

Question 6

spinal shock

Answer 6

physiologic spinal cord dysfunction

Question 7

neurogenic shock

Answer 7

hypotension w/ loss of periph vascular resist in spinal cord injury

Question 8

compare neurogenic shock w/ hypovolemic shock

Answer 8

• bradycardia

- warm extremities

Question 9

which reflex is the 1st to return in neurogenic shock?

Answer 9

bulbocavernosus reflex(S3-S4)

Question 10

overhydration in shock will lead to

Answer 10

pulm edema

Question 11

complete spinal cord injury

Answer 11

no sens/voluntary motor function is noted caudal to the level of injury in the presence of an intact bulbocavernosus reflex

Question 12

sacral sparing

Answer 12

1. perianal sens
   2.voluntary rectal motor
   3.great toe flexor
   [incomplete spinal cord injury]

Question 13

central cord syndrome

Answer 13

• flaccid paralysis (upper)
• spastic paralysis (lower)
• sacral sparing

Question 14

central cord syndrome is frequently associated w/ ______injury

Answer 14

extension injury to an osteoarthritic spine in a middle-aged person

Question 15

meds for acute spinal cord injury

Answer 15

iv methyprednisolone

Question 16

complications of spinal cord injury

Answer 16

• GI (ileus, regurg, aspir, hemorr gastritis)
• Urologic
• Pulm
• Skin

Question 17

patients w/ a diagnosed cerv fx have >=1 of the following 4 characteristics

Answer 17

1. midline neck tenderness
2. intox
3. alertness
4. painful elsewhere

Question 18

Hangman’s fx

Answer 18

traumatic spondylolisthesis of C2

Question 19

which mechanism results in teardrop fx?

Answer 19

compressive flexion

Question 20

which mechanism results in burst fx?

Answer 20

vertical compression

Question 21

clay shoveler’s fx

Answer 21

avulsion of the lower cerv and upper thor spinous processes

Question 22

sentinel fx

Answer 22

fx of lamina on either side of the spinous process

Question 23

“chalk stick” fx aft trivial injuries (very unstable)

Answer 23

ankylosing spondylitis

Question 24

most isolated thoracic and lumbar spine fx are related to

Answer 24

osteoporosis

Question 25

what are the radiologic findings of burst fx?

Answer 25

• abnl widening of the interpedicular distance

- loss of post. vert. body height

Question 26

widening of interspinous distance may infer

Answer 26

post. lig. injury

Question 27

unstable spinal injury

Answer 27

nl physiologic loads cause further neuro damage, chronic pain, and unacceptable deformity