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Description
Flashcards by Flora Bradshaw, updated more than 1 year ago
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Created by Flora Bradshaw
over 8 years ago
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| Question | Answer |
| 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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