Spinal Cord Injuries Quiz-2

Motor vehicle accidents are the most common cause of spinal cord injuries. This is because during a car crash, the sudden impact can cause the spine to twist or compress, leading to damage to the spinal cord. The force of the collision can result in fractures or dislocations of the vertebrae, which can in turn injure the spinal cord. Additionally, the high speeds involved in motor vehicle accidents can lead to more severe injuries. Therefore, motor vehicle accidents are a major contributor to spinal cord injuries.

In an unconscious patient, it is important to assume a cervical fracture until proven otherwise. This is because unconscious patients are unable to provide a history of trauma or any other symptoms that may indicate a cervical fracture. Additionally, cervical fractures can result in serious complications such as spinal cord injury, so it is crucial to take appropriate precautions and immobilize the cervical spine to prevent further damage. Therefore, assuming a cervical fracture in an unconscious patient is a prudent approach to ensure patient safety.

This statement is false. Higher injuries to the spinal cord are generally more severe and have a greater impact on bodily functions compared to lower injuries. Higher injuries, such as those occurring in the cervical (neck) region, can result in paralysis of both the upper and lower body (quadriplegia), while lower injuries, such as those occurring in the lumbar (lower back) region, may result in paralysis of the lower body only (paraplegia). Therefore, lower injuries are generally considered to be less severe and have better outcomes compared to higher injuries.

A portion of spinal cord injuries occur in transit to the hospital. This means that some individuals who sustain spinal cord injuries experience them while being transported to the hospital. This could be due to the nature of the injury or the circumstances surrounding it. It highlights the importance of prompt medical attention and the need for proper transportation protocols to minimize further damage during transit.

Neck immobilization is paramount after a possible spinal cord injury because it helps prevent further damage to the spinal cord. By keeping the neck stabilized and in a neutral position, the risk of movement that could potentially worsen the injury is minimized. This is crucial in order to prevent any additional trauma or complications that could result from spinal cord movement. Rapid transport, assessing for range of motion (ROM), and intubation may also be important in the management of a spinal cord injury, but neck immobilization takes precedence in order to ensure the safety and well-being of the patient.

When assessing a situation, the first thing to check is the ABCs. This stands for Airway, Breathing, and Circulation. It is important to ensure that the person's airway is clear and they are able to breathe properly. Checking for signs of circulation, such as a pulse, is also crucial. By assessing the ABCs, one can quickly determine if the person's vital functions are intact and address any immediate life-threatening issues.

The categories of spinal cord lesions are divided into two main types: incomplete lesions and complete lesions. Incomplete lesions refer to damage or injury to the spinal cord that does not result in a complete loss of function. This means that some sensory or motor function is still present below the level of the lesion. On the other hand, complete lesions refer to a total loss of sensory and motor function below the level of the lesion. These categories help in understanding the extent and severity of spinal cord injuries and guide treatment and rehabilitation strategies.

In Brown Sequard syndrome, the patient presents with ipsilateral (same side) loss of motor function and proprioception (the sense of body position and movement) and contralateral (opposite side) loss of pain and temperature sensation. This is due to damage to one side of the spinal cord, resulting in different symptoms on each side of the body.

In anterior spinal cord syndrome, the function that remains is the vibratory sense. This syndrome is characterized by damage to the anterior portion of the spinal cord, resulting in the loss of motor function, pain, and temperature sensation. However, the vibratory sense, which is the ability to perceive vibrations, is typically preserved. This is because the pathways responsible for transmitting vibratory sensation are located in the posterior portion of the spinal cord, which is not affected in this syndrome.

Pain and tenderness in the cervical area is usually an indication of a cervical trauma in an alert trauma patient. This is because trauma to the cervical area can result in inflammation, muscle strain, or damage to the ligaments and soft tissues, leading to pain and tenderness. It is important to assess for these symptoms in order to identify and provide appropriate treatment for cervical trauma.

During the chronic phase of spinal trauma, it takes approximately 4 weeks for the reflexes to return. This period allows for the body to heal and for the nervous system to regenerate and repair any damage caused by the trauma. The gradual recovery of reflexes indicates the restoration of nerve function and is a positive sign of healing.

Posterior cord syndrome is a rare condition characterized by damage to the posterior spinal cord. The symptoms typically include weakness in the lower extremities and heightened vibratory sensation. However, the distinguishing feature of posterior cord syndrome is the presence of burning paresthesias involving the neck, arms, and torso. This symptom is not commonly seen in other spinal cord syndromes, making it a key indicator of posterior cord involvement. Weakness in the upper extremities is not typically associated with posterior cord syndrome.

After a spinal cord injury, hemorrhages occur in the grey matter. The grey matter is responsible for processing sensory information and controlling motor functions. Hemorrhages in this area can lead to further damage and loss of function.

After a spinal cord injury, a zone of hemorrhage, edema, and necrosis spreads within the diameter of the whole spinal cord within 6-24 hours. This means that the damage caused by the injury gradually expands and affects the entire spinal cord within this time frame.

The correct answer is 6 months because it is generally believed that the maximum recovery for a spinal cord injury occurs within the first 6 months. During this time, there is a window of opportunity for the injured nerves to heal and for the individual to regain some function. After this period, the chances of significant recovery decrease. However, it is important to note that every spinal cord injury is unique, and the recovery timeline can vary depending on the severity of the injury and individual factors.

The acute phase of spinal cord trauma is characterized by two stages: spinal shock and massive autonomic instability. Spinal shock refers to a temporary loss of spinal cord function immediately after the injury, resulting in flaccid paralysis, loss of reflexes, and sensory deficits below the level of injury. Massive autonomic instability refers to dysregulation of the autonomic nervous system, leading to symptoms such as fluctuations in blood pressure, heart rate, and body temperature. These two stages are commonly observed in the acute phase of spinal cord trauma.

In Brown Sequard syndrome, the preservation of light touch is due to redundant contralateral and ipsilateral pathways. This means that even though there may be damage to one side of the spinal cord, the other side can still transmit sensory information related to light touch. This preservation of light touch is not seen in other sensory modalities such as vibratory sense and temperature, which may be affected by the spinal cord injury.

Decreased mobility can lead to contractures, which are the permanent shortening and tightening of muscles, tendons, or other tissues, causing limited range of motion and joint stiffness. Skin breakdown is another problem associated with decreased mobility, as individuals who are immobile or bedridden may develop pressure ulcers or bedsores due to prolonged pressure on certain areas of the body. Decreased mobility also increases the risk of infection, as immobility can impair the body's immune response and make individuals more susceptible to infections.

C7 is the correct answer because although it is difficult to see, it is responsible for a significant percentage of injuries. This suggests that injuries to the C7 vertebra are common and often go unnoticed due to the difficulty in visualizing it.

The standard radiologic evaluation consists of three views: the cross-table lateral view, the A-P (anteroposterior) view, and the open mouth view. The cross-table lateral view is taken with the patient lying on their side, allowing for a clear visualization of the affected area. The A-P view is taken from the front to the back of the body, providing a comprehensive view of the anatomy. The open mouth view is specifically used to evaluate the cervical spine and the temporomandibular joint. These three views together provide a comprehensive assessment of the patient's condition.

The best surgical intervention for cervical injury is a combination of decompression and stabilization. Decompression involves removing any pressure on the spinal cord or nerves, which can be caused by herniated discs or bone spurs. Stabilization is necessary to prevent further damage and maintain the alignment of the spine. This may involve the use of plates, screws, or rods to hold the vertebrae in place. Repairing of associated tissue and strengthening of supporting vertebra may be important aspects of the overall treatment plan, but they alone may not address the primary issue of cervical injury.

Computed tomography (CT) is superior to film x-rays in identifying C1 and C2 vertebrae. This is because CT scans provide detailed cross-sectional images of the body, allowing for better visualization of the complex anatomy of the upper cervical spine. Film x-rays may not provide enough clarity or resolution to accurately identify these specific vertebrae.

Corticosteroids given to try to reduce edema

In Central cord syndrome, hyperextension of the neck can cause compression and damage to the central portion of the spinal cord. This can result in weakness in the upper extremities due to damage to the nerve fibers that control the muscles in the arms and hands. Sensory loss below the lesion occurs because the sensory nerve fibers that transmit information from the lower parts of the body to the brain are also affected. Sphincter dysfunction, specifically bladder retention, can occur due to disruption of the nerve signals that control bladder function.