EMST / ATLS Ch 7 Spine and Spinal cord Questions with 100% Correct Solutions Grade A

What percentage of pt with spinal injury have at least a mild brain injury -ANSWER - at least 25% what percentage of injuries occur in each part of the spine -ANSWER - cervical 55%, thoracic 15%, thoracolumbar junction 15%, lumbosacral 15% what do approx 10% of pt with c spine fracture have -ANSWER - second non contiguous vertebral column fracture why do at least 5% of pts experience onset of neuro sx after reaching ED -ANSWER - ishcaemia, or progression of spinal for oedema, or failure to adequately immobilise. how to exclude spinal injury if pt awake and alert -ANSWER - neurologically intact, no pain or tenderness along spine risk of prolonged immobilisation -ANSWER - pressure sores (decubitus ulcers) - so come off the spinal board and log roll every two hours components of spinal stability -ANSWER - facet joints, interspinous ligaments, paraspinal muscles why do some c spine injury pts die at the scene -ANSWER - apnea from loss of phrenic nerve what type are most thoracic fractures -ANSWER - wedge compression - not associated with spinal cord injury usually, but fracture dislocation has high chance of complete spinal cord injury three spinal cord tracts that can be clinically assessed -ANSWER - corticospinal (posterolateral) - ipsilateral motor power, spinothalamic (anterolateral) - contralateral pain and temperature, posterior columns - proprioception, vibration how to demonstrate sacral sparing -ANSWER - sensory perception in perianal area, or voluntary contraction of anal sphincter Key sensory points - C5, C6, C7 -ANSWER - C5- area over deltoid. C6 Thumb. C7 Middle finger Key sensory points C8 T4 T8 T10 -ANSWER - C8 little finger. T4 Nipple. T8 xiphisterum. T10 umbilicus