2024 ATLS Module 7 - Spine and Spinal Cord Trauma Latest Questions With Complete Grade A Answers
- what do you have to consider in up to 10% of pts with a cervical spine fx?
Answer: a second, noncontiguous vertebral column fx
*therefore radiographic screening of entire spine is warranted in pts with c spine fx
- when can you safely defer evaluation of spinal injury?
Answer: if pts spine is protect- ed, evaluation of spine and exclusion of spinal injury can be safely deferred... esp in presence of systemic instability such as hypotension and respiratory inadequacy
- how can you exclude spinal injury in patients without neurological deficit, pain or
tenderness along the spine, evidence of intoxication, or additional painful injuries?Answer: absence of pain or tenderness along spine virtually excludes presence of significant spinal injury
- why should long backboards be only used during pt transportation, and every
effort should be made to remove pt from spine boards ASAP?
Answer: prolonged positioning on a hard backboard with hard cervical collar can
also be hazardous....via discomfort in conscious pts, serious decubitus ulcers, respiratory compromise
- what does the spinal column consist of?
Answer: 7 cervical, 12 thoracic, 5 lumbar vertebrae + sacrum and coccyx
- why do ~1/3 of pts with upper cervical injuries (above C3) die?
Answer: from apnea caused by loss of central innervation of phrenic nerves
- how is a child's cervical spine markedly different from that of an adults until
~8-12 years old?Answer: more flexible joint capsules & interspinous ligaments, flat facet joints, and vertebral bodies are wedged anteriorly and tend to slide forward with flexion
- most thoracic spine fxs are wedge compression fxs, not associated with spinal
cord injury... however, what happens when a fracture dislocation does occur?Answer: almost always results in complete spinal cord injury bc of the relatively narrow thoracic canal
- spinal cord originates at the caudal end of medulla oblongata at fora- men
magnum... where does it usually end? 1 / 2
Answer: near L1 bony level... aka conus medullaris... below this is the cauda equina
- what is a complete spinal injury?
Answer: pt has no sensory or motor fx below a certain level
- what is an incomplete spinal injury?
Answer: some degree of motor or sensory fx remains
- where is the corticospinal tract located and what is the function? how do you
test it?
Answer: anterior and lateral segment of cord
*controls motor power on same side of body *test = voluntary muscle contraction or involuntary response to painful stimuli
- where is the spinothalamic tract located and what is the function? how do you
test it?
Answer: anterolateral aspect of cord
*transmits pain and temperature sensation from opposite side of body *test = pinprick
- where is the dorsal columns located and what is the function? how do you test
it?
Answer: posteromedial aspect of cord
*carries position sense (proprioception), vibration sense, and some light tough sensation from same side of body *position sense in toes and fingers or vibration senses using tuning fork
- where is C5 dermatome?
Answer: area over deltoid
- where is T4 dermatome?
Answer: nipple
- Where is the T10 dermatome located?
Answer: umbilicus
- Where is the T12 dermatome located?
Answer: symphysis pubis
- / 2