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61 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Leading cause of death for spinal cord injury pt who are discharge from hospital are...
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pneumonia, pulmonary embolism, and septicemia.
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22.3
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How many bones are in the spine?
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33 irregular bones vertebrae
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22.3
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What are the bones in the spine stabilize by?
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Ligaments and muscles
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22.3
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List the function of the spine
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Support and protect neutral components; allow for fluid movement and erect stature.
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22.3
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Transverse spinous process
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The junction of the predicle and lamina bilaterally.
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22.4
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Post spinous process
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A fusion of the posterior lamina where muscles and ligaments attach.
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22.4
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The atlas (C1) and axis (C2) allow...
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for rotational movement of the skull.
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22.4
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C1 also named
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atlas
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22.4
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C2 also named
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axis
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22.4
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Info on Lumbar spine
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Contains the five largest bones of the column. Integral in carrying a large portion of body weight. Especially susceptible to injury because of this weight-bearing capacity.
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22.4
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List fused bones of the spine
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Sacral spine contains 5 fused bones, forms the posterior pelvis.
Coccyx made up of 3-5 fused bones. |
22.4
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Body flexion and extension of ______% is allowed by muscles, tendons, and ligaments without stressing the spinal cord.
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60-70
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22.5
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Cauda equina
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At L2 the spinal cord branches into a separate collection of individual nerve roots, also known as the "horse's tail."
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22.6
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How many spinal nerves and list the numbers in the regions?
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31 total
8-cervical 12-thoracic 5-Lumbar 5-Sacral 1-Coccyx |
22.6
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Plexus
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Cluster of nerve roots that permit peripheral nerve roots to rejoin and function as groups.
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22.6
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Cervical plexus
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(C1-C5) Incudes the phrenic nerve (C3-C5), which innervates the diaphragm.
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22.6
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Brachial plexus
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(C5-T1) Nerves controlling the upper exts.
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22.6
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Lumbar plexus
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(L1-L4) Nerves of the skin and muscles of the abdominal wall, internal genitalia, and lower limbs.
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22.6
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Sacral plexus
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(L4-S4) Includes the pudendal and sciatic nerves supply the buttockes, perineum, and lower limbs.
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22.6
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What is sympatheitic nervous system control by?
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The brain's hypothalamus
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22.7
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What do alpha receptor stimulate?
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Smooth muscle contraction in blood vessels and bronchioles.
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22.7
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What do beta receptors stimulate?
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Relaxation of smooth muscles in blood vessels and bronchioles, and have inotrophic effects on myocardial cells.
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22.7
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What area of the spinal cord injury will disrupt the flow of sympathetic communication?
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T6 or below
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22.7
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Parasympathetic nerves supply...
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the reproductive organs, pelvis, and legs.
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22.7
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Parasympathetic nerves begin at the...
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sacral level (S2-S4).
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22.7
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Disruption of lower Parasympathetic nerves supply causes...
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loss of bladder and bowel tone, sexual functioning.
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22.7
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Stable vs Unstable spinal cord fractures
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Stable do not involve the posterior column, they pose less risk to the spinal cord.
Unstable involve the posterior column of the spinal cord and typically include damage to portions of the vertebrae and ligaments that directly protect the spinal cord and nerve roots. |
22.7
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flexion injuries of spine
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A type of injury that results from forward movement of the head, typically as the result of rapid deceleration, such as in a car crash, or with a direct blow to the occipital.
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22.29
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rotational-flexion spine injury
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A type of injury typically resulting from high acceleration forces; can result in a stable unilateral facet dislocation in the cervical spine. Facet joint is the joint on which each vertebra articulates with adjacent vertebra.
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22.29
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vertical compression spine injury
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A type of injury typically resulting from a direct blow to the crown of the skull or rapid deceleration from a fall through the feet, legs, and pelvis, possibly causing a burst fracture or disk herniation.
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22.30
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hyperextension
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Extension of a limb of other body part beyond its usual range of motion.
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22.29
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Primary spinal cord injury
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Injury that occurs at the moment of impact.
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22.8
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Secondary spinal cord injury
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Injury that occurs when multiple factors permit a progression of the primary spinal cord injury.
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22.8
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How can prehospital care provider minimize secondary cord injury?
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Stabilization through spinal motion restriction and neutral alignment. In addition minimizing heat loss and maintaining oxgenation and perfususion.
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22.9
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Complete vs incomplete spinal cored injury
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Complete spinal cord injury involves complete disruption of all tracts of the spinal cord, with permanent loss of all cord-mediated functions below the level of transection.
Incomplete spinal cord the pt retains some degree of cord-mediated function. |
22.9
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Anterior cord syndrome
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Results from displacement of bony fragments into the anterior portion of the spinal cord, often due to flexion injuries or fractures. Disrupts blood flow and causes paralysis below the level of insult with loss of sensation of pain, temp., and touch.
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22.9
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Central cord syndrome
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A condition resulting from hyperextension injuries to the cervical area that cause damage with hemorrhage or edema to the central cervical segments; findings include greater loss of function in the upper ext with variable sensory loss of pain and temp.
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22.29
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Posterior cord syndrome
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A condition associated with extension injuries with isolated injury to the dorsal column; presents as decreased sensation to light touch, proprioception, and vibration while leaving most other motor and sensory functions intact.
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22.29
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Brown-Sequard syndrome
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A condition associated with penetrating trauma with hemisection of the spinal cord and complete damage to all spinal tracts on the involved side.
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22.29
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Spinal shock
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The temporary local neurologic condition that occurs immediately after spinal trauma; swelling and edema of the spinal cord begin immediately after injury, with sever pain and potential paralysis.
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22.30
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Neurogenic shock
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Shock caused by massive vasodilation and pooling of blood of blood in the peripheral vessels to the extent that adequate perfusion cannot be maintained.
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22.29
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Spinal cord injury without radiographic abnormalities
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SCIWORA can occur in children because their vertebrae lie flatter on top of each other. Cord may be damage through compression and transection. MRI may be required.
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22.9
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MOI that automatic call for mobilization
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-High-velocity crash (>40 mph) with severe vehicle damage.
-Unrestrained occupant of moderate to high speed mva. -Vehicular damage with compartmental intrusion (12") into the pt's seating space. -Fall from three times the pt height. -Penetrating trauma near the spine. -Ejection from a moving vehicle. -Motor cycle crash >20 mph with separation of rider from vehicle -Diving injury -Auto vs pedestrian/bicyclist > 5 mph -Death of occupant in same passenger compartment -Rollover crash (unrestrained) |
22.10
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If head injury is suspected use PCO2 monitoring to maintain CO2 levels between
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34 to 45 mm Hg
40 is a good number. |
22.12
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Before placing pt on backboard check
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PMSx4
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hyperesthesia
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Hyperactive pain to touch, includes "electric shock" and "pins and needles."
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22.29
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dermatones
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Areas of the body innervated by sensor components of spinal nerves.
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22.29
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Babinski reflex
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When the toes moves upward in response to stimulation to the sole of the foot, known as positive Babinski. Under normal circumstance, the toes move downward, known as negative Babinski.
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22.29
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Hypovolemic shock=
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Tachycardia and pale, cool, clammy skin.
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notes
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Hypotension with normal to slow pulse and warm skin=
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Possible neurogenic shock.
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notes
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Toddlers can be immobilize in
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child seat, unless they need to be supine.
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notes.
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After on board and when time allows...
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pad voids.
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notes
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What do Corticosterroids do?
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In short reduce inflammation.
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notes
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Autonomic dysreflexia
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Also called autonomic hyperreflexia is typically a late complication of spinal cord injury but can occur acutely. The potentially life-threatening emergency most commonly occurs with injuries above T4-T6 and results from loss of parasympathetic stimulation. Sympathetic system takes over. S/s include: HTN, HA, nasal congestion, dilation of pupils, anxiety, bradycardia, rebound hypotension, flushing and sweating above injury, erect hairs above injury, chills without fever, bronchospasm, sz, stroke, and death.
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22.26
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The parasympathetic nervous system includes fibers from the brain stem and upper spinal cord that carry signals to ______________________________.
A: organs of the abdomen, heart, lungs and the skin above the waist B: the heart and lungs C: kidneys, heart, lungs, and skin D: organs of the abdomen |
A: organs of the abdomen, heart, lungs and the skin above the waist
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Reason: page 22.7
Website paramedic.emszone.com |
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Rotation-flexion injuries often result from __________________________.
A: high deceleration forces B: forward movement of the head C: high acceleration forces D: None of the above |
C: high acceleration forces
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Reason: page 22.8
Website paramedic.emszone.com |
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Neurogenic shock results from ____________________________.
A: penetrating trauma of the spinal cord B: permanent loss of autonomic function, which controls cardiovascular function C: compression injury of the spinal cord D: temporary loss of autonomic function, which controls cardiovascular function at the level of injury. |
D: temporary loss of autonomic function, which controls cardiovascular function at the level of injury.
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Reason: page 22.9
Website paramedic.emszone.com |
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The degree of spinal cord injury is best determined _________ after the initial injury.
A: 8 hours B: 12 hours C: 24 hours D: 7 days |
C: 24 hours
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Reason: page 22.9
Website paramedic.emszone.com |
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Injuries occurring at or above __________ may lead to diaphragmatic paralysis.
A: C2-3 B: C3-4 C: C4-5 D: C5-6 |
B: C3-4
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Reason: page 22.11
Website paramedic.emszone.com |
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Proprioception means
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The ability to perceive the position and movement of one's body or limbs
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22.29
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List dermatones
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Cervical 1-8
*C-3, 4, 5: diaphragm *C-6, 7, 8: fingers Thoracic 1-12 *T-4: nipple *T-10: umbilicus Lumbar 1-5 *L-1,2: hip *L5-Great toe Sacral 1-5 *S-1: Knee flexion *S-2,3,4: anal sphincter Reference on hint |
Informed
EMS Field Guide ALS Version |
