EMT- Chapter 32: Spinal Injury and Spine Motion Restriction

Of the following, which spinal cord injuries are common with incomplete spinal cord injuries: -anterior cord syndrome -neurogenic hypotension -Brown-Sequard syndrome -central cord syndrome -spinal shock

-anterior cord syndrome -Brown-Sequard syndrome -central cord syndrome

5 divisions of the spinal or vertebral column?

-cervical: 7 -thoracic: 12 -lumbar: 5 -sacral: 5 -coccyx: 4

Structural divisions and functional divisions of the nervous system?

-structural: CNS, PNS -functional: autonomic and voluntary

Your suspicion regarding the presence of a spinal injury should not be altered by the pt's ability to walk: T/F?

true the pt might have a spinal injury but still be able to walk around

Distraction injury?

when the vertebrae and spinal cord are stretched/ pulled apart

7 mechanisms of spinal injury?

-compression -rotation -extension -flexion -distraction -penetration -lateral bending

3 tracts of the spinal cord?

-motor tract -pain tract (crosses paths) -light touch tract

When securing the pt to a short spine board or flexible extrication device, which body part do you secure first?

torso

The MOI in which there is severe forward movement of the head or torso, such that it is curved excessively forward is called A. flexion. B. rotation. C. distraction. D. extension.

A. flexion.

Probably the most common and reliable sign of a spinal cord injury in a conscious pt is A. paralysis of the extremity B. raccoon sign. C. Battle's sign. D. pupil dilation.

A. paralysis of the extremity

Central cord syndrome?

the pt may have weakness/ paralysis and loss of pain sensation to the upper extremities while the lower extremities have good function the inner (medial) tracts control the upper extremities; lateral controls the lower extremities

Spinal shock results specifically from injury to the spinal cord, usually high in the cervical spine: T/F?

true

Anterior cord syndrome?

injury of the pain and motor tracts; light touch is not injured

The spinal column is composed of ____ vertebrae.

33

Sports helmets typically open in the A. front. B. back. C. left side. D. right side.

A. front.

A restrained driver of a car that struck another car from behind at a low rate of speed is your patient. She has a bruise to her forehead and complains of tingling in her left leg. She is lying on the side of the road and another EMT has taken manual in-line spinal stabilization. A quick scan of her as you approach indicates that she is in little to no distress. Which one of the following should you do first? A. Check her breathing and radial pulse B. Perform a secondary assessment C. Palpate her cervical spine and apply a cervical collar D. Administer high-concentration oxygen

A. Check her breathing and radial pulse

Which one of the following is not an indication for removing a helmet in a case of suspected head/ spine injury? A. Helmet fits snugly B. Helmet interferes with assessment of the ABCs C. Patient goes into cardiac arrest D. Helmet fits loosely

A. Helmet fits snugly

You have arrived at the scene of a shooting where a middle-aged male sustained a single gunshot wound to the abd. As you approach the pt, you note that he is sitting up and attempting to talk with the police while holding a blood-soaked towel over the ULQ of his abd. Once you get beside the pt, you realize he is speaking in a different language that neither you nor the officers understand. Your initial action in caring for this pt is to A. Initiate spine motion restriction precautions B. Determine the need for airway management C. Expose the abdomen to assess the gunshot wound D. Obtain a pulse rate, respiratory rate, blood pressure, and SpO2

A. Initiate spine motion restriction precautions

A pt was ejected from a car during a rollover collision at a moderate to high speed. Which presentation in this pt is most characteristic of incomplete spinal cord injury referred to as "central cord syndrome"? A. Loss of motor function to the arms with intact motor function to the legs B. Loss of motor function and sensation to one side of the body only C. Loss of sensation to one side of the body, and loss of motor function to the opposite side of the body D. Loss of perfusion to the spinal cord that results in complete loss of motor function and sensation to both the arms and legs

A. Loss of motor function to the arms with intact motor function to the legs

A pt dove into a pool and struck his head at the bottom. He has no motor sensation in his legs but can move his arms. You should recognize: A. Paraplegia B. Quadriplegia C. Hemiplegia D. Tetraplegia

A. Paraplegia

A teenage boy was found by friends as he attempted to hang himself in a garage using chains suspended from the ceiling. As you approach, you note that the patient is conscious, struggling to breathe, and has contusions from the chains to both the anterior and posterior portions of the neck. After taking in-line spinal stabilization and opening the airway, the EMT's next action should be to: A. Start positive pressure ventilation B. Size and apply a cervical collar C. Perform a secondary assessment D. Log roll the patient onto a long spine board

A. Start positive pressure ventilation

To help maintain SMR during extrication of a pt with suspected spinal injury, the device that the EMT would apply first is the A. cervical collar. B. short spine board. C. long spine board. D. Kendrick extrication device.

A. cervical collar.

The MOI in which the vertebrae and spinal cord are stretched and pulled apart is called A. distraction. B. extension. C. rotation. D. flexion.

A. distraction.

A pt complains of lower back pain after falling down five stairs. Assessment of the pt's cervical spine reveals no displacement, tenderness, or instability. The pt does state that each leg has a feeling of "electrical shocks" shooting thru them. How should the EMT care for this pt? A. Release manual spine motion restriction precautions B. Apply a properly sized cervical collar after initiating manual spine motion restriction C. Secure the patient to a backboard without a cervical collar D. Inform the team that spine motion restriction precautions are not needed

B. Apply a properly sized cervical collar after initiating manual spine motion restriction

While performing the primary assessment on a pt with an isolated spinal cord injury, you note that he is in severe respiratory distress and struggling to breathe. Where should you suspect the spinal cord injury has occurred? A. Diaphragm B. Cervical spine C. Thoracic spine D. Lumbar spine

B. Cervical spine

A football player was struck in the head during a hard tackle, and is reportedly demonstrating retrograde amnesia to the event. Currently the pt complains of a headache and nausea and reports that he has pain to his upper back and tingling in his left hand. The EMT is providing proper care for the pt when he: A. Removes the helmet to immediately assess the patient's head B. Leaves the helmet in place but removes the face mask first C. Removes the shoulder pads to apply a cervical collar D. Does not place the patient on a long board due to the presence of shoulder pads

B. Leaves the helmet in place but removes the face mask first remove face mask first to assess A and B

A pt who was involved in a diving accident is found with his head positioned so that his left cheek is touching his left shoulder. he states that he has severe pain in his neck and it hurts to move his head. He denies numbness, tingling, or decreased strength to his arms or legs. What is the EMT's best course of action? A. Carefully straighten the head and neck so that a cervical collar can be placed B. Stabilize and maintain the head in the position in which the patient is holding it C. Straighten his neck, and position the patient on his left side on a long spinal board D. Avoid palpation of the cervical spine and apply a short vest-type device

B. Stabilize and maintain the head in the position in which the patient is holding it if it hurts to move, don't move it

A young female driver, involved in a motor vehicle collision, complains of cervical pain resulting from a lateral-type mechanism of neck injury. Based on this information, what type of collision most likely took place? A. The patient's car was struck from behind B. The patient's car was struck from the side C. The patient's car struck a utility pole head-on D. The patient's car rear-ended another car

B. The patient's car was struck from the side

You have ben called for an 87 y/o M who fell in his kitchen. The pt states that he hit his forehead but managed to catch himself on the way down and did not hit the ground "too hard." Your assessment reveals him to have kyphosis of the thoracic and cervical spine but no neurologic deficits. His legs, however, "feel weaker." Which action is appropriate given these findings? A. Avoid application of a cervical collar due to the natural deformity of the cervical spine B. Disregard application of a cervical collar since the patient has no neurologic deficits C. Apply a cervical collar and prepare the patient for any discomfort that the collar may cause D. Place a soft cervical collar instead of the rigid cervical collar

C. Apply a cervical collar and prepare the patient for any discomfort that the collar may cause

A football player was hit from behind and now complains of severe back pain and numbness to his right leg. Manual SMR is being maintained by the coach. The trainer has already removed the face mask from the helmet. Once at the pt's side, what should you do next? A. Remove the shoulder pads as you prepare to place the patient on a backboard B. Carefully remove the helmet C. Apply a cervical collar D. Assess the airway and breathing

D. Assess the airway and breathing

You have been called for a pt with severe back pain. When you are obtaining a medical history, the pt tells you that he has a history of damaged disks in his vertebrae. As a knowledgeable EMT, you should recognize that: A. The ligaments on the side of the spinal column were overstretched B. The vertebrae making up the spinal column were fractured C. The nerves making up the spinal cord have been damaged D. The fluid-filled structures between the vertebrae have been injured

D. The fluid-filled structures between the vertebrae have been injured

If the pt is responsive, a rapid trauma assessment is not indicated: T/F?

false

Brown-Sequard Syndrome

hemi section (right or left); the pt loses motor and light touch on one side but pain to the other

What is the utmost importance for SMR devices/

proper fitting improper fitting (of a C-collar, for ex) can cause more movement and thus more injury