Spinal Cord Injury Pathophysiology Overview
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Questions and Answers

What structures are included in the middle column of the spinal cord according to Holdsworth?

  • Posterior longitudinal ligament (correct)
  • Posterior wall of the vertebral body
  • Anterior vertebral body
  • Posterior ligamentous complex
  • Which type of mechanical insult can lead to primary spinal cord injury?

  • Stretching
  • Rapid compression due to bone displacement from burst (correct)
  • Bending
  • Twisting
  • What is the final pathway to neuron death in secondary spinal cord injury?

  • Electrolyte shifts
  • Free radical production
  • Cell necrosis with structural dissolution (correct)
  • Inflammatory cascade
  • Which factor contributes to reducing secondary spinal cord injury?

    <p>Aggressive field resuscitation</p> Signup and view all the answers

    In the context of spinal cord injury, what is the role of steroids according to NASCIS-2 and NASCIS-3?

    <p>Inducing apoptosis</p> Signup and view all the answers

    What timeframe is recommended for surgical decompression following a spinal cord injury?

    <p>&lt; 48 hours</p> Signup and view all the answers

    What is the typical duration of spinal shock following an injury?

    <p>48 hours</p> Signup and view all the answers

    How is the neurological level of injury defined?

    <p>The most caudal level with bilateral normal motor and sensory function</p> Signup and view all the answers

    When can an injury be considered complete?

    <p>When the bulbocavernosus reflex and/or anal wink returns</p> Signup and view all the answers

    What is the purpose of the Zone of Partial Preservation in spinal cord injury classification?

    <p>It highlights dermatomes and myotomes that remain partially innervated below the NLI</p> Signup and view all the answers

    Which organization developed the standards for neurological and functional classification of spinal cord injuries in 1992?

    <p>International Medical Society of Paraplegia (IMSOP)</p> Signup and view all the answers

    Which of the following is a common symptom associated with spinal shock?

    <p>Urinary retention</p> Signup and view all the answers

    Which reflex is used to check for anal contraction in the context of spinal shock?

    <p>Bulbocavernosus reflex</p> Signup and view all the answers

    Which grade on the MRC scale indicates complete paralysis?

    <p>Grade 0</p> Signup and view all the answers

    What is a significant indicator of spinal shock when testing for the Bulbocavernosus reflex?

    <p>Absence of anal contraction</p> Signup and view all the answers

    Which of the following is a common feature of spinal clues often associated with spinal cord injury?

    <p>Paradoxical respiratory pattern</p> Signup and view all the answers

    What is the purpose of checking for sacral sparing in a neurological examination?

    <p>To identify partial white matter tract injuries</p> Signup and view all the answers

    What is the recommended imaging study for patients who fail attempts at closed reduction?

    <p>MRI</p> Signup and view all the answers

    In patients with cervical fracture dislocation injury, what can a prereduction MRI show?

    <p>Herniated intervertebral discs</p> Signup and view all the answers

    Which age group is included in the Steroids INCLUSION CRITERIA for spinal cord injury?

    <p>14-30 years</p> Signup and view all the answers

    What is an EXCLUSION CRITERIA for receiving steroids in spinal cord injury?

    <p>Gunshot wounds</p> Signup and view all the answers

    Which RCT showed improvement with Methylprednisolone administration in spinal cord injury within the first 8 hours?

    <p>NASCIS-2</p> Signup and view all the answers

    What does the ASIA Impairment Scale grade C indicate?

    <p>Incomplete motor function but preserved sensory function below the lesion</p> Signup and view all the answers

    What percentage of cases are classified as ASIA Impairment Scale grade E?

    <p>30%</p> Signup and view all the answers

    What is measured by the Functional Independence Measure (FIM)?

    <p>Mobility</p> Signup and view all the answers

    In C-spine imaging, what does a combined lateral mass displacement over 7mm in the Open Mouth (Dens) View suggest?

    <p>Transverse ligament tear</p> Signup and view all the answers

    What scenario would benefit from CT scan imaging in C-spine evaluation?

    <p>When fracture is suspected on plain films</p> Signup and view all the answers

    What can be missed if not assessed adequately using plain films in C-spine imaging?

    <p>Soft tissue injury or fracture</p> Signup and view all the answers

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