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caroline
Ch 22 spine injuries
| Question | Answer |
|---|---|
| What is the average age at the time of injury for SCI | 32.1 years |
| 80% of patients with SCI are younger then | 40 years |
| 55% of patients who suffer SCI are between what ages | 16 and 30 |
| what are the top three causes of SCI. list them in order | MVA, acts of violence, and falls |
| Name three diseases that can cause SCI | Polio, spina bifida, Friedreichs ataxia |
| In the first few months of a SCI the ortality rate is as high as what | 20% |
| the spine consists of how many bones | 33 |
| What is the vertebral body | the anterior weight bearing structure |
| what comprises the junction of each pedicle, and lamina on each side of a vertebra | the transverse spinous process |
| What is formed by the fusion of the posterior lamina and serves as an attachment site for muscles and ligaments. | the posterior spinous process |
| what 2 bones are uniquely suited to allow for rotational movement of the skull | the atlas (C1) and the axis (C2) |
| How many vertebrae are in the thoracic spin | 12 |
| what helps to stabilize the thoracic | the rib attachments |
| the sacrum is formed of what | 5 fused vertebrae that form the posterior plate of the pelvis |
| the coccyx is made up of | 3-5 small fused vertebrae |
| Each vertebrae is seperated and cushioned by _______ ________ that limit bone wear and act as shock absorbers | intervertebral disks |
| The vertebral column can sustain normal flexion and extension of _____-_____% without stretching the spinal cord | 60-70% |
| the ACNS consists of what | the brain and the spinal cord |
| what connects the spinal cord to the remainder of the brain | the brain stem |
| the entire CNS is enclosed by a set of three membranes collectively known as what | meninges |
| the meninges consist of an outer, middle and inner layer. What are they | the dura mater, the arachnoid, and the pia mater. |
| The meninges float in what | CSF |
| The spinal cord extends from the base of the skull to where | L2 |
| What is a collection of individual nerve roots called | cauda equina |
| How many pairs of spinal nerves are there | 31 |
| Nerve roots occasionally converge into a cluster called ______ that permits peripherial nerve roots to rejoin and function as a group | plexus |
| The sensory nerves are what type of nerves? Efferent or Afferent | Afferent |
| The motor nervers are what type of nerves? Efferent or Afferent | Efferent |
| The sensory and motor nerves are reponsible for what type of function of the spinal cord | somatic |
| What part of the brain is responsible for the sympathetic nervous system | hypothalamus |
| A spinal cord injury at or above the _____ may disrupt the flow of sympathetic communication | T6 |
| Cervical flexion injuries result from what | forward movement of the head. Typically from repid deceleration, or from a direct blow to the occiput |
| anterior wedge fractures, are they stable or unstable | they can be both |
| a cervical injury that often results from high acceleration forces is known as what | Rotation-flexion injuries |
| What type of injury often occures from forces being transmitted through the vertebral bodies and directed either inferiorly through the skull or superiorly through the pelvis or feet | Vertical compression |
| What type of injury often occures from the head and neck extending to far and can result in a fracture and/or ligamentous injury of variable stability | hyperextension |
| Primary spinal cord injury is the injury that occurs | at the moment of impact |
| what is characterized by a temporary dysfunction of the spinal cord that lasts from 24-48 hours | spinal cord concussion |
| What type of injury often occures from a progression of the primary SCI | secondary spinal cord injury |
| What are 3 key elements in the care of a patient with possible SCI | Minimizing heat loss, and maintaining oxygenation and perfusion |
| What type of injury involves cmplete disruption of all tracts of the spinal cord, with permanent loss of all cord mediated functions below the level of transection | Complete spinal cord injury |
| What type of injury often occures when the patient retains some degree of cord mediated function | incomplete spinal cord injury |
| What type of injury results from the displacement of bony fragments into the anterior portion of the spinal cord, often due to flexion injuries or fractures | Anterior cord syndrom |
| What type of injury occurs from hyperextension injuries to the cervical area, and present with hemorrhage or edema to the central cervical segments | central cord syndrome |
| Posterior cord syndrome is associated with what type of injury | extension injuries |
| A condition associated with penetrating trauma with hemisection of the spinal cord and complete damage to all spinal tracts on the involved side. | Brown-sequard syndrome |
| What type of injury refers to the temporary local neurologic condition that occurs immediately after spinal trauma | spinal shock |
| What type of injury results from the temporary loss of autonomic function, which controls cardiovascular function, at the level of injury | neurogenic shock |
| what is the classic presentation of neurogenic shock | a hypotensive, bradycardic patient whose skin is warm, flushed and dry below the level of the spinal lesion |
| the diaphragm is inervated by what | the phrenic nerve C3-C5 |
| what are the ideal ETco2 levels | 35-45mm Hg |
| Where do you assess pulse and what do you assess for | radial and carotid, for rate, quality, regularity, and equality |
| What affects will hypothermia have on hemoglobin | it will impair it's ability to unbind oxygen from it |
| In a patient with multi system trauma fractures of the ribs, sternum, clavicla, scapula, or pelvis are usually associated with what other type of injury | SCI |
| Regions of the body innervated by the motor components of spinal nerves are known as | myotomes |
| Sensor commponents of spinal nerves innervate specific discrete areas of the body surface called | dermatomes |
| what is hyperesthesia | hyperacute pain to touch |
| when immobilizing pregnant patients you should do what with the backboard | tilt it at a 15-20 degree angle to displace weight off of the uterus |
| what is the benifit to placing the spine in the neutral in-line position | this provides the most space for the spinal cord and may reduce cord hypoxia and excess pressure on the tissue |
| about 80% of adults placed on a backboard will be in_______ and require ______-______'' of padding | extension, 1/2''-2'' |
| what part of the population is a high risk of spontaneous commpression fractures of the spine | older patients, especially female, with a history of osteoporosis |
| Where is herniation most commonly found in the back | L4-L5, L5-S1 |
Created by:
klindley
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