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41 Cards in this Set
- Front
- Back
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(Cameron)
Which is not a feature of an acute central cervical cord syndrome? |
B. Central Cord Syndrome : Weakness is
greatest in upper limbs. |
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(Cameron)
which is incorrect regarding an acute anterior cervical cord syndrome? A. It involves damage to the anterior spinal artery, typically via a flexion injury to the spine. B. Position sense is lost, as well as pain and temperature sensation. C. There is motor weakness- loss / paralysis below the level of the lesion, but preservation of joint sense. D. It commonly results from a flexion-rotation OR vertical compression injury to the spinal cord. |
B. Anterior Cervical cord syndrome = Loss of :
Motor - Corticospinal Pain /Temperature - Spinothalamic |
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(Cameron)
In regards to Spinal cord injuries, which of the following links is incorrect? A. Transverse Spinal cord Syndrome = Total flaccid paralysis + total anaesthesia / analgesia + areflexia spinothalamic tracts = upper limb deficit > lower limb. Motor weakness Lower limbs > upper limbs. |
D. Central Cord Syndrome : Motor weakness
Upper limbs > lower limbs |
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(Cameron)
Which is incorrect regarding Brown-Sequard Syndrome? temperature loss on the opposite side. |
C. Reflexes are variably affected.
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(Trauma Atlas)
In regards to a bilateral facet joint dislocation, which of the following is incorrect? A. It results from a forced flexion of the neck. B. It usually results in greater than 50% subluxation of the superior vertebral body on the inferior vertebral body. cord syndrome. injuries having a spinal cord injury. |
C. Bilateral Facet Joint Dislocation is Usually a complete spinal cord injury
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ETM Course Manual which of these figures is incorrect regarding Spinal fractures ? A. They are diagnosed in 5-10 % of multi-trauma patients. B. Cervical spine fractures account for 60% of all spinal column fractures. C. Spinal cord injuries are primarily a disease of young males. D. Lumbosacral spine fractures account for only 4% of all spinal column fractures. |
A. 2-3 % |
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ETM Course Manual What is the % distribution of spinal fractures in trauma between the following ? Cervical Spine Thoracic Spine Lumbosacral spine. |
Cervical spine = 60% Thoracic Spine = 30% Lumbosacral spine = 4% |
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ETM Course Manual What % of patients with a spinal column fracture will have a second fracture ? |
8% |
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ETM Course Manual In regards to the Spinal column, which of the following is incorrect ? A. It comprises 24 discrete vertebrae. B. It totals 34 vertebrae. C. There are 9 fused sacrococcygeal vertebrae. D. There are 7 cervical, 12 thoracic and 5 lumbar vertebrae. |
B. Vertebral column totals 33 vertebrae. |
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ETM Course Manual What 3 main structures pass through the cervical foramen transversarium ? |
1. Vertebral artery ( at C6) 2. Vertebral vein 3. Sympathetic nerve fibres |
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ETM Course Manual At what spinal canal level ( bony canal ) is the surrounding spinal cord space the narrowest - cervical -thoracic or lumbar ? |
Thoracic spinal canal is the narrowest |
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ETM Course Manual What are the 3 main spinal cord tracts that are readily assessable at the bedside ? |
1. Corticospinal 2. Spinothalamic 3. Dorsal Columns |
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ETM Course Manual What do the Corticospinal tracts control ? |
Corticospinal = Ipsilateral Motor function |
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ETM Course Manual What fibres do the Spinothalamic tracts carry ? |
Spinothalamic = Contralateral sensory fibres for : 1. Pain and temperature 2. Deep / coarse pressure |
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ETM Course Manual What fibres do the Dorsal columns carry ? |
Dorsal Columns = Ipsilateral fibres for : 1. Proprioception and vibration sense 2. Fine touch |
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ETM Course Manual List the 6 main unstable cervical spine fractures / dislocations . |
" Jefferson Bit Off A Hangmans' Thumb" Jefferson fracture Bilateral facet joint dislocation Odontoid fractures type II and III Atlanto-occipital dislocation Hangman's Fracture Teardrop / flexion fracture |
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ETM Course Manual Which of the following is incorrect regarding Bilateral Facet Joint dislocation injuries ? A. The mechanism is usually a forced extension B. they have a high rate of spinal cord injury C. Vertebral body displacement is usually > 25-50% D. They are associated with vertebral artery injuries |
A. Forced flexion Injury |
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ETM Course Manual in regards to Odontoid Fractures which of the following is incorrect ? A. There are 3 main types. B. They account for 10-20% of all cervical spine fractures C. Type III involves the vertebral body of C1. D. Type I injuries are associated with atlanto-occipital instability |
C. Type III Odontoid fracture involves body of C2 |
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ETM Course Manual in regards to the Hangman's Fracture, which of the following is incorrect ? A. It involves the pars interarticularis of C2 B. It is a distraction hyperflexion injury. C. It is not typically seen in suicidal hangings. D. Major trauma-High speed MVA is it's association. |
B. Hangman's Fracture = Hyperextension distraction injury |
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ETM Course Manual What is the most severe of the cervical spine fractures / dislocations ? |
Flexion Teardrop fracture |
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ETM Course Manual In regards to the Flexion Teardrop Fracture of the cervical spine, which of the following is incorrect ? A. It is the most severe cervical spine fracture, commonly occurring at C6C7. B. It often causes quadriplegia C. It often causes anterior cervical spinal cord syndrome. D. It's mechanism is flexion-compression, as with diving accident head first. |
A. Flexion Teardrop = C5-6 |
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ETM Course Manual Which is not a part of the Posterior column of the thoracic spine? A. Posterior wall of the vertebral body B. Ligamentum flavum C. Neural arch D. The pedicles. |
A. Posterior wall of vertebral body is part of the middle column. |
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ETM Course Manual List 5 parts of the posterior Column of the thoracic spine. |
Posterior Column of Spine 1. Spinous process of vertebrae 2. Supraspinous and interspinous ligaments 3. Neural arch 4. Facets 5. Pedicles 6. Intertranvserse and capsular ligaments. |
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ETM Course Manual In regards to Burst fractures, which of the following is incorrect ? A. They involve the middle column ( as well as anterior column ) B. They most commonly occur in the lumbar spine C. Result from axial loading D. They are unstable by definition. |
B. Most commonly in cervical spine |
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ETM Course Manual What Associated injuries occurring with Fracture -dislocations in the thoracic spine lead to an increased suspicion for the latter ? |
1. Sternal fracture 2. Mediastinal injury 3. Lung injury |
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ETM Course Manual What is the Clinical triad for Neurogenic Shock ? |
Clinical Triad For Neurogenic Shock : 1. Hypotension 2. Bradycardia 3. Peripheral vasodilatation. |
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ETM Course Manual What is the definition for Neurogenic Shock ? |
Inadequate tissue perfusion - caused by significant loss of sympathetic autonomic outflow , usually above the T6 level. |
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ETM Course Manual What is the definition for Spinal Shock ? |
Complete loss of all neurological function below the level of spinal cord injury ( including autonomic control and and rectal reflex tone ) ** Without demonstrable abnormality on CT /MRI It usually involves 24-72 hours of complete loss of sensory , motor and segmental reflex activity, with flaccid paralysis and areflexia below the level of injury. |
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ETM Course Manual what 2 main clinical findings can occur with a Loss of autonomic function below the level of a spinal cord injury ? |
1. Hypotension ( neurogenic shock ) 2. Priapism |
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ETM Course Manual What are the 3 main incomplete spinal cord syndromes ? |
3 Main Incomplete Spinal Cord Syndromes : 1. Anterior cord syndrome 2. Central cord syndrome 3. Brown-Sequard Syndrome |
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ETM Course Manual in regards to the Anterior Cord Syndrome, which of the following is incorrect ? A. It has the poorest prognosis of all spinal cord syndromes. B. It usually occurs from axial compression OR extension-rotation type injuries. C. It is usually as result of anterior spinal artery flow disruption AND ischaemia / infarction. D. Corticospinal loss of motor function occurs below the level of the lesion. |
B. Flexion-rotation injuries OR axial compression type injuries. |
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ETM Course Manual In regards to Central Cord Syndrome, which of the following is incorrect ? A. It usually occurs from a hyper-extension mechanism. B. It typically occurs in the Elderly, with pre-existing cervical canal stenosis. C. It results from contusion and oedema of the central white matter of the cord. D. It can occur from forward falls with facial impact. |
C. Central grey matter |
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ETM Course Manual In regards to the central cord syndrome, which of the following Clinical Features is incorrect ? A. Weakness is most marked in the upper limbs than lower limbs. B. Weakness is more marked in the proximal upper limb muscles than the distal upper limb muscles. C. Loss of sensation occurs in both upper and lower limbs. D. Sensory loss occurs more in the upper than lower limbs. |
B. Weakness is more marked in the distal upper limb muscles ( hands ) |
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ETM Course Manual List 5 Causes for respiratory insufficiency in Trauma patients with suspected spinal cord injury. |
1. Local Haematoma + airway obstruction ( In high cervical spine injuries) 2. Spinal cord injury at C5 or higher ( Phrenic nerve) 3. Intercostal muscle paralysis from thoracic spine damage from T1-T12 4. Concurrent Thorax injury 5. Aspiration |
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ETM Course Manual What are the 2 main aims of documentation on the ASIA Chart for Spinal cord injury? |
1. Determine the level of the spinal cord lesion 2. Identify the need for emergent management of complications - especially respiratory failure |
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ETM Course Manual In determining the sensory level of a spinal cord lesion, what determines the level ? |
The lowest dermatome with NORMAL sensory function |
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ETM Course Manual What determines the motor level for a spinal cord injury ? |
It is defined as the lowest key muscle that has a grade of at least 3/5 power. |
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ETM Course Manual List the sensory levels for C4, C5 and C6 dermatomes. |
C4 = suprasternal notch C5 = deltoid region C6 = Thumb |
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ETM Course Manual List the motor levels for C4, C5 and C6. |
C4 = Spontaneous breathing C5 = Shoulder abduction C6 = Wrist extension |
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ETM Course Manual What is the Definition of the Neurological Level ? |
The Most caudal segment of the spinal cord that has normal sensory and motor function on both sides of the body. |
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ETM Course Manual List 5 indications for Emergent Surgery with a spinal cord injury. |
1. Cord Compression [ secondary to vertebral body displacement / retropulsion into spinal canal ] 2. Progressive neurological deficit 3. Worsening radiculopathy 4. Unstable injuries ** [ > 2 columns or dislocation ] ** 5. Correct significant deformity |
