Serious Spinal Injury

Beschreibung

Karteikarten am Serious Spinal Injury, erstellt von Flora Bradshaw am 13/05/2016.
Flora Bradshaw
Karteikarten von Flora Bradshaw, aktualisiert more than 1 year ago
Flora Bradshaw
Erstellt von Flora Bradshaw vor etwa 8 Jahre
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Zusammenfassung der Ressource

Frage Antworten
What 4 aspects of a patient's state suggest a potential spinal injury? 1. Mechanism of injury 2. Unconsciousness 3. Neurological deficit 4. Spinal pain/tenderness
What 6 SSI clinical features would you find in an unconscious patient? 1. Flaccid areflexia 2. Diaphragmatic breathing 3. Pain response above clavicle 4. Bradycardia 5. Hypotension 6. Priapism (painful, persistant erection)
Define the term 'shock' State of inadequate organ perfusion & tissue oxygenation
List 5 types of shock 1. Hypovolaemic shock 2. Cardiogenic 3. Neurogenic 4. Septic 5. Anaphylactic
List the 4 stages of spinal injury management 1. ABCDE (D = disability, E = exposure)/ALTS 2. Protection: Airway & spine control 3. Detection: Examine clinically & CT 4. Management: Conservative or surgery
What points need to be covered in a SSI history? (4) 1. Pain 2. Mechanism 3. Immediate post injury neurology 4. Associated injury
What 2 areas need to be covered in SSI examination? 1. Spine for tenderness, gap, step & marked spasm 2. Spinal cord (incomplete vs. complete)
Explain the differences between complete & incomplete SCI Incomplete would be defined by no sensation or voluntary motor function below level of injury
Describe the bulbocavernous reflex - Lowest possible reflex - Place finger in anus, & stimulate genitalia - Should feel contraction of anus
List & explain 2 features of neurogenic shock 1. Hypotension: Loss of blood vessel tone with resultant venous pooling 2. Bradycardia: Reduced cardiac stimulation
What is the difference between primary & secondary injury? Primary occurs during initial insult to cord & secondary occurs after injury due to shock, haemorrhage, schema, fluid-electrolyte imbalances etc.
List the four characteristic mechanisms of primary injury 1. Impact plus persistent compression 2. Impact alone with transient compression 3. Distraction (stretching) 4. Laceration & transection
Explain the pathophysiology of primary spinal injury 1. Initial mechanical insult --> damage of grey matter (relative white matter sparing) 2. Haemorrhage & blood flow disruption 3. Local infarction due to hypoxia & ischaemia 4. Neurons physically disrupted due to diminished myelin, microhaemorrage & oedema
List the 5 types of cord syndrome 1. Central 2. Anterior 3. Posterior 4. Brown-sequard 5. Complete
Which is the most common kind of cord syndrome? Central
Which cord syndromes have the best prognoses? Central & Brown-Sequard
What are the 4 types of instability? 1. Static 2. Dynamic 3. Neurological 4. Mechanical
How is static instability identified?
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