Spine Trauma Flashcards
(26 cards)
The halo vest is most effective at controlling which of the following spinal motions?
ideal for controlling motion at upper cervical spine and atlantoaxial joint.
With halo immobilization the anterior pin should be placed?
approximately 1-cm region just above the lateral one third of the orbit (eyebrow) at or below the equator of the skull.
What is the most common neurologic complication with halo traction?
Cranial nerve VI palsy is the most common nerve palsy associated with halo cervical traction. A cranial nerve VI palsy would result in paralysis of the lateral rectus, causing a deficit in lateral eye movement.
What is tetraplegia?
injury to the cervical spinal cord leading to impairment if function in the arms, trunk, legs, and pelvic organs
What is paraplegia?
injury to the thoracic, lumbar or sacral segments leading to impairment if function in the trunk, legs, and pelvic organs depending on the level of injury. Arm function is preserved
What is a complete cord injury?
no spared motor or sensory function below the affected level.
must have recovered from spinal shock (bulbocavernosus reflex is intact) before an injury can be determined as complete.
ASIA-A
contraindications to steriod administration
GSW (gun shot wounds) pregnancy under 13 years > 8 hours after injury brachial plexus injuries
High dose methylprednisone what is dose and timing?
must be initiated in first 8 hours to be effective
load 30 mg/kg over 1st hour (2 grams for 70kg man)
drip 5.4 mg/kg/hr drip
for 23 hours if started < 3 hrs after injury
for 48 hours if started 3-8 hours after injury
what is spinal shock?
defined as temporary loss of spinal cord function and reflex activity below the level of a spinal cord injury.
characteristics of spinal shock are?
- flaccid areflexic paralysis
- bradycardia & hypotension (due to loss of sympathetic tone)
- absent bulbocavernosus reflex
Neurogenic Shock
characterized by hypotension & relative bradycardia in patient with an acute spinal cord injury
Treatment of Neurogenic Shock
Swan-Ganz monitoring for careful fluid management
pressors to treat hypotension
usually, low doses of dopamine in the 2- to 5-mcg/kg/min range are sufficient
function of C1-3 tetraplegic
Ventilator dependent with limited talking.
- Electric wheelchair with head or chin control
function of C3-4 tetraplegic
Initially ventilator dependent, but can become independent
- Electric wheelchair with head or chin control
level of function of C5 tetraplegic
Ventilator independent
- Has biceps, deltoid, and can flex elbow, but lacks wrist extension and supination needed to feed oneself
- Independent ADL’s; electric wheelchair with hand control, minimal manual wheelchair function
Level of function of C6 tetraplegic
C6 has much better function than C5 due to ability to bring and to mouth and feed oneself (wrist extension and supination intact)
- Independent living; manual wheelchair with sliding board transfers, can drive a car with manual controls
Level of function of C7 tetraplegic
Improved triceps strength
- Daily use of a manual wheelchair with independent transfers
Level of function of C8-T1
Improved hand and finger strength and dexterity
- Fully independent transfers
level of function SCI T2-T6
- Normal UE function
- Improved trunk control
- Wheelchair-dependent
Level of function T7-T12 SCI
Increased abdominal muscle control
- Able to perform unsupported seated activities; with extensive bracing walking may be possible
ASIA -AIS - A
complete SCI No motor or sensory
ASIA - AIS - B
Incomplete. No motor function but some remaining sensory
ASIA - AIS- C
Incomplete. 50% or more of muscles below injury are less than Grade 3.
ASIA- AIS - D
Incomplete. 50% or more of muscles below injury are greater than or equal to than Grade 3.
