Spinal Anatomy
The spinal column is composed of 33 vertebrae and divided into 5 sections. Name the sections.
What are the cervical, thoracic, lumbar, sacral, and coccygeal?
The posterior neck muscles allow for flexion and extension to these degrees to happen without stretching of the spinal cord.
What is 60 degrees of flexion and 70 degrees of extension?
Spinal injuries may be classified as this.
What are sprains, strains, fractures, dislocations, sacral and coccygeal fracture, and cord injuries?
These are the signs and symptoms a paramedic should be mindful of when evaluating for spinal injury.
What is AMS, spinal pain/tenderness, neurologic deficit/complaint, anatomical deformity of spine, unreliable patient?
This lift technique is recommended by sports medicine experts for players who may have spinal injuries and are wearing a helmet and pads.
What is the eight-person direct lift technique?
These are in the skin and some mucous membranes.
What are peripheral thermoreceptors?
These are brief, intermittent and muscular cramps that occur in hot environments.
What are heat cramps?
This is the leading cause of death in children 1-4yrs.
What is drowning?
This occurs at altitudes 8200ft or more above sea level.
What is high-altitude illness?
According to the book, this is the second priority during evaluation on spinal cord injury.
What is to preserve spinal cord function and avoid secondary injury to the spinal cord?
This fibrous band extends vertically within the vertebral canal. It connects the posterior surfaces of the vertebral bodies from the axis (C2) down to the sacrum, and it is continuous with the tectorial membrane at the upper end.
What is the posterior longitudinal ligament?
What is an axial loading injury or vertical compression?
Sprains and strains are usually the result of these types of forces.
What are hyperflexion and hyperextension?
National Registry defines spinal immobilization as this.
What is the use of adjunct devices to minimize movement of the spinal column?
Manual in-line stabilization of the supine patient includes this.
What is kneel or lie at the patient's head and place thumbs of each hand just below the zygomatic arch of the cheek?
These are in or near the anterior hypothalamus.
What are the central thermoreceptors?
This occurs when the body's temperature-regulating mechanisms break down entirely and mental status becomes affected.
What is heatstroke?
This refers to the head being below water.
What is submersion?
According to the book, this many people live above 12,000ft.
What is 35 million people?
This is how the paramedic can test voluntary muscle function in the fingers and hands (controlled bu T1 nerve roots.)
What is instruct their patient to spread the fingers apart on both hands and keep their fingers spread apart while the paramedic squeezes the second and forth fingers?
Ligaments between these provide support for the movements of flexion and extension.
What are the spinous processes?
Extremes in these cause fracture, ligament injury, and muscle injury.
What is flexion, hyperextension, and hyperrotation?
Pain from a spinal sprain or strain is usually described as feeling like this.
What is nonradiating, aching soreness of the neck and back muscles.
Please list all examples of positive mechanism of injury for spinal injury.
What is violent impact to head/neck/torso/pelvis, assault, entrapment after structural collapse, incidents related to sudden acceleration/deceleration, high speed MVC, pedestrian struck, explosion, falls, ejection of fall from motorized vehicle, shallow-water diving incidents.
When tending to a patient with a sports related injury who is wearing a helmet, the paramedic may need this from athletic trainers.
What is special equipment or a key to remove helmets and face pieces?
This is the regulation of heat production
What is thermogenesis?
This can occur when the core body temperature is less than 95 degrees F (35 degrees C).
What is hypothermia?
These are life-threatening complications of drowning.
What are respiratory failure, hypoxia, and acidosis?
This illness usually develops within 4-6 hours of reaching a high altitude and reaches maximum severity in 24-48 hours.
What is acute mountain sickness (AMS)?
This controls the extensors of the hands and fingers.
What is the C7 nerve roots?
This is a condition of the spine characterized by fixation of stiffness of the vertebral joint.
What is spondylosis?
Serious injuries often are the result of a combination of these forces. These often produce displacement or fracture of one or more vertebrae.
What are loading and rotational forces?
The most frequently injured spinal regions include C5-C7, C1-C2, and T12-L2. Of the injuries occurring in these regions, these are the most common.
What are wedge-shaped compression fractures and teardrop fractures or dislocations?
Medical direction bases their decision for spinal immobilization for a positive MOI on this.
What is the paramedic's assessment, a reliable patient history, and the absence of distracting injuries?
This must be maintained throughout helmet removal.
What is in-line stabilization of the cervical spine?
This is the direct release of body heat to cooler surroundings.
What is radiation?
These are the classifications of the progression of symptoms of hypothermia.
What is mild, moderate, severe, and profound?
This accounts for 85% of drowning injury and can cause central cooling if done in cold water.
What is aspiration?
This is the most severe form of acute-altitude sickness.
What is high-altitude cerebral edema (HACE)?
Can you list the symptoms?
This controls the plantar flexors of the foot and can be tested by the paramedic by asking the patient to press their foot against resistance.
What is the S1 and S2 nerve roots?
The spinal cord does not run the full length of the spine. It ends here is adults and here in infants.
What are L1-L2 for adults and L3 for infants.
This type of injury occurs when a sudden lateral impact moves the torso sideways. Examples include side or angular MVC and injuries from contact sports.
What are lateral bending injuries?
Teardrop fractures and dislocations are unstable injuries that result from this.
What is a combination of severe hyperflexion and compression forces and are often seen in MVCs?
A negative MOI includes this.
What are the events in which force or impact does not suggest a likely spinal injury.
These types of incidents involve injury to the patient's head, neck, and spine.
What are diving incidents?
This is the transfer of body heat by mass motion of a fluid such as air or water.
What is convection?
This temperature measurement is preferred for hypothermia after an airway has been secured.
What is an esophageal probe?
This reflex is stimulated by submersion in cold water and causes the body to shunt blood to the brain and heart from the skin, GI, and extremities.
What is the mammalian diving reflex?
This is caused by increased pulmonary artery pressure that develops in response to hypoxia.
What is high-altitude pulmonary edema?
Can you list the symptoms?
This is a sign used to assess neurological function. It is tested by stroking the sole of the foot from the back of the foot to the toes. In children younger than 2yrs, this will cause the toes to fan outward.
What is the Babinski sign?
This is the collection of nerve roots that that continue through the coccyx and look somewhat like a horse's tail.
What are the cauda equina?
This may occur if the cervical spine is stopped suddenly while the weight and momentum of the body pull away from it.
What is distraction?
Spinal cord injuries may be classified as primary or secondary. Please define each.
What is primary injuries occur at the time of impact and secondary injuries occur after the initial injury. These often include swelling, ischemia, and movement of bony fragments.
These are examples of negative MOI.
What is dropping an object on the foot, twisting an ankle while running, isolated soft tissue injury?
This results from the blockade of vasoregulatory fibers, motor fibers, and sensory fibers.
What is neurogenic shock?
These glands regulate heat production.
What are the endocrine glands? (thyroid, adrenal medulla)
This condition associated with diabetes can interfere with vasodilation, perspiration, and thermoregulatory input.
What is autoimmune neuropathy?
Victims of submersion incidents often are at risk for this.
What is hypothermia?
Strategies to prevent high-altitude sickness include these.
What is gradual assent, limited exertion, sleeping at a lower altitude, adequate fluid intake, high-carbohydrate diet, medications?
According to the book, C3 through C5 control what motor and sensory areas?
What are the diaphragm (motor) and the top of shoulder (sensory)?
This is a map that shows the skin surface area supplied by a single spinal root.
What is a dermatome map?
At times, penetrating trauma may produce this. it is defined as a complete or incomplete lesion to the spinal cord.
What is a complete transection?
Please define and describe central cord syndrome.
What is occurs with hyperextension and cervical injuries. It is characterized by damage to the central part of the spinal cord, particularly in the cervical region. This condition often arises from traumatic injuries, such as falls or car accidents, but can also develop in older adults with cervical spondylosis, where the spinal canal narrows due to degenerative changes. Other causes may include tumors, vascular abnormalities, or conditions like syringomyelia. Includes paralysis of the arms, and sacral sparing?
The book defines a reliable patient as this.
What is a patient who is calm, cooperative, sober, alert, and oriented?
This is known as autonomic dysreflexia, may occur after resolution of spinal shock. This is associated with chronic SCI patients who have an injury at T6 or above.
What is Autonomic Hyperreflexia Syndrome?
These are mechanisms that increase heat loss.
What are vasodilation of skin vessels and sweating?
This may be present upon ECG for the hypothermic patient. It is characterized by a positive deflection at the J point. This is also known as a J wave.
What is an Osborn wave?
The following are signs and symptoms of what diving-related condition: impaired judgement, sensation of alcohol intoxication, slowed motor response, loss of proprioception, euphoria.
What is nitrogen narcosis?
These other medical conditions predispose pediatrics to altitude sickness.
What is otitis media, severe scoliosis, and neuromuscular disease?
This area is provided sensation by T4.
What is the nipple line?
There is an opening in the center of the vertebra that allows for the spinal cord to extend down the spinal column. This is the name of the opening.
What is the vertebral foramen?
The most common MOI in children ages 0-7 years is this and the most common for ages 8-15 is this.
What is struck by vehicle or involved in a crash and sports injuries or MVCs?
Please define and describe Brown-Sequard syndrome.
What is a hemitransection of the spinal cord? The most common cause of Brown-Séquard syndrome is trauma, particularly penetrating injuries such as gunshot or stab wounds. In classic presentation, injury to 1/2 of the spinal cord results in weakness or paralysis of the extremities on the same side.
Any patient who has altered mental status or altered pain perception should be considered unreliable. Examples include this.
What is patients with Alzheimer disease, psychiatric illness, and those under the influence of alcohol and other drugs.
Symptoms of this often resolve within 24 hours but can rarely last days to weeks after injury.
What is spinal shock?
According to a study of hypothermia sited in the text, this number/percentage of patients were hypothermic when they arrived at the trauma center.
What is 159 patients (5.2%)?
This is a cold injury to the foot that does not cause the tissue to freeze. Onset usually occurs within 24 hours.
What is trench foot or immersion foot?
The following are signs and symptoms of what diving-related condition: gradually increasing chest pain, hoarseness, neck fullness, dyspnea, dysphagia, subcutaneous emphysema.
What is pulmonary overpressurization syndrome (POPS)?
What is a key sign of progression of AMS to HACE?
What is ataxia?
A patient has a spinal injury and is no longer able to move or feel their lower extremities. They state pain in their lower, mid-spine and they can no longer feel sensation below their umbilicus. This nerve root may be affected.
What is T10?