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72 Cards in this Set
- Front
- Back
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Of all patients who suffer neurolgical deficit from trauma, some 40 percent have experienced what?
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Spinal Cord Injury
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What is the best treatment for spinal cord injury?
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Prevention
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Vertebral Column
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The main support for the axis of the body, consisting of 33 bones (vertebrae); also called the spinal column.
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Vertebra
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One of 33 bones making up the vertebral column.
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Sacrum
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Triangular bone, formed from five fused vertebrae, that lies between the fifth lumbar vertebra and the coccyx.
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Coccyx
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Small bone, formed from four fused vertebrae, that lies below the sacrum at the base of the vertebral column.
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Cervical Vertebrae
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The seven vertebrae that form the top of the vertebral column, supporting the neck.
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Thoracic Vertebrae
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The twelve vertebrae that lie betweenthe cervical and lumbar vertebrae, helping to support the thorax.
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Lumbar Vertebrae
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The five vertebra that lie between the thoracic vertebrae and the sacrum, helping to support the back.
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Intervertebral Disc
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Cartilaginous pad between vertebrae that serves as a shock absorber.
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Spinal Canal
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Opening in the vertebrae that accomodates the spinal cord; also called the vertebral foramen.
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What are the 5 divisions of the vertebral comlumn?
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Cervical Spine
Thoracic Spine Lumbar Spine Sacral Spine Coccygeal Spine |
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The range of motion provided by the cervical spine is the greatest allowed by any portion of the spinal column, yet the cord in this region is what?
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Critical to life functions.
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Spinal Cord
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Central nervous system pathway responsible for transmitting sensory input from the body to the brain and for conducting motor impulses from the brain to the body muscles and organs.
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What is the spinal cord protected by?
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Vertebrae
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Axon
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Extensionof a neuron that serves as a pathway for transmission of signals to and from the brain; major component of white matter.
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Ascending Tracts
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Bundles of axons within the spinal cord that transmit signals from the body to the brain.
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Descending Tracts
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Bundles of axons within the spinal cord that transmit signals from the brain to the body.
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Ipsilateral
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Same Side
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Contralateral
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Opposite Side
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Spinal Meninges
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Protective structures that cover the spine, consisting of the dura mater, the arachnoid membrane, and the pia mater.
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C-3, C-4, and C-5 Rythm
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Keep the diaphram alive.
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Spinal Nerves
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31 pairs of nerves that originate along the spinal cord from anterior and posterior nerve roots.
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Dermatome
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Topographic region of the body surface innervated by one nerve root.
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Myotome
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Muscle and tissue of the body innervated by spinal nerve roots.
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Because of the structures of the spine, the forces necessary to induce injury from lateral bending are generally less than those needed to cause what?
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Flexion/ Extension Injury
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Often the spinal injury process involves what?
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A combination of mechanisms.
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Connective tissue and skeletal injuries represent potential instability of the spinal column and the danger that any subsequent motion may result in what?
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Spinal Cord Injury
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What section accounts for over half of all spinal injuries?
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Cervical Spine
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What are the 6 types of primary and secondary spinal cord injuries?
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Concussion
Contusion Compression Laceration Hemorrhage Transection |
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Signs and Symptoms of Spinal Injury
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Paralysis of the extremities.
Pain with and without movement. Tenderness along the spine. Imparied breathing. Spinal deformity. Priapism Posturing Loss of bowel or bladder control. Nerve impairment to extremities. |
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Transection
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Cutting across a long axis; a cross-sectional cut.
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Paraplegia
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Paralysis of the lower limbs and lower trunk.
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Quadrpelgia
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Paralysis of all four limbs.
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Complete Cord Transection
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A total severing of the spinal cord.
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Anterior Cord Syndrome
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Condition that is caused by bony fragments or pressure compressing the arteries of the anterior spinal cord and resulting in loss of motor function and sensation to pain, light touch, and temperature below the injury site.
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Central Cord Syndrom
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Condition usually related to hyperextension of the cervical spine that results in motor weakness, usually in the upper extremities and possible bladder dysfunction.
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Brown-Sequard Syndrome
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Condition caused by partial cutting of one side of the spinal cord resulting in sensory and motor loss to that side of the body.
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Cauda Equina Syndrome
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Condition caused when nerve roots at the lower end of the spinal cord are compressed, interrupting sensation, movement, and function in the lower body.
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Spinal Shock
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The loss of spinal reflexes after injury of the spinal cord that affects muscle innervated by the cord segments below the site of the injury.
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Spinal shock is often a transient problem if the cord is not what?
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Seriously Damaged
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Neurogenic Shock
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Vasodilation caused by spinal cord injury, cerebral trauma, or hemorrage.
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Autonomic Hyperreflexia Syndrome
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Condition associated with the body's adjustment to the effects of neurogenic shock; presentations include sudden hypertension, bradycardia, headache, blurred vision, as well as sweating and flushing above the point of injury; a medical emergency in which seizures, stroke, or death may result.
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The most obvious difference between nerve root and spinal cord injury is that what?
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In the former a single dermatone is affected while in the latter multiple dermatones are affected.
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The mismatch of elasticity between the vertebral column and the spinal cord is the major factor contributing to the high incidence of what?
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SCIWORA injuries in young children.
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What is SCIWORA?
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Spinal Cord Injury without Radiographic Abnormality, its defined as the presense of a spinal injury despite normal radiographic studies.
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What is essential of the lowest remaining functional level is essential?
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Early Documentation
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If you are unclear about the mechanism of injury or the potential for spinal involvement, you should always do what?
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Err on the side of overprotecting the patient.
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Provide any patient sustaining a serious injury with immediate manual spinal immobilization, followed by full mechanical immobilization from your first moments at his side until when?
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Until arrival at the emergency department.
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Kyphosis
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Exaggerated convexity in the curvature of the thoracic spine as viewed from the side.
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Scoliosis
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Lateral deviation of the normally straight vertical line of the spine.
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Kyphosis is an exaggeration of the thoracic curve, It is most common in the elderly and results from what?
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Compression fractures secondary to osteoporosis.
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Ankylosing Spondylitis
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A form of inflammatory arthritis that causes inflammation of the joints between the vertebrae of the spine and the sacroilic joints in the pelvis and may also cause inflammation and pain in other parts of the body.
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Bamboo Spine
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Development of bony bridges between vertebrae causing the spine to become stiff and inflexible, effectively fusing the spine.
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Manual immobilization must continue even after a cervical collar has been applied and until when?
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Until it is maintained with mechanical immobilization.
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Be very watchful for patients with bradycardia, especially when it is likely that they may be experiencing what?
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Hypovolemia and Shock
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Various spinal clearance protocols have been developed. If you have any doubt the potential for spinal injury, what should you do?
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Continue spinal precautions including full immobilization. Always follow your system's protocols.
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Any signs of abnormally low blood pressure, slow heart rate, or absent, diaphragmatic, or shallow respirations suggest what?
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Possible spinal cord injury.
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What is the one major objective for spinal precautions?
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Maintaining the patient in a neutral, in-line position.
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What should you do when you meet with resistance or increased pain during any positioning of the head or spine?
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Immobilize the patient as found.
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Bring the head to the neutral in-line position and maintain manual immobilization until when?
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Until the head, neck, and spine are mechanically immobilized.
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What should you do if you cannot access the patient from behind to apply manual immobilization?
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Use alternative hand placement.
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Does a cervical collar by itself immobilize the cervical spine?
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No
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What is important about cervical collars?
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Ensure that they are correctly sized or chose another one.
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Who directs and controls the movement of the patient with a suspected spinal injury?
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The provider at the head.
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A four countis prefered cadence because why?
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It gives the other providers a good oppotunity to anticipate the start of the move.
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What is the vest-type immobilization device used for?
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Not lifting but pivoting him.
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During all movements of a spinal injury patient, keep the spine in the neutral, in-line position by doing what?
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By keeping the patients eyes facing directly forward, and the shoulders, pelvis, and toes in the same plane.
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How does a vacuum mattress work?
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It adequately immobilize the spine injury patient. The device is shaped around the patient and air is withdrawn. The patient is then secured to the rigid, conforming vacuum mattress.
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How do you immobilize the adult patient to the long spine board?
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The head should be elevated 1 to 2 inches, the knees slightly flexed, and with limited padding at the small of the back and the space behind the neck.
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What is no longer recommended in spinal injuries?
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Routine use of steroids.
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Aggressive fluid resuscitation may be necessary for who?
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Patients in neurogenic shock.
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