Questions and Answers
How many vertebrae make up the vertebral column?
33
Which part of the spinal cord is surrounded by the pia mater?
The nucleus pulposus is the outer ring of tissue in a spinal disk.
False
What imaging study is better for imaging injuries from trauma?
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What condition involves hyperextension injury to the spinal cord resulting in motor and sensory loss in upper extremities?
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What is one major consequence of spinal cord injury at or above C5?
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The refill of the bladder can result in __________ dysreflexia.
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Spinal shock occurs immediately after a spinal cord injury.
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Which of the following is a risk factor for autonomic dysreflexia?
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What is the preferred method for opening the airway in a patient with a spinal injury?
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Match the types of drug therapy used to prevent neurological damage with their effects:
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Study Notes
Vertebral Column
- Composed of 33 vertebrae: 7 cervical (C1-C7), 12 thoracic (T1-T12), 5 lumbar (L1-L5), 5 sacral (S1-S5), and 4 fused coccygeal.
Disks
- Intervertebral disks act as shock absorbers; comprise anulus fibrosus (ring of tissue) and nucleus pulposus (gelatinous core).
- The nucleus pulposus loses water with age, reducing its shock-absorbing capability.
Spinal Cord
- Extends from the brainstem to the second lumbar vertebra (L2).
- Encased in three protective meningeal layers: dura mater (outer), arachnoid (middle, contains cerebrospinal fluid), and pia mater (inner, directly on the cord).
- Cerebrospinal fluid (CSF) maintains CNS protection and circulation.
Diagnostic Tests
- Radiography identifies vertebral issues, fractures, and misalignments.
- CT scans are ideal for trauma assessments; MRI excels in soft tissue evaluation.
- Myelograms visualize the spinal cord using dyed fluid injected into the subarachnoid space.
Types of Injuries
- Classified by location (cervical, thoracic, lumbar), type (open or closed), and extent of damage (complete vs. incomplete).
- Complete injury indicates total severance; incomplete injury allows for some function below the injury site.
Effects of Spinal Cord Injury
- Symptoms vary based on injury level and severity; spinal cord edema may complicate initial assessments.
- Incomplete injuries allow partial function below the injury; examples include central cord syndrome (motor/sensory loss in arms) and Brown-Sequard syndrome (opposite side pain/temperature loss).
Severity of Injury
- Higher spinal cord injuries result in more severe dysfunction.
- Quadriplegia (tetraplegia): affects all four limbs, typically from high cervical injuries.
- Paraplegia: lower body paralysis resulting from injuries at or below T2.
Respiratory Impairment
- Injuries at or above C5 may lead to respiratory failure due to nerve damage.
- Injuries below C4 may allow independent breathing but can still affect intercostal and abdominal muscles.
Spinal Shock
- Immediate response post-injury; causes temporary loss of reflexes below injury level.
- Can obscure the full extent of injury; resolves over days to months with potential spasticity in extremities.
Autonomic Dysreflexia
- A serious condition post-injury at/above T6, causing exaggerated autonomic responses.
- Common triggers include bladder distension, constipation, and skin irritation.
- Symptoms may include hypertension, bradycardia, and severe headaches.
Management of Spinal Cord Injury
- Initial priority is establishing an airway; conventional methods may worsen spinal damage.
- Traction methods (e.g., Gardner-Wells and Crutchfield tongs) stabilize cervical injuries.
- Drug therapy with Methylprednisolone minimizes cellular damage and enhances recovery potential if administered promptly.
Surgical Interventions
- Early surgery (within 24 hours) on damaged cords is crucial for recovery.
- Laminectomy and spinal fusion may be performed to alleviate compression and stabilize the spine.
Rehabilitation
- Focused on maximizing self-care and autonomy with a comprehensive interdisciplinary team.
- Emotional and physical adjustments are necessary for patients and families.
Patient Care Considerations
- Regular monitoring of vital signs, neurological function, and respiratory status post-laminectomy.
- Prevent complications from immobility through ROM exercises, routine repositioning, and skin care.
- Address potential for autonomic dysreflexia through awareness and immediate elevation of the head during episodes.
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Description
This quiz explores the anatomy of the spinal cord and vertebral column, including details about the 33 vertebrae and the intervertebral disks. Understand the different regions of the spine and their functions as shock absorbers. Test your knowledge on cervical, thoracic, lumbar, sacral, and coccygeal vertebrae.
